What is health?
We tend to think more closely about our health when we are feeling vulnerable or during illness. We depend on our health; it ensures we can operate a full and enjoyable life as well as defending against disease or injury to our bodies.
The worldwide influenza pandemic has heightened our attention to health messages, as we try to protect ourselves and maintain or improve upon our health. Depending upon who you ask about health, you will receive varied definitions, each of which contributes to an overall understanding of the breadth of what ‘health’ means.
(1) Health as the absence of disease; or simply ‘not feeling ill’.
(2) Health as a reserve. The ability to recover from disease or impact upon health. Greater reserves allow a person to improve sooner than someone with less reserves when their health is impacted
(3) Health as physical fitness. The most common and idealised health dimension. It expands upon the notion of an ‘absence of disease’ to include an emphasis upon physical capabilities. Physical fitness is often understood through the appearance of the body; for example, between women is common to relate it with a slim body, shiny hair and healthy-looking skin. Instead, men relate it with strength skills and the ability to perform activities that require strength or endurance without significant fatigue.
(4) Health as a 'behavior towards a healthy life'. This refers to the ‘energy’ and ‘vitality’ that a person has to the completion of the various activities in the day. For example, the vitality to which a person faces the morning and arranges and approaches tasks and social activities in each day.
(5) Health as a social relationship it is related to the ability of a person to have and keep good relationship with others. Important factors for good social relationships are strong communication skills, accountability and intimacy. Depending on age, gender or interest of the people social relationships can be seen in many different ways.
(6) Health as 'function'. This conception of health is most relevant when considering the elderly where the physical functions of the body directly impact a person’s lifestyle. Where a person’s functional health is diminished, the person may not be able to fully complete activities without requiring external assistance. Function is therefore associated with greater health.
(7) Health as psycho-social well-being. Is perhaps the most complex conception of health. It is the interrelationships between social factors, thoughts and behavior. It is generally understood as the ability of a person to manage their feelings associated with their behaviors. Appropriately managing pressure and stress signals good health. In the day to day; this concept of health is related to self-esteem, self-confidence, the ability to express their feelings clearly and the ability to manage their emotions when necessary. Psycho-social well-being contributes to positive feelings of well-being and happiness.
Based on the previous definitions of health is possible to see how the concept of Health can be determined by factors such as age, gender and external factors like culture.
The Academic literature has found that Health can be understood by viewing Health through five (5) dimensions; these are Social, Mental, Spiritual, Emotional and Physical. These dimensions work together to give us a complete picture of health.
1. Social health: Refers to the ability people to make and maintain relationships with others. For example, an individual’s relationships with friends, teachers and colleagues. ‘Social health’ improves when these relationships are development through communication, accountability and intimacy.
2. Mental health: Is identifiable as an awareness of one’s own potential, ability to cope with daily stresses, and ability to productively contribute to society. Strong ‘Mental Health’ provides an individual with a positive sense of well-being
3. Spiritual Health: Grants a person a motivating feeling drawn from their spirituality. It contributes to a healthy life by improving the ability to face events with positivity. Strong ‘Spiritual Health’ contributes to an individual’s ability to establish harmony and peace in their lives. The development of ‘Spiritual Health’ requires a strengthening of the congruence between acts and values.
4. Emotional Health: Is the ability of people to manage their emotions and feelings. An individual with strong ‘Emotional Health’ will invite both positive and negative emotions and feelings, with an ability to balance, adjust, adapt and monitor these emotions while maintaining their lifestyle, social relationships and health.
5. Physical health: Is simply the absence of disease, and is considered along a continuum from diseased, such as cancer or diabetes to optimum physical condition, in the health sense rather than fitness sense. It is the most commonly considered health dimension.
The 5 dimensions when considered together are referred to as ‘Holistic Health’.
We can use the impact of COVID-19 to help us understand the relationship between these dimensions of health, as the pandemic’s effects have been so broad. COVID-19’s immediate effect was its direct effect on ‘Physical Health’ through direct harm to the respiratory system and reduced mobility caused by illness. ‘Emotional Health’ of relationships were impacted by lockdowns, business closures, travel limits, which caused people hardship and different emotions to work through and manage. Inability to leave homes, attend weddings, Sports events, larger funerals and return home from overseas has impacted ‘Emotional’, ‘Social’ and ‘Spiritual Health’, causing a general decline to these dimensions of health. Gym closures and limits on exercise has significantly impacted the ability to attain a healthy ‘Physical’ lifestyle. Cooking at home however may have improved nutritional choices.
By looking at Health through the lens of each of the 5 Dimensions in relation to COVID-19 we gain an appreciation of how these dimensions operate together and separately upon an individual’s ‘Holistic Health’.
Societal Health: 4 Groups
Now that we have covered Individual Health, we can look to the 4 Groups which operate at the Societal level. ‘Societal Health’ has 4 distinct groups; Social, Economic, Political and Cultural. These factors contribute to and can determine the ability of people to establish and maintain a healthy lifestyle.
Intuitively, we know that a population’s ‘income’, ‘employment’, ‘education’, ‘social support’ and ‘housing’ may negatively or positively impact Societal Health. These smaller factors can be grouped under the ‘Social’, ‘Economic’, ‘Political’ and ‘Cultural’ Societal Health groups.
The least intuitive grouping; ‘Culture’, shows how different societies conceptualise what Health means. A society may have a different set of Cultural standards of what Societal Health means; such as weight, physical appearance, age, hygiene, physical form and function. Factors considered healthy in one society may not necessarily be appreciated as Healthy in others. Societal Health can be influenced or reformed through changes to ‘Economic’, ‘Social’ and ‘Cultural’ factors. This is often done more directly through ‘Political’ mechanisms such as policies, guidelines and government interventions.
While individual health refers to each person – and we can look at a person’s discrete health characteristics; it is important to remind ourselves that Societal Health and individual health are fundamentally interwoven. The factors which affect a population will also impact the individual, and vice versa.
In conclusion, when thinking about ‘Health’ in the broadest sense, we can draw upon a variety of conceptual tools to help us view the discrete elements of both Health at the Societal level and Individual level, and how these interact. Understanding health is essentially, the process of considering the 5 dimensions of individual health or ‘Holistic Health’: physical, mental, social, emotional and spiritual, and how health upon the population of individuals interplays with its broader environment; through social, cultural, economic, and political factors and influences.