Health and environment from adaptation to adaptivity: a situated relational account

Abstract

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO—‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Preamble to the constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)—and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as ‘coping with the environment’. We develop the idea of ‘coping with the environment’, by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings.

Enactive and simondonian reflections on mental disorders

“…If we assume the active role played by the individual in anticipating and modifying its coupling with the environment, then health is not only related to the responsive capacity of the individual, but with its preventive capacities. A similar shift from adaptation to adaptivity can be seen in discourses promoting a preventive medicine over treatment-based medicine ( Larson, 1999 ; Menatti et al, 2022 ).…”

“…For instance, preventive medicine and allostatic perspectives on psychological processes have already made the claim that not only adaptation counts to health. The concept of adaptivity requires transformation in self-organization and/or transformation of the environment ( Kirmayer et al, 2011 ; Menatti et al, 2022 ). In the same vein, phenomenological perspectives advocate looking at pathology as existential conditions of life processes that demand changes ( Lindsey, 1996 ; Ratcliffe and Broome, 2012 ; Carel, 2013 ).…”

“…While adaptation implies intervention to counterbalance external changes, minimizing its effects in order to maintain a stable internal milieu, adaptive regulation implies maintaining certain internal flexibility, regulating the interaction with the external world, or even intervening in the environment. To put it succinctly, adaptivity implies taking advantage of change rather than merely preventing it ( Menatti et al, 2022 ).…”

Do We Care Enough About the Presence of Sexual Problems in Diabetic Patients?

“…The World Health Organization (WHO) defines health as a state of complete physical, mental, and social well-being. 1 Sexual health is not only the absence of sexual dysfunction or disability, but also the presence of physical, emotional, mental, and social well-being related to sexuality. 2 Sexuality is an integral part of human life and one of the essential requirements.…”

Methodological Aspects of Using Normometrical Scaling for Multidimensional Assessment of Health Reserves

“…Амосов зазначав, що саме сумою резервних можливостей функціональних систем організму визначається кількість здоров'я, що можна обчислити за допомогою спеціальних резервних коефіцієнтів, які враховують відношення показника максимального споживання кисню за умов навантаження до цього ж показника у стані спокою. Проблематику різних аспектів дослідження і оцінювання адаптаційних механізмів активно досліджують та обговорюють у наукових статтях, монографіях, сайтах в Інтернеті, в яких наведено дані про сучасні підходи до оцінювання функціональних резервів та регуляторно-адаптаційних можливостей організму [4][5][6][7][8][9].…”