Towards a Dynamic Definition of Health and Disease

Abstract

A multifactorial and growing crisis of health care systems in the developed world has affected medicine. In order to provide rational responses, some central concepts of the past, such as the definitions of health and disease, need to be updated. For this purpose physicians should initiate a new debate. As a point of departure the following definitions are proposed: Health is a dynamic state of wellbeing characterized by a physical, mental and social potential, which satisfies the demands of a life commensurate with age, culture, and personal responsibility. If the potential is insufficient to satisfy these demands the state is disease. This term includes sickness, illness, ill health, and malady. The described potential is divided into a biologically given and a personally acquired partial potential. Their proportions vary throughout the life cycle. The proposed definitions render it empirically possible to diagnose persons as healthy or diseased and to apportion some of the responsibility for their state of health to individuals themselves. Treatment strategies should always consider three therapeutic routes: improvements of the biologically given and of the personally acquired partial potentials and adaptations of the demands of life. These consequences favourably contrast with those resulting from the WHO-definition of health.

A miliőtan története

“…Úgy tűnik, az egészség, a nem-egészség, illetve a betegség multifaktoriális állapotok, és viszonylagosak; az egészség a teljes jóllétet jelenti egyéni és környezeti vonatkozásban egyaránt (azaz tágabb értelemben vett homeosztázis), míg a betegség ennek (azaz a homeosztázisnak) megbomlása. A kettő viszonya nem egyértelmű, valószínűleg azért, mert nem diszkrét állapotokról, hanem kontinuumról van szó Bircher, 2005 , melynek kezdőpontja az egészség, végpontja a halál.…”

“…Ezek azonban nem diszkrét állapotok, hanem egyfajta folytonosság mentén változnak Bircher, 2005 . Állapotváltozások azonban nemcsak a betegség-egészség vagy az egészség-betegség kontextusában lehetnek, hanem a mindennapi életben is, például egy szomorú állapotból egy vidámba, egy feszült állapotból egy ellazult állapotba, egy magányos állapotból egy társas állapotba, stb.…”

Study on College Students' Mental Sub-Health and its Intervention System

“…[1] This definition are widely cited, but there are other definition of health, for example, Bircher (2005) defined it as: "a dynamic state of wellbeing characterized by physical, mental and potential, which satisfies the demands of a life commensurate with age, culture, and personal responsibility." [2] Saracchi (1997) proposed the following definition: "health is referred to under such happiness, no disease, and no weakness, and have basic, universal human rights" [3].…”

Conceptualising Health: Insights from the Capability Approach

“…Recent work on the concepts of health, disease and related notions has suggested that health in an individual is a matter of that individual having the resources to cope with her needs (Nordenfelt, 1987(Nordenfelt, , 2001(Nordenfelt, , 2007Kovacs, 1998;Bircher, 2005). While there are differences in the details of such accounts, the basic idea seems plausible.…”