What Does It Mean To Be Healthy?
‘We are being led to the conclusion that we each must make our own definition of health, just as we each define ‘the good life’’ - Sigmund Freud
The way we define health determines the way we strive towards it; so, it is essential to have a clear idea of what we are actually aiming for. When taking steps to improve our health, we typically focus on very narrow outcomes such as how we perform in the gym, or even how we look in the mirror. Although these metrics have their place, they offer an incomplete picture of health, which can be conceived of as a dynamic state of whole person adaptation to an ever changing and demanding environment. Reducing the complexity of health down to a few simple and easy to measure variables, like macros and bodyweight, is epistemically flawed. If we truly want to live healthier lives and help others to do the same, we must take a more expansive perspective on health and wellbeing.
But First... Why Should We Care?
Our state of health has a huge impact on our quality of life, physical function, mental health, cognition and social interactions. A positive state of wellbeing is associated with numerous benefits related to health, work, family, and economics [1]. It pays to have an understanding of it.
Pascal said it is impossible to know the whole without knowing the parts in detail; similarly, we cannot understand what ‘health’ is without studying the many different factors that influence it. Reflecting on the complexity of health is important to ensure that our pursuit of it is accurately guided. If we do not know what health is, how can we go about achieving it? From a coaching perspective, how do we know if we have been successful in improving a client’s health if we do not know what indicators to look out for?
How Should We Define Health?
Defining health is pretty tricky, due to its intangible, complex, adaptive and emergent nature. We can’t see health like we can see our bodies in the mirror, and we can’t measure it like we can with our weight on the scales. Even more crucially, we cannot visibly see all of the factors that influence it either - it is not as simple as having the ‘right’ foods on our plates, no matter how perfectly structured the macronutrients may be.
The World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ [2]. The recognition of mental health was revolutionary at the time, facilitating a paradigm shift away from the Cartesian-based mind-body dualism that had been dominating the biomedical field. Although many consider this definition to be conventional wisdom [3], it raises some important questions. What do we mean by complete? Rather than defining health as a negative state, ‘the absence of’, we should consider the positive, personal dimensions of health that we can actively seek out in our daily lives.
Nietzsche distinguished between small health, the absence of disease, and great health, the ability to live a life that makes sense [4]. Health is a positive state, an expanding strength that is constantly achieved, and not simply a background operation of a well-functioning system. Despite recognising that the mere absence of disease or infirmity is an insufficient condition for health, the WHO definition is an inadequate attempt to make the leap from small health to great health. The question remains: how can we achieve great health?
VanderWeele imagines health in terms of ‘flourishing’, meaning to grow and prosper across different domains of life [5]. Flourishing is a multi-dimensional construct comprised of six domains:
Happiness and life satisfaction
Physical and mental health
Meaning and purpose
Character and virtue
Close social relations
Financial and material stability, as a means of securing the other five domains of flourishing
When we take care of our physical and mental health, foster deep social relationships, feel connected to a sense of meaning and purpose, live virtuously and feel satisfied with our lives, we flourish. Aristotle declared flourishing as the ultimate goal of human existence; he viewed it as being important in its own right, not just as a means to an end [6]. Could he have been on to something?
Flourishing health incorporates aspects of wellbeing, which is understood not simply as positive emotions, but, rather, as thriving across multiple domains of life [7]. In the eudaemonic paradigm, wellbeing is const