Health

Health is a multifaceted concept generally understood to refer to a state of physical and emotional well-being associated with the normal functioning of the human body and the absence of disease, injury or significant discomfort. Modern interpretations extend beyond the biomedical model to recognise the social, psychological and environmental dimensions that shape an individual’s capacity to live a fulfilling life. Health can be improved by engaging in beneficial habits such as regular physical exercise and sufficient sleep, and by reducing harmful exposures including smoking, excessive stress and hazardous environments. While some influences on health arise from personal choice and agency, others reflect wider social structures, access to healthcare and genetic factors beyond individual control.

Historical Development of the Concept

Definitions of health have evolved considerably over time. Early conceptions, aligned with the biomedical model, emphasised the body’s ability to function normally and viewed disease as a disruption of this state. Such definitions framed health in terms of anatomical, physiological and psychological integrity, as well as the ability to fulfil personal, familial and societal roles while managing biological and social stress.
A major shift occurred in 1948 when the World Health Organization (WHO) introduced a broader definition, describing health as a state of complete physical, mental and social well-being rather than merely the absence of disease or infirmity. Although innovative, this definition was criticised for being overly idealistic, difficult to measure and impractical for public health assessment.
From the 1980s onwards, the WHO influenced a more dynamic interpretation of health, viewing it as resilience—a resource that enables individuals or groups to cope with challenges, achieve goals and adapt to their environment. In 1984, health was redefined as the extent to which people can realise aspirations, satisfy needs and manage environmental demands. This conception highlighted homeostasis, recovery from adversity and the significance of mental, intellectual, emotional and social capacities.
The revised approach encouraged health promotion and marked a departure from a disease-focused model. It opened avenues for health education, empowerment and skill-building, enabling individuals to sustain well-being even when living with chronic illness or multiple conditions.
In the United States, the Healthy People programme—active since the late 1970s—has periodically set national objectives for population health improvement. Healthy People 2020, for instance, emphasised disease prevention, health promotion and addressing the social determinants of health. Its outcomes continue to be evaluated within a decentralised and complex health system.

Determinants of Health

Health is shaped by a wide variety of factors, collectively termed the determinants of health. According to the WHO, these determinants include the social and economic environment, the physical environment, and individual characteristics and behaviours. Their influence can be summarised under several key domains:

• Income and social status
• Education and literacy
• Employment and working conditions
• Social support networks and community cohesion
• Genetics and biological predispositions
• Healthy child development
• Personal health practices and coping skills
• Access to healthcare services
• Physical environment, including housing, pollution and built infrastructure
• Spirituality and cultural influences

Both individual lifestyle choices and broader societal arrangements play vital roles. For example, while individuals may choose whether to engage in high-risk behaviours, access to safe housing, nutritious food and healthcare services is largely determined by social structures.
The Lalonde Report (1974) in Canada was instrumental in identifying three interrelated fields influencing health: biomedical factors, environmental conditions and lifestyle choices. This framework broadened health policy discourse beyond medical care alone.
Research such as the Alameda County Study has demonstrated links between healthy behaviours—regular exercise, adequate sleep, spending time in nature, maintaining a healthy weight, limiting alcohol and drug use and refraining from smoking—and improved physical and mental outcomes. These findings underpinned many global and national health initiatives, including the promotion of taxes on sugary drinks in response to rising obesity rates.

Mental, Social and Emotional Dimensions

Modern definitions acknowledge that health encompasses more than physical functioning. Mental health includes the ability to handle stress, maintain emotional stability and make sound decisions. Social health involves forming and sustaining supportive relationships and participating in community life. These aspects contribute to an individual’s resilience and their capacity to live independently.
The concept of the health triangle—a balance of physical, mental and social well-being—captures the interdependence of these domains. Each influences the others: chronic stress, for example, can adversely affect physical health, while social isolation can contribute to mental illnesses.

Public Health and Health Promotion

Health is preserved and enhanced not only through medical interventions but also through systematic public health measures. These include:

• Preventing disease through vaccination, sanitation and education
• Promoting healthy lifestyles via community programmes and policy initiatives
• Improving environments by ensuring clean water, safe housing and accessible public spaces
• Addressing social determinants, such as poverty reduction and equitable healthcare access

The Ottawa Charter for Health Promotion (1986) emphasised that health is a resource enabling daily living. It advocated for supportive environments, strengthened community action and the development of personal skills as cornerstones of health promotion.

Contemporary Perspectives

In the 21st century, the reconceptualisation of health as an ability has increased the importance of self-assessment as a measure of health. This approach allows individuals to view themselves as healthy despite chronic or terminal illnesses, provided they maintain resilience, autonomy and well-being in daily life.
Current debates in health policy focus on reducing inequality, improving access to healthcare, tackling lifestyle-related diseases and addressing social and environmental determinants. Achieving and maintaining health is now widely recognised as a shared responsibility between individuals, communities, organisations and governments.