The definitions that people have attributed to health have changed over time and today there are many ways of viewing health, which makes measurement difficult. Health in Western Societies tends to be defined as simply “the absence of illness and disease” because of the dominance of medicine in these societies (Naidoo & Wills, 2001). However, this definition has been criticised as being incomplete by many health professionals. The World Health Organisation (WHO) agree that health no longer refers to the mere absence of disease and illness, but it is a dynamic lifelong process in which the physical, mental, social, environmental and spiritual dimensions are considered essential (Donatelle & Davis, 1994). Rene Dubos added to this WHO definition of health by stating “Health is a quality of life, involving social, emotional, mental, spiritual and biological fitness on the part of the individual, which results from adaptations to the environment” (Donatelle & Davis, 1994).
As a result of these many different dimensions of health in Dubos’ and the WHO definitions, Dubos believed that it is not possible for people to achieve perfect health. To be perfectly healthy in each dimension, people would have to be perfectly adapted to their environment, a situation he believed was unattainable and this is what led him to state that “the concept of perfect and positive health is a utopian creation of the human mind” (1980, p.346).
To be perfectly and positively healthy, according to each of the dimensions in the WHO and in Dubos’ definitions of health, we would need to be healthy physically. This includes such characteristics as body size and shape, susceptibility to disease, ability to perform certain tasks, body functioning and sensory acuity (Donatelle & Davis, 1994). We also would need to be socially healthy, which refers to our ability to adapt to various social situations and our ability to have satisfying interpersonal relationships. Mentally we would need to be healthy, which would include the ability to learn and perform intellectual abilities. We would need to be emotionally healthy, which refers to our ability to control emotions so that we feel comfortable expressing them when appropriate as well as expressing them appropriately (Donatelle & Davis, 1994).
Environmentally we would also need to be healthy. We would need to appreciate our external environment and play a role in preserving, protecting and improving environmental conditions (Donatelle & Davis, 1994). Finally, we would need to be spiritually healthy. This refers to a belief in a higher form of living or a specified way of living because of a particular religion (Donatelle & Davis, 1994). Spirituality is a sense of unity, meaning and value with nature, others and the environment, which encourages us to care and respect other things (Donatelle & Davis, 1994).
The closer we become to achieving the ideal level of functioning and balance between each of these above dimensions, the closer we are to achieving a high level of health (Donatelle & Davis, 1994). Basically, the closer people get to their potential in Dubos’ five dimensions of health, the more healthy they will be (Dubos, 1980). People with an illness or disability are usually seriously deficient in one or more of the health dimensions. Dubos emphasised however, that we cannot become balanced at an equal level in all these dimensions. He believes that people in the real world face the physical, biological and social forces of their environment, which are forever changing, usually in an unpredictable manner, and frequently for dangerous consequences for themselves as people and for the human species in general (Dubos, 1980). Therefore, the concept of perfect and positive health is not realistic or achievable because of people’s continuously changing environments.
In conclusion, the concept of health has been given a considerable amount of research, which has caused its definition to change dramatically over the years. The multidimensional definitions of health by the WHO and Dubos has altered the concept that some people hold of perfect and positive health. This concept of perfect and positive health cannot become reality because people will never be so adapted to their environment that their lives will not involve struggles, failures and sufferings (Dubos, 1980). “Man and his species are in perpetual struggle – with microbes, with incompatible mothers-in-law, with drunken car drivers and with cosmic rays from Outer Space… The ‘positiveness’ of health does not lie in the state, but in the struggle – the effort to reach a goal which in its perfection is unattainable” (Dubos 1980, p.349). However, this utopia of positive health, like other ideals, allows people to set goals and helps medical science to chart its course toward these goals (Dubos, 1980). Health these days is no longer seen as a state, that can be modified to perfection, but as a process towards the achievement of each person’s potential (Naidoo & Wills, 2001).
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