Abstract

Towards a new definition of health?

Health is not the same as the absence of disease. Butwhat is health? A question with no ready answer. Thewell-known WHO definition dates back to 1948 andseems obsolete. Everyone agrees that we are in needof a new definition, but opinions differ as to what thisnew definition of health should look like. In this issue ofSpectrum, we carry the discussion about the definitionof health a little further and share some new researchfindings as well as viewpoints from experts in the field.

Henk Smid, CEO of ZonMw, sets the stage by pointingout that it is certainly worth our while to reflect onexisting concepts and definitions of health. A few yearsago, an international conference under the auspices ofZonMw and the Dutch Health Council was held to do justthat. The conference did end up with a proposal to defi-ne health as ‘the ability to adapt and self-manage’. Afollow up conference was called for and will be heldlater this year, where among others, the results ofMachteld Huber’s new study will be discussed. Mach-teld is now working on refining the new concept byoperationalizing the different dimensions of health. Inthis Spectrum issue, she shares her first results with us,and shows how different stakeholders have very diffe-rent opinions. Striking is that policy makers and re-searchers employ a much narrower definition of healththan the chronically ill and the ordinary citizen. Sjoerd

Kooiker has asked precisely that latter group abouttheir concept of health in a qualitative study. He illu-strates his story with a sample of a typical conversationas it unfolded itself in one the focus groups he organi-zed. In short, according to his study, health has twomeanings to people: being healthy enables them to dowhat they want to do, and being healthy means feelinghealthy. A different, but related concept is found amongthose who advocate the concept of ‘salutogenesis’. Len-neke Vaandrager explains that salutogenesis meanssearching for the origins of health. Stressors put peopleunder pressure, resulting in a movement towards lesshealth (pathogenesis). Alternatively, individuals canfind ways to deal with the stressor and move towardsgood health (salutogenesis). Finally in this issue, ArieNieuwenhuijzen Kruseman shares his critical view onMachteld’s new definition of health. He wonders if beingable to adapt is similar to being healthy. He argues thatwell-being is an important aspect of health. With hisdefinition as ’the ability to adapt and self-manage resul-ting in physical, mental and social-well being’ he seeksto combine the best elements of the old and new defini-tions of health.

Keywords: definition, health, positive health

Spectrum

tsg jaargang 91 / 2013 nummer 3 spectrum - pagina 138 / www.tsg.bsl.nl