What Are ‘Health and Wellbeing’?

Abstract

What is health? What is wellbeing? Various definitions of health explored: a common-sense definition first. The health of middle-aged men and the effectiveness (or otherwise) of health and wellbeing programmes (including smartphone apps) in the workplace. US occupational physician, Dr Ray Fabius’ finding that such programmes work only in workplaces with a culture of health. Definition of health: the WHO’s definition (‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’), rejected as an unworkable tool; and one proposed in The Lancet in 2003 as ‘the ability to adapt’. Radically, this definition sees a patient in the context of their current life; the doctor’s role is to help the patient adapt to their prevailing condition. The social determinants of health. Dr Machteld Huber’s definition in The BMJ: ‘health is the ability to adapt and self-manage’. Her subsequent research and definition of six domains in which health manifested. Patients and nurses gave all six about equal weight, but policymakers rated bodily functions as much more important. Doctors rated the spiritual/existential dimension lower than patients. Patient-centred model of medical practice proposed that gives equal weight to all six. Moving towards a positive concept of health. Maslow’s ‘hierarchy of needs’ from his 1943 paper ‘A theory of human motivation’ explained. Professor Martin Seligman, former president of the American Psychological Association, and the concept of flourishing. Seligman’s five components of wellbeing in the PERMA model. Author’s definition of positive health.