3 Different perspectives on health

Perspectives of public health are shaped by ideology, including ideas about what is meant by the concept of health.

Activity 3: Thinking about your own health

Timing: Allow 45 mins

Take a few minutes to think about your health or the health of someone close to you (such as a friend, family member or partner). Write notes to the questions below in the word document provided. If you’re thinking about somebody else’s health, think about the questions from their perspective.

• How would you describe your health?
• Thinking about your own health compared to ten years ago, would say you are healthier/less healthy/about the same?
• Is your health important to you? Why do you say that?

Now watch the video below in which both public health professionals and members of the public discuss what health means to them. How do the views of professionals like Mary and Joanna differ from the perceptions of members of the public like Bernadette and James? How do your perceptions of health compare?

Download this video clip.Video player: Film 1

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Transcript: Film 1 Views on health (© The Open University)

Mary Black

I would define health as a sense of wellbeing. If we ask people to define their health they do not define it in terms of what they cannot do. They define it in a feeling of wellbeing, a feeling of happiness almost. So that is the definition that I would look toward. But that is quite complex, obviously. It’s mental. It’s physical. It’s social. And indeed it’s spiritual.

So those elements create health and wellbeing. And of course the determinants of health, we now know, very clearly lie outside of individual behaviours. They lie in a multitude of factors. So for me health is a feeling of wellbeing. Irrespective of what my physical health may indicate and the limitations I may have physically, I can still be extremely healthy.

Jonna Monaghan

The definition that we use in Healthy Cities right across Europe for health is the WHO definition of health from as long ago as 1948, which says that health is not just the absence of disease. It’s a state of physical, mental and social wellbeing. Health is the result of people’s wider physical and social living conditions. Yes, your genetics, your lifestyle play a role, but those are shaped by other things.

And one that I really quite like, that comes from, again ... from the World Health Organization, from the Ottawa Charter back in 1986 … that says that health is a resource for daily living, not an end in itself. So the idea that if we’re healthy we can live our lives to the full. We can take opportunities, whereas if we’re not healthy in the sense that we have very low aspirations, we don’t feel able to do things, we can’t do that.

Wendy Moss

Good health for a child, I feel, is about making those healthy choices so that families have the full information to do so. Providing information on healthy eating, activities, that … child–adult interaction so that the attachment is there, so that they have social opportunities by playing with their peers. It’s about enabling that environment for that child to thrive and reach its full potential in whatever shape or form that may take.

Margaret Mallon

Having my health, I can be independent. My children don’t have to worry about me. I’m quite capable of looking after myself, because they have their families to look after. They have their work to go to. So they’re there if I need them. But if I can keep myself healthy as long as possible I can, it’s off their shoulders. They don’t have to worry. And that’s the main thing with me.

Bernadette McGreevy

We do come to the groups, and I do try to come in to do whatever is going on and join in as much as we can. But I do have a knee replacement, and I have another knee that is crumbled. And I have arthritis all through my body. And I do have a little heart trouble and asthma. But I try not to get me down, so I try and get on as best I can.

James Johnson

Good health, for me, enables me to be the most productive, connective, useful version of myself that I can be. I notice if my diet is out of balance or if exercise is out of balance that there is an impact on things like energy levels and concentration … so keeping that ... that balance of a healthy way of living is imperative for me to be the best person that I ... or the best version of myself that I can be.

End transcript: Film 1 Views on health (© The Open University)

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Film 1 Views on health (© The Open University)

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Discussion

Bernadette’s definition of health seems to be focused around the presence of disease. In contrast, Mary and Joanna discuss health as wider wellbeing that encompasses mental, physical, emotional and spiritual dimensions. They discuss health as being determined by factors outside the control of the individual, something we shall return to in the next section. James, however, sees his own lifestyle behaviours as being very important to his sense of health.

Activity 3 reveals that it is hard to arrive at a straightforward definition of health. Over the years different, and often competing, definitions of health have developed. Traditionally health has been defined in terms of disease and death, and this framing remains strong to this day. However, our understanding of health has gradually developed, and now there is the idea that health is not just the absence of disease, but overall physical, mental and social wellbeing. You may also define health as how you feel about yourself and your ability to do and achieve things.

Across countries there is variation in what is counted as public health activity, ranging from public health being concerned with disease prevention in a narrow medical sense, to a broader view of public health tackling wider social causes of health. This variation reflects very different understandings of the meaning of health.