In 1948, the World Health Organization (WHO) defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. In 1984, WHO further expanded clarification of health as "the optimal state of health of individuals and groups…including the realization of the fullest potential of an individual physically, psychologically, socially, spiritually, and economically, and the fulfillment of one’s roles and expectations in the family, community, place of worship, and other settings” (Nutbeam & Kickbusch,, 1998).
These definitions brings together the concept of health and wellness. We begin to see how an individual's health is impacted by their environment and community. An example of this is looking at an individual's mental health. We consider an individual to have a 'healthy' mental/emotional well-being based on their perceptions of their own coping abilities with regular day-to-day stressors in life, able to meet their activities of daily living and are able to interact/contribute to their community. Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community (The Lancet, 2009). To bring health and wellness together within our health care system, means to promote a healthful lifestyle that supports individuals to lead a full life with meaning and purpose.
The Ottawa Charter for Health Promotion (1986) states that the fundamental conditions and resources for health are peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice and equity. These are foundational to address health disparities and improve overall health. As a public health professional, my practice is based on the Ontario Public Health Standards (OPHS). Following these standards ensures the programs and services provided are evidence-based and informed for effective public health practice. Using the most up-to-date evidence available allows public health professionals to be responsive and address the needs and emerging issues of their community. This includes integrating population health assessments and focusing on health equity when delivering services.
Source: Ontario Public Health Standards (2021); page 6
As a nurse and health promotion specialist, my role is grounded in a population health approach. This aligns with OPHS (1986) to "focus on upstream efforts to promote health and prevent diseases to improve the health of populations and the differences in health among and between groups...to address health across the life course". OPHS summarizes this well in this graphic portraying the population health approach and how it can be applied across the lifespan.
Expanding the original WHO definition to include the social determinants of health and using a population health approach will improve our health care system. We need to continue to advocate for preventative care, early interventions, and equitable access to services.
References
Constitution of the World Health Organization. Retrieved October 10, 2022, from https://www.who.int/about/governance/constitution
Huber, M. (2011). Health: How Should We Define It? BMJ: British Medical Journal, 343(7817), 235-237.
Nutbeam, D., & Kickbusch, I. (1998). Health promotion glossary. Health Promotion International, 13(4), 349–364.
Ontario Public Health Standards: Requirements for Programs, Services and Accountability. (2021). 76.
Ottawa Charter for Health Promotion. (1986).
The Lancet(2009). What is health? The ability to adapt. The Lancet, 373(9666), 781. https://doi.org/10.1016/S0140-6736(09)60456-6
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