Jennifer Butler, B.Sc.(Pharm)

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” (WHO, 1948). Since then, many have proposed updated definitions that address several of the criticisms of the original WHO definition, and provide a modern perspective. Below is a list of some of the proposed definitions of health put forth by various scholars and organizations over the past 77 years.  

Author(s) or Organization	Year	Definition
WHO	1948	Health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”
WHO & UNICEF (Declaration of Alma-Ata)	1978	Reconfirmed the definition above but added: “Health… is a fundamental human right and … the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector”
WHO (The Ottawa Charter)	1986	“Health is a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”
Huber et al.	2011	Health is the ability to adapt and self-manage
Bradley et al.	2018	Did not present a new definition of health but proposed that a contemporary definition of health should include the following:Recognition that disease and disability can co-exist with healthThat health should center around fullness of life and not absence of diseaseAcknowledgement that health involves the integration of the body, mind and spiritRecognition of the social, environmental and behavioral determinants of health
Leonardi, F.	2018	“Health [is] the capability to cope with and to manage one’s own malaise and well-being conditions. Health may be conceptualized as the capability to react to all kinds of environmental events having the desired emotional, cognitive, and behavioral responses and avoiding those undesirable ones.”
Krahn et al.	2021	Health is the dynamic balance of physical, mental, social, and existential well-being in adapting to conditions of life and the environment.
First Nations Health Authority (FNHA)	n.d.	Does not provide a definition of health, but a visual depiction of First Nations perspective on health and wellness that centres human beings surrounded by six circles, each circle symbolizing different determinants and aspects of health.

The first most common criticism of the WHO’s definition pertains to the inclusion of the words “complete well-being” and “not merely”. Critics argue that a state of complete well-being promotes a perfectionist view of health. Similarly, the inclusion of the words “not merely” create a prerequisite of disease absence in order to attain health. (Bradley et al., 2018; Huber et al., 2011; Krahn et al., 2021; Leonardi, 2018). If one accepts both of these interpretations, a state of health is virtually unattainable. Conversely, Schramme defends the WHO’s definition and contends that the perfectionist view of health is a misinterpretation of the original WHO authors’ intent of the definition; he argues that the word “complete” should be interpreted to convey a holistic perspective of well-being, encompassing physical, mental and social aspects (2023). 

Another common criticism of the WHO’s definition is that it reflects the post-war era in which it was written, where acute illness had a more significant impact on healthcare systems. Whereas in modern times, people are living with disabilities and chronic diseases for years or even decades (Huber et al., 2011; Krahn et al., 2021). 

In contemporary definitions and perspectives, health is not a fixed objective, but a continuous, ever-changing process that can be supported and nurtured at any age, by any person regardless of functional limitation. Furthermore, there is no universal standard for what constitutes “good health”; rather it is defined by the individual and shaped by the environment around them (FNHA, n.d.; Huber et al., 2011; Krahn et al., 2021; Leonardi, 2018).

Leonardi’s definition carries a deficit-based perspective that frames health primarily in terms of coping and managing difficulties, rather than fostering growth and well-being (Leonardi, 2018). This outlook may not be conducive to motivating individuals and populations toward proactive health promotion and positive health experiences. Furthermore, the concept of coping and managing one’s conditions risks shifting the responsibility of health promotion away from healthcare systems and governments, placing a disproportionate burden on the individual. 

Many parallels exist between Krahn et al.’s definition of health and the perspective offered by the FNHA. Both are holistic and emphasize balance between all aspects of well-being. The use of circles in the FNHA’s visual depiction demonstrates the continuity of health described by Krahn et. al. While Krahn et. al. acknowledge the impact of one’s values on health, the FNHA ascribe specific cultural values within their perspective (FNHA, n.d.; Krahn et al., 2021). Ultimately these two views on health allow for a multimodal approach to health promotion, not only by individuals, but also populations, systems and policymakers.

References

Bradley, K. L., Goetz, T., & Viswanathan, S. (2018). Toward a Contemporary Definition of Health. Military Medicine, 183(11/12), 204–207.

First Nations Health Authority. (n.d.). First Nations Perspective on Health and Wellness. Retrieved February 16, 2025, from https://www.fnha.ca:443/wellness/wellness-for-first-nations/first-nations-perspective-on-health-and-wellness

Huber, M., Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R., Kromhout, D., Leonard, B., Lorig, K., Loureiro, M. I., van der Meer, J. W. M., Schnabel, P., Smith, R., van der Weel, C., & Smid, H. (2011). Health: How Should We Define It? BMJ: British Medical Journal, 343(7817), 235–237.

Krahn, G. L., Robinson, A., Murray, A. J., Havercamp, S. M., Havercamp, S., Andridge, R., Arnold, L. E., Barnhill, J., Bodle, S., Boerner, E., Bonardi, A., Bourne, M. L., Brown, C., Buck, A., Burkett, S., Chapman, R., Cobranchi, C., Cole, C., Davies, D., … Witwer, A. (2021). It’s time to reconsider how we define health: Perspective from disability and chronic condition. Disability and Health Journal, 14(4), 101129. https://doi.org/10.1016/j.dhjo.2021.101129

Leonardi, F. (2018). The Definition of Health: Towards New Perspectives. International Journal of Health Services, 48(4), 735–748. https://doi.org/10.1177/0020731418782653

Schramme, T. (2023). Health as Complete Well-Being: The WHO Definition and Beyond. Public Health Ethics, 16(3), 210–218. https://doi.org/10.1093/phe/phad017

World Health Organization. (1948). Constitution of the World Health Organization. World Health Organization. https://www.who.int/about/governance/constitution

World Health Organization. (1986). Ottawa Charter for Health Promotion. World Health Organization. https://www.canada.ca/content/dam/phac-aspc/documents/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion/charter.pdf

World Health Organization (WHO) & United Nations International Children’s Emergency Fund (UNICEF). (1978). Declaration of Alma-Ata. WHO & UNICEF.