Overcoming the Utopian Perspectives on Health: Health Must Also Include States of Unwell-Being

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2025-02-07 DOI:10.1111/jep.70008
Fabio Leonardi
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Abstract

Background

Equating health with complete physical, mental and social well-being, as defined by the WHO, has played an important role in the development of healthcare systems in Western countries. However, this definition has contributed to the rise of the myth of well-being, increasing the demand on healthcare systems and raising the risk of medicalizing all aspects of life. Additionally, equating health with complete well-being is conceptually flawed for two important reasons.

Aim

The aim of this article is to move beyond this utopian vision, which has led to negative consequences for both individual health and the sustainability of healthcare systems.

Methods

This article analyses the most relevant definitions of health proposed in the scientific literature over the last 50 years.

Findings

There have been some attempts within the WHO itself to reduce the utopian content of its definition, but these efforts have not yielded significant results. Outside the WHO, many different proposals have emerged, including those that incorporate malaise into the concept of health. Nevertheless, none of the definitions proposed in the last 50 years have achieved widespread consensus.

Discussion and Implications for Practice

While there are various approaches to defining health, the crucial issue is that each definition should include states of unwell-being. Incorporating this perspective would represent a paradigm shift in the field of health, fostering more realistic expectations and reducing the risk of medicalization.

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背景 根据世界卫生组织的定义,健康等同于完整的身体、精神和社会福祉,这在西方国家医疗保健系统的发展中发挥了重要作用。然而,这一定义助长了幸福神话的兴起,增加了对医疗保健系统的需求,提高了将生活的各个方面医疗化的风险。此外,由于两个重要原因,将健康等同于完全幸福在概念上存在缺陷。 目的 本文旨在超越这种乌托邦式的观点,因为它已对个人健康和医疗系统的可持续性造成了负面影响。 方法 本文分析了过去 50 年来科学文献中提出的最相关的健康定义。 研究结果 世卫组织内部曾试图减少其定义中的乌托邦内容,但这些努力并未取得显著成效。在世卫组织之外,也出现了许多不同的建议,包括将 "乏力 "纳入健康概念的建议。然而,过去 50 年中提出的定义都没有取得广泛共识。 讨论和对实践的启示 虽然定义健康的方法多种多样,但关键问题是每个定义都应包括不健康状态。纳入这一观点将代表健康领域的范式转变,促进更现实的期望,并降低医疗化的风险。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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