A Quantitative Approach to the World Health Organization Definition of Health: Physical, Mental and Social Well-being

Our concept and measurement of health has generally focused on ill health. This focus on pathology probably arose from the fact that for most of human existence the health problem facing society, and medicine in particular, has been overcoming disease. By mid-twentieth century, however, already for some of mankind and hopefully soon for the rest, the health picture had changed—people as a whole were not disease-ridden and ideas of so-called positive health emerged. This emboldened the WHO to define health in a new way as ‘physical, mental and social well-being, not merely the absence of disease or infirmity’. To absorb this concept and use it in medical science has not been easy for those trained to approach health through pathology. The Human Population Laboratory of Alameda County, California, have been trying to apply the WHO idea in the measurement of health and in ascertaining how to improve health. This paper discusses the various aspects of and approaches to this subject and describes a trial of their method of measurement and the preparations for another survey in 1973. For an individual or a community it appears possible to measure health status through questions that only individuals can answer about themselves, as in the Human Population Laboratory, and through testing by physical means the extent of functional reserves, as in multiphasic screening. Medicine would then focus on improving health in the sense of (i) moving people toward the favorable end of the health spectrum, as determined subjectively by responses to questions, and (ii) enhancing the bodily reserves, as determined by screening tests.