What is “health”?
A useful definition comes from the World Health
Organization: “Health is a state of complete
physical, mental and social well-being and
not merely the absence of disease or infirmity.”
“Wellness” refers to the presence of positive
attributes in one’s life – well-being,
quality of life, happiness, and satisfaction.
“Illness” is a person’s subjective experience
of feeling unwell.
A “sickness” is a socially and culturally
defined entity.
Finally, a “disease” is the pathologic
process going on in the body.
For example: a person experiences chest pain
– this is their illness.
They fear a heart attack – a sickness – which
causes them to seek help.
The doctor explains to the patient that he
has pericarditis – a disease.
So, what determines how healthy someone is?
The determinants of health include genetics
and biology, but they also include social
factors.
Many of these social determinants of health
are as important as physical factors like
smoking status, blood pressure, and exercise.
 They include income, social support networks,
education, and social exclusion, for example.
Why do these social factors matter so much?
The common theme is stress.
When income is low, employment opportunities
are few, and social support networks are limited,
people have difficulty meeting their basic
needs, and have uncertainty about their future.
This chronic stress takes a toll on the body
– contributing to many chronic diseases
– and may also lead to unhealthy coping
behaviours.
So, when talking to your patients, consider
their social context.
Factor it into your clinical decision-making.
And remember that health is more than just
being “disease free,” and means different
things to different people.
