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health.This article is about the human condition. For other uses, see Health (disambiguation).Health is the ability of a biological system to acquire, convert, allocate, distribute, and utilize energy sustainably. The World Health Organization (WHO) defined human health in a broader sense in its 1948 constitution as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."^[1][2] This definition has been subject to controversy, in particular as lacking operational value, the ambiguity in developing cohesive health strategies and because of the problem created by use of the word "complete", which makes it practically impossible to achieve.^[3][4][5] Other definitions have been proposed, among which a recent definition that correlates health and personal satisfaction.^[6] [7] These challenges with definitions has motivated the emergence of a conceptualization (an effort to translate ideas into words, acknowledging their limitations), which considers health as the ability to adapt and manage the physical, mental and social challenges we face through life

History

The meaning of health has evolved over time. In keeping with the biomedical perspective, early definitions of health focused on the theme of the body's ability to function; health was seen as a state of normal function that could be disrupted from time to time by disease. An example of such a definition of health is: "a state characterized by anatomic, physiologic, and psychological integrity; ability to perform personally valued family, work, and community roles; ability to deal with physical, biological, psychological, and social stress".^[9] Then in 1948, in a radical departure from previous definitions, the World Health Organization (WHO) proposed a definition that aimed higher: linking health to well-being, in terms of "physical, mental, and social well-being, and not merely the absence of disease and infirmity".^[10] Although this definition was welcomed by some as being innovative, it was also criticized as being vague, excessively broad and was not construed as measurable. For a long time, it was set aside as an impractical ideal and most discussions of health returned to the practicality of the biomedical model.^[11]

Just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a leading role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for living". 1984 WHO revised the definition of health defined it as "the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities".^[12] Thus, health referred to the ability to maintain homeostasis and recover from insults. Mental, intellectual, emotional and social health referred to a person's ability to handle stress, to acquire skills, to maintain relationships, all of which form resources for resiliency and independent living.^[11] This opens up many possibilities for health to be taught, strengthened and learned.

Since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States’ approach to improving population health.^[13][14] In each decade, a new version of Healthy People is issued,^[15] featuring updated goals and identifying topic areas and quantifiable objectives for health improvement during the succeeding ten years, with assessment at that point of progress or lack thereof. Progress has been limited to many objectives, leading to concerns about the effectiveness of Healthy People in shaping outcomes in the context of a decentralized and uncoordinated US health system. Healthy People 2020 gives more prominence to health promotion and preventive approaches and adds a substantive focus on the importance of addressing social determinants of health. A new expanded digital interface facilitates use and dissemination rather than bulky printed books as produced in the past. The impact of these changes to Healthy People will be determined in the coming years.

Determinants

See also: Social determinants of health and Risk factor

Generally, the context in which an individual lives is of great importance for both his health status and quality of their life^[20]. It is increasingly recognized that health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. According to the World Health Organization, the main determinants of health include the social and economic environment, the physical environment and the person's individual characteristics and behaviors.^[21]

More specifically, key factors that have been found to influence whether people are healthy or unhealthy include the following:^[21][22][23]

Income and social status Social support networks Education and literacy Employment/working conditions Social environments Physical environments

Personal health practices and coping skills Healthy child development Biology and genetics Health care services Gender Culture

Donald Henderson as part of the CDC's smallpox eradication team in 1966.

An increasing number of studies and reports from different organizations and contexts examine the linkages between health and different factors, including lifestyles, environments, health care organization and health policy, one specific health policy brought into many countries in recent years was the introduction of the sugar tax. Beverage taxes came into light with increasing concerns about obesity, particularly among youth. Sugar-sweetened beverages have become a target of anti-obesity initiatives with increasing evidence of their link to obesity.^[24]– such as the 1974 Lalonde report from Canada;^[23] the Alameda County Study in California;^[25] and the series of World Health Reports of the World Health Organization, which focuses on global health issues including access to health care and improving public health outcomes, especially in developing countries.^[26]

The concept of the "health field," as distinct from medical care, emerged from the Lalonde report from Canada. The report identified three interdependent fields as key determinants of an individual's health. These are:^[23]

• Lifestyle: the aggregation of personal decisions (i.e., over which the individual has control) that can be said to contribute to, or cause, illness or death;
• Environmental: all matters related to health external to the human body and over which the individual has little or no control;
• Biomedical: all aspects of health, physical and mental, developed within the human body as influenced by genetic make-up.

The maintenance and promotion of health is achieved through different combination of physical, mental, and social well-being, together sometimes referred to as the "health triangle."^[27][28] The WHO's 1986 Ottawa Charter for Health Promotion further stated that health is not just a state, but also "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."^[29]

Focusing more on lifestyle issues and their relationships with functional health, data from the Alameda County Study suggested that people can improve their health via exercise, enough sleep, maintaining a healthy body weight, limiting alcohol use, and avoiding smoking.^[30] Health and illness can co-exist, as even people with multiple chronic diseases or terminal illnesses can consider themselves healthy

The environment is often cited as an important factor influencing the health status of individuals. This includes characteristics of the natural environment, the built environment and the social environment. Factors such as clean water and air, adequate housing, and safe communities and roads all have been found to contribute to good health, especially to the health of infants and children.^[21][32] Some studies have shown that a lack of neighborhood recreational spaces including natural environment leads to lower levels of personal satisfaction and higher levels of obesity, linked to lower overall health and well being.^[33] This suggests that the positive health benefits of natural space in urban neighborhoods should be taken into account in public policy and land use.

Genetics, or inherited traits from parents, also play a role in determining the health status of individuals and populations. This can encompass both the predisposition to certain diseases and health conditions, as well as the habits and behaviors individuals develop through the lifestyle of their families. For example, genetics may play a role in the manner in which people cope with stress, either mental, emotional or physical. For example, obesity is a significant problem in the United States that contributes to bad mental health and causes stress in the lives of great numbers of people^[34]. (One difficulty is the issue raised by the debate over the relative strengths of genetics and other factors; interactions between genetics and environment may be of particular importance

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