The dictionary states that health is: “Physical and mental well-being; freedom from disease, pain, or defect; normalcy of physical and mental functions; soundness.”
The World Health Organization (WHO) defines health as a state of “complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The Centers for Disease Control and Prevention, along with a range of WHO partners, endorses this definition. Being healthy, in their view, excludes having any disease.
This definition used to make sense. Today, managing disease, not solely its absence, is a means to a healthy life, especially for older adults. Rather than pursuing the “absence” of disease, we need a more inclusive definition of health – one that works for more people – rather than categorically excluding an entire segment of the life course.
Seventy years ago, the WHO definition of health was a powerful clarion call to international action. Global life expectancy then was approximately 48 for men and 53 for women. Polio and diphtheria were rampant.
Today polio and diphtheria, along with measles, tuberculosis and pertussis, are largely preventable and treatable. Heart disease, cancer and stroke were the top three causes of death for Americans at mid-century and remain so today. Their definition, diagnosis and management are now distinctly different.
Cancer is now detected at ever-earlier stages and the continuous development of therapies, as well as lifelong screening and management, has radically altered survival with cancer. The bedside practice of medicine with its focus on the patient’s history of illness and the relief of suffering has given way to a desktop practice dedicated to running the numbers, calculating risks, and relieving anxieties.
A definition of “complete” health as the absence of disease leaves little space for people with chronic diseases and for managing them in new ways. Having disease and feeling healthy are no longer mutually exclusive, especially for older adults. Managing multiple diseases is the norm for older Americans, despite many reporting they are in good or very good health. High blood pressure, diabetes, high cholesterol, arthritis, kidney disease, thyroid conditions and osteoporosis are among the most common chronic conditions. With regular access to continuous medical care, these and many more can be managed well, sometimes even without symptoms.
Managing multiple diseases, maximizing function, optimizing medication regimens, prioritizing different health risks and outcomes, and preparing for end-of-life considerations are some of the areas that deserve to be included in basic definitions of health. A definition of health should include adapting to evolving health needs over the life course and optimally managing disease as a means to physical, mental and social well being.
There are times when the absence of disease is a perfect goal. Vaccination in older adults remains important, for example, and being free of influenza should be a public health goal for old and young alike. We also need to incorporate early and excellent management of disease as part of health, with objectives for prioritizing risks and benefits according to an individual’s evolving needs, priorities and health profile over the life course.
Developing a definition of health that works for everyone – or, perhaps, that works for more people across different segments of the life course – will allow older adults the chance to be healthy. We should revise our definitions of health to account for the need for early and excellent disease management. Managing disease, and not solely its absence, is a means to a healthy life.
Typically, many rely on conventional medicine to define their health. It is important to take a proactive approach. A variety of approaches are available to treat patients with health problems. Two different approaches with some overlap are integrative medicine and functional medicine.
Integrative medicine is the combination of traditional treatments and alternative therapies to treat the body with a holistic approach. Integrative medicine does not focus on just one physical health problem a patient has. It works to correct the mind, body and spirit so the entire body heals. This broad approach to healing the entire person rather than just a single condition aims to make patients healthier and happier overall.
Integrative medicine addresses different aspects of a patient’s life such as physical, mental, social, emotional and environmental influences that work together. Examples include detoxification therapies, medication reduction therapy, nutritional therapy (supplements, herbal medicines, naturopathic medicines), and regenerative medicine. These treatments work together with some traditional treatments to effectively treat a patient in a faster, more effective way.
Integrative medicine isn’t meant to replace the care you receive from your primary doctor. It complements existing treatments prescribed by your primary care and specialty providers. Any suggested natural remedies and complementary therapies included in your personalized wellness plan should not interfere with any traditional medications you’ve been prescribed.
Functional medicine is an approach that focuses on optimal function of the body. This means helping the body function in the best way possible by focusing on efficiency in each organ of the body. Functional medicine understands that every individual is different. There is a personalized approach for each patient.
Functional medicine works to correct problems in organs and the rest of the body, using natural supplements wherever possible. It heavily emphasizes lifestyle changes to fix health problems, such as diet, exercise, sleep patterns, stress levels and other aspects of life. Examples of functional medicine include acupuncture, naturopathy, massage, chiropractic medicine, osteopathic medicine, body movement therapies, tai chi and yoga.
As we continue to learn about the human body, it is important not to limit what we define health as. Health is about more than not being sick and there are ways we can take a proactive approach today in order to prevent future conditions.