It’s Time to Change the Definition of ‘Health’

By Cara Kiernan Fallon and Jason Karlawish

Meet Betty, a typical aging American. At 82, she spends almost as much time with her doctors as she does with her grandchildren. She has to. She takes seven prescription medications to treat her high blood pressure, high cholesterol, diabetes, and arthritis. Ten years ago, she was treated for breast cancer.

Is Betty healthy? According to her, “Absolutely!” She enjoys her spacious apartment, two cats, close friends, and 50-gallon fish tank.

But according to the World Health Organization, Betty is mistaken. The 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.

Once upon a time, this definition made 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. A definition of health needs to work for a nation. And most nations in both the developed and developing world are aging.