Guest Post David Mapletoft, Diabetes Educator
Is Health is the level of functional or metabolic efficiency of a living organism?
In humans, is health the general condition of a person’s mind and body, usually meaning to be free from illness, injury or pain (as in “good health” or “healthy“)?
The World Health Organization (WHO) defined health in its broader sense in 1946 as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.
Although this definition has been subject to controversy, in particular as lacking operational value and because of the problem created by use of the word “complete,” it remains the most enduring. Other definitions have been proposed, among which a recent definition that correlates health and personal satisfaction.
Another somewhat arguably liberating definition of health is from French physician, Georges Canguilhem, in his 1943 book, The Normal and the Pathological. Canguilhem rejected the idea that there were normal or abnormal states of health. He saw health not as something defined statistically or mechanistically. Rather, he saw health as the ability to adapt to one’s environment. Health is not a fixed entity. It varies for every individual, depending on their circumstances.
Health is defined not by the doctor, but by the person, according to his or her functional needs. The role of the doctor is to help the individual adapt to their unique prevailing conditions. This should be the meaning of “personalised medicine”.
The beauty of Canguilhem’s definition of health—of normality—is that it includes the animate and inanimate environment, as well as the physical, mental, and social dimensions of human life. It puts the individual patient, not the doctor, in a position of self-determining authority to define his or her health needs.
The doctor becomes a partner in delivering those needs.
What Do You Think?
Some of my clients – men with diabetes – who attended a focus group in 2004 defined health as:
“Sitting here. I have survived cancer. Now I have diabetes. I want to learn all I can. Knowing that I am alive still – able to walk and talk, do the things that I want to do.”
“Being able to do what I want to do, have enough energy to go for a walk, go out shopping, do things.”
“Not running out of breath.”
Others have defined good health as:
“Good health means participating in a daily exercise regimen and eating well. Keeping my cholesterol and sugar numbers in check is an important factor. When I’m heart-healthy, the rest follows along. Following the Best Life guidelines keeps me in good health.”
“I believe you need to address the physical, mental and spiritual aspects of your life. When you achieve balance and harmony, you attain true health.”
“Good health means being able to look at myself in the mirror and know that I’ve eaten right, I’ve been active and that I’ve been honest with myself. These are the things within my control. My best healthy life means taking care of the things over which I have power.”
“Good health is not the number on the scale, although that is a warning sign that something is wrong. What’s important are the numbers on your cholesterol report, your blood pressure, and the percentage of body fat. Healthy eating and portion control are not all that’s needed; an active lifestyle, a sense of purpose or a reason to get up in the morning and take on the world, a positive outlook on life and inspiring people to do the same are true signs of good health.”
“Good health is more than lack of disease. It is being my personal best physically, mentally, and emotionally. It is being at the ‘top of my game,’ which includes mindful eating, regular exercise, a positive mindset to overcome challenges, and pure fun and joy…and being grateful for all these things.”
“For a long time, I thought good health meant a super-strict diet, obsessive exercise and complete deprivation of anything indulgent. I now know it means mindful eating with more fresh ingredients, being as physically active as possible and allowing for the once-in-a-while treat to enjoy life!”
“To me, good health means to be fit physically and emotionally as well as being illness-free. When one thing is off, our health is out of balance. In order to have good health, we have to have proper nutrition, stay active and take the time to mentally take care of our body and emotions.”
“Good health means that I am feeling my absolute best, physically and mentally. I have found that eating well and continued exercise are the answers for me.”
“Good health is a reflection of body, mind and spirit. Through integration of moderate functional exercise, meditation and awareness, balanced nutrition, morality and peace-loving relationships (with family, at the workplace and with friends), the absence of disease can be attained”
“I define good health with one word: balance. When I eat healthfully, exercise regularly, sleep well and am social with family and friends, I am balanced. This is when I feel that my health is not just good–it’s great!”
What is YOUR definition of ‘good health’?
…. and, how can you achieve good health when living with such a chronic and complex disease like diabetes?
Do you believe that using a team of experts – dietitian for meal planning; diabetes educator for interpreting BGL’s, understanding your medications and assessing if you are on the optimal medication for you, helping you understand the relevance of a good foot care plan, etc etc; the podiatrist to assess your nerves, circulation and bio-mechanics of your feet; your GP to prescribe and measure your body’s functions – helps you to achieve good health?
Does health mean “I feel fine, therefore I must be healthy” or does it mean “ visit the doctor regularly for tests to check all of my body functions are on target to reduce my risk of future health problems?”
Or something different?
What is Your Role?
The manner in which nurses, physicians, patients, and administrators interact is crucial for the overall efficacy of a healthcare system. From the viewpoint of the patients, healthcare providers can be seen as being in a privileged position, whereby they have the power to alter the patients’ quality of life. And yet, there are strict divisions among healthcare providers that can sometimes lead to an overall decline in the quality of patient care. When nurses and physicians are not on the same page with respect to a particular patient, a compromising situation may arise.
One method of overcoming this ‘power imbalance’ could be taking a proactive approach to your health.
As we live in an information age. By doing some research on the w.w.w, and following the trials and tribulations of people like yourselves on blogs and forums such as these, you can put yourself in the driver’s seat.
Being prepared with a set of goals that you may wish to achieve and asking your health professional some questions relating to help you achieve these goals may be a useful strategy.
For example: a common goal is to make a healthy eating plan. So byy taking along to your dietitian appointment:
1. a week’s food diary,
2. a set of beliefs obtained from various source, and
3. a set of 3-4 questions
You may not only put you in the driver’s seat, you may make the appointment even more satisfying for you both.
Another example is going to your diabetes educator with a set of questions relating to the things you are not quite sure about in your self care plan.
For example: a common comment in my practice is ‘my BGL’s are all over the place, I really don’t understand why’. You could ask something like “My health goal is to manage my diabetes well. Can you please help me understand what’s going on with my BGL’s?”
Health is a two way street. Who do you want to be the driver?
David – Diabetes Educator