The concept of health is neither univocal nor immutable; rather, it has evolved throughout history in response to cultural, scientific, and social changes. For a long time, health was understood simply as the absence of disease or as the functional impairment of organs and systems (the classical/biomedical concept). Today, however, it is considered a complex condition involving multiple dimensions of human life.
From Biology to Complexity: The Scientific Concept of Health
One of the most well-known and frequently cited definitions is that proposed by the World Health Organization (WHO) in 1948, according to which health is: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” [1].
This formulation represented an important turning point, moving beyond a purely biological view of health by including psychological and social aspects. Over time, however, it has been criticized: the expression “complete well-being” suggests an overly ideal and static state that is difficult to achieve in real life, especially for people with chronic illnesses or disabilities, who, according to this definition, would be considered unhealthy [2].
From Antiquity to the Present: Balance as the Foundation of Health
Even in antiquity, health was not viewed solely as the absence of disease. In Greek medicine, particularly in the thought of Hippocrates, health was understood as the dynamic balance of the four bodily humors — blood, phlegm, yellow bile, and black bile. Disease resulted from an imbalance (dyscrasia, from the Greek meaning “bad mixture”), whereas health arose from a dynamic harmony (eucrasia, meaning “good mixture”) among the body, the environment, and lifestyle [3; 4]. This concept shows how the idea of balance, albeit supported by different theoretical tools, has been present since the origins of medicine.
Health as a Dynamic Process
Starting in the 1960s, with the development of modern medicine and the social sciences, many scholars emphasized that health is not a fixed point but a continuously evolving process. In 1966, Alessandro Seppilli defined health as:
“a condition of harmonious functional, physical and psychological balance of the individual dynamically integrated into his natural and social environment” [5].
According to this perspective, health depends on the balance between the individual and the environment, involving physical, psychological, and social aspects. It can be maintained even in the presence of disease, provided that the person is able to adapt and manage their condition.
A further contribution is the model of salutogenesis, developed by medical sociologist Aaron Antonovsky (1923–1994), which shifts attention from the causes of disease to the factors that support the maintenance of health [6]. Antonovsky observed that, despite traumatic experiences—for example among survivors of the Holocaust—some individuals were able to preserve a good level of well-being. In this view, health lies along a continuum between well-being and illness and depends on the ability to cope with stress and find meaning in one’s experiences [7].
Health therefore emerges from the interaction between stressors, protective factors, and available resources [8]. Elements such as comprehensibility (understanding the situation), manageability (the ability to face challenges), and meaningfulness (a sense of purpose) constitute the Sense of Coherence, which facilitates the maintenance of health over time [6]. From this perspective, health does not consist in the perfect absence of problems, but in the capacity to adapt, maintain, or restore personal balance in the face of internal and external demands [7]. Some contemporary authors define health as the “ability to adapt and self-manage,” acknowledging uncertainty, chronic illness, and functional variations throughout life [9].
From a Static to a Dynamic Concept
In light of these reflections, a key distinction emerges: the static view considers health as an ideal state of complete balance and well-being, whereas the dynamic view interprets it as a continuously evolving process influenced by biological, psychological, social, and environmental factors. Today, the latter perspective is more widely shared, particularly in the field of public health.
Although a revision of the definition of health was proposed in 1998 — “Health is a dynamic state of complete physical, mental, social and spiritual well-being, not merely the absence of disease.” — this modification was not formally adopted due to linguistic, cultural, and religious reasons that were not universally shared [10].
Conclusion
Health is configured as a complex and multidimensional concept that takes on different meanings depending on scientific, cultural, and individual perspectives. There is therefore no single definition valid for all people or contexts, as each individual and situation may interpret it differently. For this reason, in healthcare and public policy it becomes essential that the meaning of “health” be clearly shared between professionals and users in order to avoid misunderstandings and ensure effective interventions [2]. Ultimately, health should be understood as a dynamic and contextual process, influenced by biological, psychological, social, and environmental factors, and its understanding requires attention to the multiple dimensions that define it.
References:
- World Health Organization (WHO). Constitution of the World Health Organization.
https://www.who.int/about/governance/constitution - Concepts of health in different contexts: a scoping review. PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953139/ - Treccani. La filosofia della medicina ippocratica. Enciclopedia Treccani.
https://www.treccani.it/enciclopedia/la-filosofia-della-medicina-ippocratica_%28Storia-della-civilta-Europea%29/ - Wikipedia. Eucrasia. Eucrasia – Wikipedia
- Seppilli, A. Lezione di Bioetica e Medicina Sociale (BMES Lez. 1 – materiale didattico).
Microsoft PowerPoint – BMES Lez.1 (materiale didattico universitario, consultato online) - Wikipedia. Salutogenesi. Salutogenesi – Wikipedia
- Promozione Salute Svizzera. Salute. Salute | Promozione Salute Svizzera
- quint-essenz. Salutogenesis. quint-essenz: Temi: Salutogenesis
- SaluteInternazionale.info. La salute come capacità di adattamento.
La salute come capacità di adattamento | SaluteInternazionale - Wikipedia. Salute. Salute – Wikipedia