Disease has, for most of the history of mankind, been thought of predominantly as physical incapacitation due to injury, infection, or congenital deformity. Health has simply been the absence of such problems, freedom from pain and the ability to perform physical work. Merriam Webster defines health as the condition of an organism or one of its parts in which it performs its vital functions normally or properly: the state of being sound in body or mind; especially: freedom from physical disease and pain. Health maintenance is defined as the provision of comprehensive health care to individuals and families with limited referral to outside specialists. Although limited in scope, for many years, this was the way in which health was principally thought of, in terms of pathogenesis, i.e. the process of how one becomes ill.
We have now moved on; the current focus is one of salutogenesis, the process by which one becomes well. Life has now progressed towards greater possibilities for achievement, and the concept of health has changed. The World Health Organisation (WHO) has defined health as The level of well-being that allows for the total fulfilment of the physical, psychological, educational and occupational potential of each individual.
Rather than referring to health or illness, we now embrace the salutogenesis of both individuals and populations when we refer to the ‘wellness arena’. The wellness arena incorporates wellness consultants, the healthcare professions and disease prevention specialists; in addition to the manufacture of medicines, medicinal aids and meeting the clinical needs, lifestyle requirements and some of the relaxation and leisure provision (spa’s hydro’s and gymnasiums) of the population. Such services and professions are now referred to collectively as ‘the wellness industry’. The art of taking care of one’s own health is about developing an understanding of life and a value for life that provides a basis for a sufficiently responsible way of living. This, in turn, promotes the development of self-confidence and the ability to solve problems.
One can no longer separate health and wealth, as the WHO now recognises that without the fulfilment of individual potential, the potential of a community, and even a country cannot be fully met. Lack of health results in a downward spiral that culminates in the inability to utilise or develop inherent skills, resulting in poverty, low standards of living and social inequalities. Those who engage in health-enhancing behaviour have access to and make better use of social, educational and employment opportunities.
The fulfilment of one’s potential allows for what is now termed a ‘quality of life’, which encompasses many ways of life that have several key features:
• physiological stability
• psychological stability
• the ability to fulfil one’s basic needs
• happiness
• self-realisation
The attainment of one’s full potential is achieved through adherence to certain principles of living, which may be termed ‘a healthy lifestyle’. Self-realisation, or self-fulfilment, is what follows when all the other aspects of health are in place, and one can take up the opportunities that life presents in a state of full physical and mental health and vitality. The study of how one may develop a quality of life and the new health science and research that surround this is termed quality of life medicine.
In order to reduce the global economic burden of disease and the extent of human suffering, one needs to ask ‘how can we prevent health problems’?