9.1 Introduction to Health Concepts

There is considerable cultural variation in what it means to be healthy. The World Health Organization (WHO) has developed a widely adopted definition of health that includes a biopsychosocial approach to well-being. For many, the identification of health versus illness often depends on subjective labeling of how a person feels in the moment, but in reality, overall health is determined by a complex set of variables. There is a great deal of intracultural variability in the United States when it comes to health and well-being. In particular, disparity exists in groups based on socioeconomic status and race/ethnicity when it comes to access to health resources and care. Additionally, enculturated experiences, perceptions, and values further influence American health in regard to diet and sleep hygiene. The future of health in the United States and globally will be shaped by the ability of future generations to tackle the complex challenges faced within each culture.

This lesson will explore what it means to be physically healthy globally and throughout different cultures.

Physical Health and Culture

As a student, you probably work to maintain good grades, have an active social life, and stay healthy, but there is a prevalent joke about what it’s like to be in college—you can only pick two of these things. The busy life of a college student doesn’t always allow you to maintain and balance all three areas of your life, especially around midterm and finals. Researchers found that students taking exams were more stressed, smoked more, drank more caffeine, had less physical activity, and had worse sleep habits (Oaten & Chang, 2005) than at other times, all of which could have detrimental effects on their health. Positive health practices are especially important during times of stress, but how have the habits you have been enculturated into shaped those practices? What are the similarities and differences in staying healthy as a college student in the United States compared to other countries?

Globally, human beings are living longer than ever, but living a longer life does not necessarily mean we are living healthier. Researchers in the field of health want to improve our understanding of how social and technological advances in medicine and lifestyle are being undermined by increasing rates of obesity, unhealthy behaviors, and widening gaps in access to health care. For centuries of human history, life expectancy has slowly and steadily risen for each generation; however, current unhealthy habits (smoking, substance abuse, obesity) may potentially threaten this trend. The New England Journal of Medicine reported that the average youth of today may live less healthy, and even shorter, lives than their parents (Olshansky et al., 2005). If that is the case, today’s youth would be the first generation in modern, recorded history to not automatically be expected to outlive the generation that raised them.

What Does it Mean to be Healthy?

The meaning of health has evolved over time, but early definitions of health focused on the theme of the body’s ability to function. Originally, health was seen as a state of normal function that could be disrupted from time to time by disease. Disease is a broad reference to any condition that impairs the normal functioning of the body. Most Western countries focus on the physical processes—pathology, biochemistry, and physiology of a disease—as primary contributors to health. This is known as the biomedical model. According to the biomedical model, health means freedom from disease, pain, or defect, but does not consider the role of social factors or individual subjectivity. There is a contrasting model of health that takes a more holistic approach, often referred to as traditional medicine.

The World Health Organization (WHO) defines traditional medicine as “the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures” (2020). In 1977, American psychiatrist George Engel developed an interdisciplinary model that looked at the interconnection between biology, psychology, and socio-environmental factors. With his biopsychosocial approach, Engel strived for a more holistic approach to health by recognizing that each patient has his or her own thoughts, feelings, and history. Engel’s biopsychosocial model views the development of illness through the complex interaction of biological factors (genetic, biochemical), psychological factors (mood, personality, behavior), and social factors (cultural, familial, socioeconomic, medical). For example, a person may have a genetic predisposition for depression, but he or she may have social factors such as extreme stress at work and family life, and psychological factors such as a perfectionistic tendency, which, when combined, can trigger this genetic code for depression.

Global Definition of Health

Health, as defined by the WHO (2024), is a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” This definition has been subject to controversy, as it may have limited value for implementation. Generally, the context in which we live our lives is critical for our health and quality of life. It is increasingly recognized that health is maintained and improved not only through the advancement and application of health science, but also through intelligent lifestyle choices and efforts of the individual, as well as larger society.

According to the World Health Organization, the main determinants of health include:

• Social environment
• Economic environment
• Physical environment
• Individual characteristics and behaviors

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