Health


 * Definition and Etymology **

As human understanding of [|health processes] , the body, and environments has evolved over time, so, too, has the concept of health. Historically, the conceptualization of health has been cyclical in nature, favoring biological and empirical approaches, then religious and spiritual approaches and back again (du Pre, 2005, pp. 25-37). Today, health is largely viewed from a biopsychosocial perspective, holistically weighing the well-being of one’s mind, physicality, and environment (du Pre, pp.10-11), although the biological and empirical roots planted by scholars such as Hippocrates (humeral theory of health and illness) or Louis Pastuer (Germ Theory) remain firmly planted (de Pre, pp. 25-37). Health’s etymological origin reflects this current view and is derived from the Old English and Old High German words for “whole” or “heal,” meaning “uninjured or unbroken,” or “sound bodily condition; freedom from sickness” (Oxford English Dictionary, 2012, n.p.). The Oxford English Dictionary echoes similar meanings for health but distinguishes between the body and the mind/spirit, stating “soundness of body,” or “spiritual, moral, or mental soundness or well-being” (Oxford English Dictionary, 2012, n.p.). A more integrated conceptualization of health is advocated by the World Health Organization (WHO) which defines health as, “a complete state of physical, mental and social well-being and not merely the absence of disease or infirmity” (2006, p. 1).


 * Health perspectives **

Despite the relative congruity of these definitions, however, perspectives on and approaches to the concept of health are varied. Health, for some, is conceptualized as //organic //, which assumes that health can be understood in terms of presence (or absence) of physical signs/symptoms of disease (du Pre, p. 208). This idea of health is closely related to evidence-based medicine, which is the treatment of health issues based only on results of verifiable testing to prove the presence of disease (Levin, 1998, p. 334).

In contrast, the concept of health as //harmony// argues that health is not merely an absence or presence of disease but, rather, is indicated by a person’s overall well-being (du Pre, p. 210). This perspective is consistent with the biopsychosocial model of health (du Pre, p. 11) and is gaining popularity in modern medicine. A related way that health is sometimes both colloquially and academically conceptualized is as “long-lived.” Due to the shift from acute to chronic illnesses, the world has seen changing populations and longer life expectancies, although whether this definition of health is valid is often debated with respect to health quantity versus quality (de Pre, p. 21).

Stepping outside of the widely known variations, health, by some, is conceptualized as a //phenomenon//. du Pre (2005), interpreting Bohm’s (1980) theory of explicate order versus implicate order, explains that life is an experience which must include negative events to provide a full understanding of ourselves and the world around us (p. 214). Building on and specifying Bohm’s work to health, Newman explains that health is expanded consciousness because health and health events are important and experiential parts of life that allow personal growth and change (2000, p. 32).

Another recent conceptualization of health is as a //human right//. Johnathan Mann, a pioneering advocate for human rights and HIV/AIDS treatment, argued that society causes disease and thus, society should guarantee health care to maintain the absence of disease (1994, 1999). In this perspective, the “concept of health includes yet goes beyond health care to embrace the broader societal dimensions and context of individual and population well-being” (Mann, Gostin, Gruskin, Brennan, Zita, Lazzarini, & Fineberg, 1994, p. 9). The WHO supports this movement, as well, stating “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being” (WHO, 2006, p. 1). The WHO further explains the human rights approach to health as, “Using human rights as a framework for health development” (WHO, 2002, p. 16). This conceptualization is based in the idea that health and human rights are inextricably connected (London, 2007, p.678; Mann, Gruskin, Grodin, & Annas, 1999, p. 5) and guaranteed by the Universal Declaration of Human Rights (Universal, 2006, p.1)

Finally, health can be conceptualized as //cultural interpretation // (du Pre, 2005, p. 208). Many cultures have their own approaches to and ideas of health, which may or may not coincide with any other perspectives. du Pre explains, “cultures conceptualize health in various ways. Some consider that disease is manifested differently within each person. Others see disease as something objective and independent, outside the patient’s control and beyond their understanding” (p. 208). For example, Anne Fadiman's (1997) novel //The Spirit Catches You and You Fall Down//, describes the clash between a Hmong family dealing with their young child's epilepsy, which they believe to be reflective of a spiritual default, and the Western doctors and nurses who are responsible for the young girl's care. The cultural implications of health are especially important for health care professionals to be aware of (du Pre, 2005).

 **Health and communication**

With respect to the field of communication , health has become a widely studied concept in the last several decades. Although fairly new to the communication discipline, health communication has rapidly expanded since its inception and continues to grow (Kreps, Bonaguro, & Query, 1998 p. 5). Defined by Kreps and Thornton (1992) as “how we seek, process, and share meanings regarding health and health information” (p. 2), health communication has established formal divisions within the International Communication Association and National Communication Association (as well as others), has produced its own peer-reviewed journals, and holds its own conferences and mini-conferences each year (Kreps, Bonaguro, & Query, 1998, pp. 5-7). Borrowing from humanistic studies, social scientific disciplines, and critical and cultural approaches (Zoller & Dutta, 2008, pp. 10-14), the trend toward studying communication in health <span style="color: #0000ff; font-family: Arial,sans-serif; font-size: 10pt;">contexts <span style="font-family: Arial,sans-serif; font-size: 10pt;"> was a natural development of the communication field (Kreps, Bonaguro, & Query, p. 3).

<span style="font-family: Arial,sans-serif; font-size: 10pt;">The study of health communication is typically examined from either the perspective of //health care delivery// or //health promotion// (Kreps, Bonaguro, & Query, p. 3), although the topics studied from these approaches are numerous and ever-growing. For example, research on health related issues can be found within studies on cultural issues (such as health literacy, health disparities), interpersonal interactions (patient-provider interaction, networks and social support, interpersonal health interventions, relationships within health contexts), the field of persuasion (campaigns, interpersonal persuasion, narratives and rhetoric, media effects on health), health care organizations (such as the health insurance industry), and the family (Kreps, Bonaguro, & Query, p. 2). Communication scholars have also begun exploring how changes in one’s health impacts his/her interpersonal relationships (Weber & Solomon, 2008, p. 549). The application of health concepts or contexts within the field of communication continues expand.

<span style="font-family: Arial,sans-serif; font-size: 10pt;">Because the applications of and approaches to the concept of health within communication are so varied and plentiful, a clear conceptualization of health remains undone. However, with so much societal and scholarly attention directed toward understanding health, Hadler (2004) a cohesive conceptualization may remain elusive. According to Hadler (2004), the wealth of health information promulgated by all sorts of purveyors of health care, including the medical profession, while intended to be helpful may actually be counterproductive. Much of the existing “health” information, as well as the information-seeking behaviors, destroys our essential sense of invincibility, without doing much positive good in the long run (pp. 3-4). Further, he explains that the constant flow of health communication and information has created a medicalized world in which healthiness is unattainable (Hadler, p. 128).

<span style="font-family: Arial,sans-serif; font-size: 10pt;">Ironically, health may be one of the most sought after human qualities or conditions, yet it seems to be one of the least understood. On its face, health seems to have a generally accepted meaning, but in unpacking the concept, one can see it has many derivations and nuances that shape how communication scholars approach and apply the term. These nuances have far reaching consequences for both theory building and practical application. How one understands and interacts with the concept of health is shaped by and contributes to the overarching view that society holds on the concept of health.

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 * References**

Bohm, D. (1980). //Wholeness and the implicate order//. London: Routledge.

du Pre, A. (2005). //Communicating about health// (2nd ed.). Boston: McGraw-Hill.

Fadiman, A. (1997). //The spirit catches you and you fall down//. New York: Farrar, Straus, and Giroux.

Hadler, N.M. (2004). //The last well person: How to stay well despite the health-care system//. Montreal: McGill-Queen’s University Press.

Health. (2012). In //Oxford English Dictionary online//. Retrieved from http://dictionary.oed.com.

Kreps, G.L., Bonaguro, E.W., & Query, J.L. (1998). In L.D. Jackson & B.K. Duffy (Eds.), //Health communication research: A guide to development and directions//, (pp. 1-15). Westport, CT: Greenwood Press.

Kreps, G.L., & Thornton, B.C. (1992). //Health communication: Theory and practice// (2nd ed.). Prospect Heights, IL: Waveland Press.

Levin, A. (1998). Evidence-based medicine gaining supporters. //Annals of Internal Medicine, 128//, 334-336.

London, L. (2007). Human rights and public health: Dichotomies or synergies in developing countries. Examining the case of HIV in South Africa. In R.J. Cook and C.G. Ngwena 3 (Eds.), //Health and human rights//. Hamshire, England: Ashgate Publishing Limited.

Mann, J.M., Gostin, L., Gruskin, S., Brennan, T., Lazzarini, Z., & Fineberg, H.V. (1994). Health and human rights. //Health and Human Rights, 1,// 6-23.

Mann, J.M., Gruskin, S., Grodin, M.A., & Annas, G.J. (1999). Human rights and public health. In J.M. Mann, S. Gruskin, M.A. Grodin, & G.J. Annas (Eds.), //Health and human rights: A reader//, (pp. 5-6). New York: Routledge.

Newman, M.A. (2000). //Health as expanding consciousness// (2nd ed.). Newbury Park, CA: Sage Publications.

Universal declaration of human rights (2006). In S.P. Marks (Ed.), //Health and human rights: Basic international documents// (2nd ed.). Cambridge, MA: Harvard University Publishing.

World Health Organization (2002). //25 Questions and answers on health and human rights//. Geneva, Switzerland: Author.

World Health Organization (2006). //Constitution of the World Health Organization. In Basic Documents// (45th ed.). New York: Author.

Zoller, H.M., & Dutta, M.J. (2008). Theoretical foundations: Interpretive, critical, and cultural approaches to health communication. In H.M. Zoller & M.J. Dutta (Eds.), //Emerging perspectives in health communication: Meaning, culture, and power// (pp. 1-38). New York: Routledge.