unit 1-1
unit 1-1
Health
In 1946 the World Health Organisation defined health as a
“complete state of physical, social and mental well-being,
and not just the absence of disease or infirmity” (WHO
2009; p. 1), thus establishing a close relationship between
the two concepts. This definition has remained almost
unchanged over the last 7 decades, but has attracted
criticism since, especially in view of the fact that an ever-
larger proportion of the world’s population reach an age
at which multi-morbidity is the rule rather than the
exception (Barnett et al. 2012). As a consequence of our
aging societies, therefore, fewer and fewer people would be
considered “healthy” according to this definition, thereby
rendering it diagnostically obsolete and stigmatizing.
In contrast to the WHO definition of 1946 the focus has
shifted from health as a state of complete physical, mental
and social well-being to one of health as the capacity to
adapt and to self‐manage when facing physical, mental and
social challenges (Huber et al. 2011). This applies to us both
as individuals and as members of a community. Health in
general is increasingly understood as the ability of an
individual or community to adapt and to self-manage, even
in the face of adversity, e.g. chronic disease or disability.
Well-being
While individual well-being seems to be included in these
conceptualisations of health, it is widely acknowledged
that the two constructs are related but distinct. Even if
health is conceptualised as the ability to self-manage and
adapt, it can be assessed at the physiological, emotional,
cognitive and behavioural level. In contrast, well-being
emphasises the experiential aspect, which describes a
feeling that is often referred to as “subjective well-being”
(SWB). SWB is, therefore, primarily a psychological
construct as it is concerned with people’s evaluation of
their lives; however, it includes a wide range of notions,
from momentary moods to global life satisfaction
judgments.
Well-being is also of increasing importance as a concept in
public health (Dooris et al. 2018; La Plaza and Knight 2014).
This perspective not only considers well-being as a matter of
individual lifestyle and its subjective experience, but also its
wider contextual determinants (Aked and Thompson 2011;
Huppert, 2009). McNaught (2011), for example, considers
health as only one component of well-being, and proposes a
definitional framework comprising individual, family,
community and society levels. He defines well-being as a
“macro concept concerned with the objective and
subjective assessment of how human beings survive, thrive
and function” (p. 11).
ILLNESS-WELLNESS CONTINUUM
Hedonic Happiness
Probably most of us would hope first for a
long
life—one that does not end prematurely.
Suicide,
however, is a reminder that the quality of
life is more
important to many people than the quantity
of life.
As for quality of life, happiness might be
number
one on our list. Most people would likely
hope for
a happy and satisfying life, in which good
things
and pleasant experiences outnumber bad
ones.
Particularly in American culture, as we
noted earlier,
happiness seems to be an important part of
how people
define a good life. Defining the good life in
terms
of personal happiness is the general thrust
of the hedonic view of well-being.
While there are many varieties of
philosophical hedonism dating back to the
ancient
Greeks, a general version of hedonism
holds that the
chief goal of life is the pursuit of happiness
and
pleasure. Within psychology, this view of
well-being
is expressed in the study of SWB (Diener,
1984;
Diener et al., 1999). Subjective well-being
takes a
broad view of happiness, beyond the
pursuit of
short-term or physical pleasures defining a
narrow
hedonism. Subjective well-being is defined
as life
satisfaction, the presence of positive affect,
and a relative
absence of negative affect. Together, the
three
components are often referred to as
happiness.
Research based on the SWB model has
burgeoned in
the last 5 years (Ryan & Deci, 2001).
Studies have
delineated a variety of personality
characteristics and
life experiences that help answer questions
about
who is happy and what makes people
happy.
Eudaimonic Happiness
Consider a hypothetical example suggested
by
Seligman (2002a). What if you could be
hooked to
an “experience machine” that would keep
you in a
constant state of cheerful happiness, or
whatever
positive emotion you desired, no matter
what happened
in your life. Fitting the hedonic view, you
would experience an abundance of
happiness all
the time. Would you choose to be hooked
up?
We
might like it for awhile, but to experience
only one
of our many emotions, and to have the
same cheerful
reaction to the diversity of life events and
challenges
might actually impoverish the experience of
life. And some of what we would lose might
be
extremely valuable. For example, negative
emotions
like fear help us make choices that avoid
threats to
our well-being. Without fear and other
negative
emotions we might make very bad choices.
We’d be
happy, but we might not live very long.
Seligman
(2002a) argues that we would likely also
reject the
experience machine because we want to
feel we are
entitled to our positive emotions, and to
believe
they reflect our “real” positive qualities
and behaviors.
Pleasure, disconnected from reality, does
not
affirm or express our identity as
individuals.
Above all, most of us would probably reject
the experience machine because we believe
that
there is more to life than happiness and
subjective
pleasure. Or as Seligman (2002a) describes
it, there
is a deeper and more “authentic
happiness.”