There are a number of words that we use regularly and with which we are familiar that are very difficult to define. How would you describe colour to someone who was born blind, for example, and what is time, other than something that passes all too quickly? We are comfortable in using the terms because we are very familiar with them and know exactly what they refer to. In fact you would think me strange if I said, I don’t know what colour is. They are terms we have grown up with; toddlers’ books ask them to find the red ball and the blue train. It is surprising that things that are so common and so familiar in use are so hard to describe. The point is that we learn what they are from dealing with them, we use them, rather than learning what they are from a book.
Health is something else that we refer to regularly and which is of fundamental value to us, that is also very difficult to define. Most people when asked what is most important to them in life, will place their health somewhere near the top of the list—usually above wealth. But what is it?
I recognise when I feel well, or have a cold or a pain but it’s hard to say exactly what it is that I recognise. The problem is we can’t always rely on how we feel. It’s possible to have a disease, even quite serious disease, and, at least for a time, not feel unwell. This is why screening for bowel and breast cancer is recommended and we have blood tests. It’s also possible for all the tests to be negative, but for us to still feel unwell. Pregnancy is usually regarded as the pinnacle of a woman’s health, but it can be associated with symptoms such as sickness and tiredness which in other situations are signs of serious disease. Someone with a disability such as a missing limb or congenital blindness can still describe themselves as healthy. So how should we understand it?
Most of the time this difficulty doesn’t concern us; we just get on with life. The problem is when our health is affected as happens when we have severe pain, for example, and we can’t ‘just get on with life’. Perhaps the biggest health challenge today concerns chronic conditions, that is conditions that persist over a long period or which may never get better. Over 40% of the UK population claims to suffer from a chronic health problem, including diabetes, depression, hypertension, persistent back or neck pain and so on.
If we are in that situation we may tell ourselves that when we feel better, when we get our health back, we’ll be able to live a normal life. We look at other people and speculate about what we would do if we had their health. But perhaps that’s the wrong way of thinking.
The definition of health that I like best is simply, ‘Health is living well.’ The focus shifts from what I am to what I do, from the state my body is in, to how I get on with my life even if it does have limitations. The point is that we know that we don’t get healthy sitting around and waiting for it to happen. There is now plenty of evidence to show that health improves when we are active. Children need physical activity to develop, elderly people live longer and have fewer illnesses when they keep active. In medicine the thinking used to be to rest and let the body recover. Patients would spend weeks in bed recovering. Increasingly that thinking has been overturned as the evidence shows that for many and perhaps most conditions, health returns more quickly if we do things. This is true for heart attacks, arthritis and particularly for back pain. Rest weakens muscles and stiffness increases; moving may be painful but it restores normal function and health returns more quickly.
We learn what colour and time are by experiencing them and using them. Saying exactly what health is may be difficult, but if we think of it in terms of ‘living well’ and doing things, perhaps we can have a bit more of it.