Health

• 1. Introduction

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  Health, for most of recorded medical thinking, meant one thing: a body that worked. A state of normal function that disease could interrupt from time to time. Then, in 1948, the World Health Organization said something that startled people. Health, it declared, is a state of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity. That single sentence aimed far higher than any definition before it. Some welcomed it as innovative. Others called it vague, excessively broad, and impossible to measure. For years it was shelved as an impractical ideal. So what is health, really? A fixed condition you either have or lack, or something more like a resource you spend and renew? This documentary follows that question across competing definitions, the forces that shape a person's well-being, and the systems built to protect it.

• 2. From State To Resource

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  In the 1980s the World Health Organization stopped treating health as a static condition and helped launch the health promotion movement. The idea shifted. Health became dynamic, framed in terms of resiliency, described as a resource for living. In 1984 the WHO revised its definition again. Health, it now said, is the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living. It is a positive concept, emphasizing social and personal resources as well as physical capacities. Under this view, health meant the ability to maintain homeostasis and recover from adverse events. Mental, intellectual, emotional and social health described a person's capacity to handle stress, acquire skills, and maintain relationships. The 1986 Ottawa Charter for Health Promotion repeated the point that health is a resource for everyday life, not the objective of living. By the first decade of the 21st century, this framing had a striking consequence. Self-assessments became the main indicators for judging efforts to improve health. A person could now feel healthy even while living with multiple chronic diseases or a terminal condition.

• 3. The Determinants

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  Education and literacy, employment and working conditions, income and social status: these sit near the top of the factors that decide whether people are healthy or unhealthy. The list continues through physical and social environments, social support networks, biology and genetics, culture, gender, health care services, healthy child development, and personal coping skills. The World Health Organization groups the main determinants into the social and economic environment, the physical environment, and a person's individual characteristics and behaviors. The idea of a health field, distinct from medical care, emerged from the 1974 Lalonde report in Canada. That report named three interdependent fields. The biomedical field covers physical and mental health developed within the body and shaped by genetic make-up. The environmental field covers everything external to the body over which the individual has little or no control. The lifestyle field covers the personal decisions a person does control, those that can contribute to or cause illness or death. The Alameda County Study in California turned this into practical advice. People can improve their health through exercise, enough sleep, time in nature, a healthy body weight, limited alcohol, and avoiding smoking. Clean water and air, adequate housing, and safe roads all contribute to good health, especially for infants and children. Genetics shapes the picture too, influencing both predisposition to disease and even how people cope with stress.

• 4. Burdens Of Ill Health

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  Roughly 36 million people die each year from non-communicable diseases, according to figures cited from GlobalIssues.org, among them cardiovascular disease, cancer, diabetes and chronic lung disease. Communicable diseases take their own toll. AIDS and HIV, tuberculosis, and malaria, both viral and bacterial in origin, cause millions of deaths every year. Malnutrition strikes hardest at the young. Approximately 7.5 million children under the age of 5 die from it, often simply because families lack the money to find or make food. Bodily injuries form another global burden, from bone fractures to burns, sometimes fatal through the infections that follow. Lifestyle choices drive much of the rest. Smoking, poor diet, inactivity, lack of sleep, excessive alcohol, and neglected oral hygiene all feed poor health, alongside inherited genetic disorders. Most of these problems are preventable, yet roughly 1 billion people lack access to health care systems at all. The most common and harmful issue, arguably, is that a great many people simply have no access to quality remedies.

• 5. The Mind's Health

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  Mental health, in the words of the World Health Organization, is a state of well-being in which the individual realizes their own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community. It is not merely the absence of mental illness. Mental illness covers the spectrum of cognitive, emotional, and behavioral conditions that interfere with social and emotional well-being and with people's lives and productivity. It can impair a person's mental functioning, temporarily or permanently. Approximately twenty percent of all adults in the United States are considered diagnosable with a mental disorder. Such disorders are the leading cause of disability in both the United States and Canada. The named examples run from schizophrenia and ADHD to major depressive disorder, bipolar disorder, anxiety disorder, post-traumatic stress disorder, and autism spectrum disorder. The roots are tangled. Biological factors such as genes or brain chemistry, a family history of mental health problems, and life experiences such as trauma or abuse all contribute.

• 6. The Daily Maintenance

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  A healthy diet draws on a variety of plant-based and animal-based foods, supplying the body with energy and the materials to build bones, muscles, and tendons. Macronutrients, the proteins, carbohydrates, and fats consumed in large quantities, sit alongside the micronutrients, vitamins and minerals taken in smaller amounts but essential to body processes. Food pyramids divide these groups into sections showing recommended intake. The Mediterranean diet is commonly linked to health-promoting effects, sometimes credited to bioactive compounds such as phenolic compounds, isoprenoids and alkaloids. Exercise carries its own register. The National Institutes of Health describe four types: endurance, strength, flexibility, and balance. The CDC notes that physical exercise can reduce the risk of heart disease, cancer, type 2 diabetes, high blood pressure, obesity, depression, and anxiety. Even housework, yardwork, or standing while on the phone counts for more than nothing. Sleep proves just as load-bearing for the body. In one study, people with six hours of sleep a night or less were four times more likely to catch a cold than those sleeping seven hours or more. In 2007 the International Agency for Research on Cancer declared that shiftwork involving circadian disruption is probably carcinogenic to humans. In 2015 the National Sleep Foundation issued updated sleep recommendations by age, from 14 to 17 hours for newborns down to 7 to 8 hours for older adults.

• 7. Systems Of Care

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  Contemporary medicine runs within health care systems whose legal, credentialing, and financing frameworks are set by individual governments. From ancient times, Christian emphasis on practical charity gave rise to systematic nursing and hospitals, and the Catholic Church today remains the largest non-government provider of medical services in the world. Advanced industrial countries, with the exception of the United States, and many developing countries provide care through universal health care, aiming to guarantee access on the basis of need rather than ability to pay. Care itself sorts into three tiers. Primary care offers first contact and can handle about 90% of medical visits. Secondary care comes through specialists at clinics and community hospitals after a referral. Tertiary care lives in specialist hospitals and regional centers, covering trauma, burns, organ transplants, and radiation oncology. Public health works on a different scale entirely. Described as the science and art of preventing disease, prolonging life and promoting health, it watches over populations as small as a handful of people or as large as several continents during a pandemic. Its results are tangible. Life expectancy has increased for Americans by thirty years since 1900, and worldwide by six years since 1990, a gain owed in part to public health itself.