Defining Health: Perspectives on Physical, Mental & Social Well-being

Six Models of Health: From Absence of Disease to Flourishing

Health is a contested, multidimensional concept. Major frameworks:

1. Biomedical Model

Health = absence of disease/injury. Reductionist; focuses on pathology. Dominates acute care.

2. WHO Holistic Definition (1948)

"Complete physical, mental, and social well-being, not merely the absence of disease." Aspirational; hard to operationalize.

3. Salutogenic Model (Antonovsky)

Focus on origins of health (salutogenesis) vs. disease (pathogenesis). Key: Sense of Coherence (SOC) — comprehensibility, manageability, meaningfulness.

4. Social Determinants Model

Health shaped by upstream factors: income, education, housing, racism, environment, policy. "Zip code > genetic code."

5. Ecological / Planetary Health

Human health inseparable from natural systems: climate, biodiversity, water, air. Degradation → disease.

6. Positive Health / Flourishing (Keyes, Seligman)

Health as presence of wellness: positive emotion, engagement, relationships, meaning, accomplishment (PERMA).

Why Multiple Models Matter

• Clinical: Biomedical for trauma; salutogenic for chronic disease self-management.
• Policy: Social/ecological models drive upstream prevention.
• Personal: Positive health guides life choices beyond symptom avoidance.

No single definition suffices. Effective healthcare integrates perspectives.