Lesson 1 · How do we understand and measure Australia's health?
Meanings of health: the WHO definition and why people define health differently
Ask a surgeon, a marathon runner, an aged-care nurse and a 16-year-old whether a woman with well-managed type 1 diabetes is healthy, and you can get four different answers from four people who all know what they are talking about. They are not disagreeing about her blood glucose. They are using different definitions of the word. This lesson is about what those definitions are, and why the disagreement turns out to be the useful part rather than a problem to be tidied away.
Write your own one-sentence definition of health. Do not look anything up.
Then test it, using your definition rather than your instinct: is a person with a permanent disability, who is fit, employed and content, healthy? If your definition says no, write down what you would have to change about it to say yes.
- State the WHO definition of health and say what it changed about the way health was understood.
- Explain the main criticism of that definition, and why the criticism has force without making the definition useless.
- Compare the WHO definition with the biomedical, functional and holistic meanings, in terms of what each counts and what each leaves out.
- Explain why people give different meanings to health, using age, experience, culture, occupation and circumstance.
- Use a repeatable method to compare any two definitions, rather than simply preferring one.
- Health — contested. Each meaning below is an answer to the question, and the differences between them are what this lesson is about.
- WHO definition — health as a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity. Adopted in 1948 and unchanged since.
- Biomedical meaning — health as the absence of diagnosable disease or injury; the working definition of clinical medicine.
- Functional meaning — health as being able to do what your life requires of you.
- Holistic meaning — health as the whole person in their whole context, rather than a body considered on its own.
- Social and emotional wellbeing — the term used in Aboriginal and Torres Strait Islander health for a concept covering connection to body, mind and emotions, family and kinship, community, culture, Country and spirituality.
- Dimension of health — one aspect that a definition counts: physical, mental, social, and in some frameworks spiritual and cultural.
The World Health Organization defines health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. It was written into the WHO constitution in 1948 and has not been amended since.
Two phrases do the work. The definition is positive — health is something you have, not a gap where illness is absent. Most earlier official definitions worked the other way round, so a person with no diagnosis counted as healthy by default. And it names three dimensions, which brings mental and social wellbeing inside health rather than leaving them beside it. A person with no disease but no sleep, no friends and no secure housing is not, on this definition, healthy.
That is why it is quoted so heavily in policy. It licenses a government to treat housing, employment and isolation as health matters, because the definition already counts them as part of health.
Quick check: Which part of the WHO definition does most to widen health beyond medicine?
The most common criticism of the WHO definition is aimed at a single word. If health is complete wellbeing across all three dimensions, then on a strict reading very few people qualify at any given moment — and a standard almost everyone fails is difficult to use for anything.
The criticism has more force again for chronic illness and disability. Many people live for decades with a managed condition or a permanent impairment while working, competing, raising families and describing themselves as well. A definition that classes all of them as unhealthy for the whole of their lives is at least describing something other than what they mean by the word.
None of that makes the definition worthless, and an answer that says so has overreached. Its value has always been more as a statement of ambition than as a test applied case by case: it says what health systems should aim at, which is a different job from sorting individuals into healthy and unhealthy.
True or false: The main criticism of the WHO definition is that it ignores mental health.
The WHO definition is the one the syllabus names, but it is not the only one in use, and the others are not simply worse versions of it. Each is good at the job it was built for.
Narrower than WHO
- Biomedical. Health as the absence of diagnosable disease or injury. Precise, measurable and testable, which is what a clinician needs at three in the morning. It is close to silent on whether a life is going well.
- Functional. Health as being able to do what your life asks of you. This is what most people mean in conversation, and it explains why one condition counts as ill health for one person and an inconvenience for another.
Wider than WHO
- Holistic. Health as the whole person in context. In Aboriginal and Torres Strait Islander health this is expressed as social and emotional wellbeing, covering connection to body, mind and emotions, family and kinship, community, culture, Country and spirituality — and treating the health of the individual and of the community as inseparable rather than as two topics.
Read across and the pattern is visible: each meaning is wider or narrower than its neighbour, and the trade runs the same way each time. Widening buys relevance at the cost of precision; narrowing buys precision at the cost of relevance. The biomedical meaning can be settled in a laboratory and tells you little about a life; the holistic meaning describes a life well and resists being reduced to a number.
Match each meaning of health to the job it does best.
- Biomedical
- Functional
- WHO
- Holistic
- Deciding whether a patient needs treatment tonight
- Explaining why one condition disrupts one life and not another
- Arguing that housing and isolation are health policy, not only welfare policy
- Describing health where community, culture and Country are inseparable from the person
People do not pick a definition of health at random. What someone counts as healthy tends to track what health has cost or given them, which is why the differences are patterned and can be explained rather than only noticed.
- Age and life stage. A 16-year-old commonly defines health as energy, appearance and fitness; an 80-year-old more often defines it as independence and freedom from pain. Each is naming what is currently at stake for them.
- Experience of illness or disability. Living with a condition tends to move a person from “health is having nothing wrong” towards “health is managing what is wrong well enough to get on with things”.
- Culture and family. Where health is understood collectively, a definition that stops at the individual body will look as though it is missing the point.
- Occupation. A labourer and an accountant do not need the same body, so they do not set the threshold in the same place.
- Circumstance. What a person counts as achievable shapes what they count as normal, so people with fewer resources often set the bar where they can actually reach it.
None of these makes a definition wrong. They make it situated — built by someone, somewhere, for some purpose. That is the word to reach for when a question asks you to explain the differences.
Two truths and a lie. Which statement is false?
Compare is a directive with a shape. It does not mean describe one and then the other, and it does not mean pick a winner. It means setting them beside each other on the same three questions, so that the differences are shown rather than asserted.
- What does it count? Which dimensions are inside the definition — physical, mental, social, spiritual, cultural — and is the unit the individual or the community?
- What does it leave out? Every definition draws a boundary, and the argument is almost always about what falls outside it.
- Who is it useful for? A definition is a tool. Ask whose work it makes possible: the clinician's, the policymaker's, or the person's own.
A definition is a choice about where to draw a boundary. To compare two of them, say what each counts, what each leaves out, and whose work each makes possible — then judge them against a stated purpose, never in the abstract.
Text description
- Four definitions of health stacked from narrowest at the top to widest at the bottom, with a downward arrow labelled wider between each.
- First, and narrowest, is the biomedical meaning, health as the absence of diagnosable disease or injury; its strength is that it is precise and testable and its limit is that it is silent on wellbeing.
- Next is the functional meaning, health as being able to do what your life requires; its strength is that it matches everyday use and its limit is that the threshold shifts from person to person.
- Next is the WHO definition of 1948, complete physical, mental and social wellbeing and not merely the absence of disease; its strength is that it makes housing, work and isolation health matters and its limit is the word complete.
- Last, and widest, is the holistic meaning, including social and emotional wellbeing, covering body, mind, family, community, culture, Country and spirituality; its strength is that it describes a whole life and its limit is that it resists measurement.
- A band beneath the four reads: every widening buys relevance and costs precision, every narrowing buys precision and costs relevance.
- Three questions sit at the foot: what does it count, what does it leave out, who is it useful for.
Activities · put the method to work
For each statement, name the meaning of health the speaker is using, and give the one influence from Card 07 that best explains why they hold it. Do not judge whether they are right.
“My scans came back clear, so I'm healthy.”
“I've had asthma since I was six. I'm healthy — I know my triggers and I train around them.”
“You can't talk about my health without talking about my family and my community.”
“I'm 82. If I can still get to the shops on my own, I'm doing well.”
A local council has funding for one youth health project and two proposals in front of it. Proposal A is a free drop-in clinic offering screening and treatment. Proposal B is a supported sports and social program in a suburb where a lot of young people report having nobody to spend weekends with.
Write a paragraph that (a) names the meaning of health under which Proposal A is obviously the better buy, (b) names the meaning under which Proposal B is, (c) explains what each definition would have to leave out to make the other proposal look wasteful, and (d) says which definition you would ask the council to state publicly before it decides, and why. There is no correct proposal here — the marks are for showing that the choice of definition is doing the work.
Complete the comparison method.
To compare two meanings of health, ask what each , what each leaves , and who each is for.
Odd one out. Three of these are dimensions a definition of health may count. Which one is not?
Compare the WHO definition of health with the biomedical meaning of health.
Compare asks for similarities and differences, shown side by side against the same criteria. Two paragraphs that describe one definition and then the other is a Describe answer wearing a Compare label.
Plan: state the shared ground, then run both against counts / leaves out / useful for, then judge against a purpose.
Both are attempts to say what health is, and both treat the absence of disease as relevant to it. The WHO definition explicitly includes that absence, in the phrase “not merely the absence of disease or infirmity”, so the biomedical meaning is closer to a subset of the WHO definition than a rival to it.
The biomedical meaning counts one dimension: the physical state of the body, judged by diagnosable disease or injury. The WHO definition counts three, adding mental and social wellbeing, so conditions such as isolation or insecure housing register as health matters under WHO and do not register at all under the biomedical meaning.
The biomedical meaning leaves out whether a person's life is going well, so someone lonely and exhausted but undiagnosed counts as healthy. The WHO definition leaves out attainability: by requiring complete wellbeing it excludes almost everyone at some point, and classes people managing a lifelong condition as unhealthy even where they describe themselves as well.
The biomedical meaning is built for clinical decisions: it is precise, testable and can settle whether treatment is needed now. The WHO definition is built for policy: because it counts social conditions as health, it licenses action on housing, work and isolation as health action rather than as welfare.
Both definitions attempt to say what health is, and both treat the absence of disease as relevant — the WHO definition names it directly in “not merely the absence of disease or infirmity” — so the biomedical meaning functions as a subset of the WHO one rather than a rival. They differ in what they count: the biomedical meaning counts the physical state of the body alone, judged by diagnosable disease, while the WHO definition adds mental and social wellbeing, so isolation and insecure housing are health matters under WHO and invisible under the biomedical meaning. They also differ in what they leave out. The biomedical meaning omits whether a life is going well, so someone lonely and exhausted but undiagnosed counts as healthy; the WHO definition omits attainability, since requiring complete wellbeing excludes most people at some point and classes those managing a lifelong condition as unhealthy even where they describe themselves as well. The difference follows from purpose: the biomedical meaning is built to settle clinical decisions and is precise enough to do so, whereas the WHO definition is built to justify policy and is broad enough to bring housing and work inside health. Neither is simply better; each is stronger for the job it was written to do.
Explain why two people can give different meanings to health without either of them being mistaken.
Explain asks for cause and effect — the mechanism by which one thing produces another. Listing two definitions describes them; the marks are for showing why the difference arises.
Plan: state the principle that a definition is built for a purpose, then give two linked pairs of cause and effect, then answer the question directly.
A definition of health is a boundary drawn for a purpose, so what a person counts as health depends on what they need the definition to do. Two definitions can therefore differ without either being false, in the way that two maps of one city at different scales can both be accurate.
What is at stake changes across a life, so the definition tracks it: a 16-year-old whose body is not yet a constraint defines health as fitness and energy, whereas an 80-year-old for whom mobility is the daily question defines it as independence. Living with a long-term condition does the same work, moving a person from “nothing wrong” to “well managed”, because the first definition would make them permanently unhealthy and would describe nothing they could act on.
Culture sets the unit that health is measured over, so where wellbeing is understood as belonging to a family and a community rather than to a body, a definition stopping at the individual will appear incomplete. Circumstance sets the level, so a person with fewer resources tends to define health at a threshold they can actually reach, which means the same words describe a different standard.
A definition of health is a boundary drawn for a purpose, so what a person counts as health depends on what they need the definition to do, and two definitions can differ without either being false. What is at stake changes across a life: a 16-year-old whose body is not yet a constraint defines health as fitness and energy, while an 80-year-old for whom mobility is the daily question defines it as independence. Living with a long-term condition works the same way, moving a person from “nothing wrong” to “well managed”, because the first definition would classify them as permanently unhealthy and would offer them nothing to act on. Culture sets the unit the definition covers, so where wellbeing belongs to a family and a community rather than to a body, a definition stopping at the individual looks incomplete; circumstance sets the level, so people with fewer resources often define health at a threshold they can reach. The differences are therefore patterned rather than arbitrary, and explaining them means naming the purpose each definition serves rather than deciding which speaker is correct.
Go back to card 01. You wrote a definition of health and tested it on a person with a permanent disability who is fit, employed and content. Which of the four meanings was yours closest to? And having read Card 05, would you now change the word your definition turned on — or keep it and state the purpose it serves?
Multiple choice · 5 questions
MC 1. The WHO defines health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. The phrase “not merely” is significant because it:
- A. removes disease from the definition of health altogether
- B. keeps the absence of disease inside health while refusing to let it be the whole of health
- C. makes the definition easier to measure
- D. restricts the definition to physical health
MC 2. The most widely made criticism of the WHO definition is that:
- A. it does not mention mental health
- B. it was written too recently to be authoritative
- C. requiring “complete” wellbeing sets a standard almost nobody meets, including many people who describe themselves as well
- D. it applies only to individuals in high-income countries
MC 3. A doctor decides a patient does not require treatment because no disease can be diagnosed. The meaning of health being used here is:
- A. holistic
- B. functional
- C. biomedical
- D. the WHO definition
MC 4. A person says “you can't describe my health without describing my family, my community and my connection to Country”. This statement is best understood as:
- A. a rejection of the idea that health can be defined at all
- B. a holistic meaning, in which the unit of health is broader than the individual body
- C. a functional meaning, concerned with daily tasks
- D. a claim that only physical health can be measured
MC 5. Two students give different definitions of health. The most defensible conclusion is that:
- A. one of them must be wrong
- B. definitions of health are a matter of opinion and cannot be compared
- C. each definition can be compared by what it counts, what it leaves out and whose purpose it serves
- D. the more detailed definition is the more accurate one
Short answer · exam style
SA 1. Understand Band 4 Outline the WHO definition of health and identify two ways it differs from a definition of health as the absence of disease. (4 marks)
SA 2. Analyse Band 5 A person living with a well-managed chronic condition describes themselves as healthy. Analyse what this tells us about the meanings of health people use. (5 marks)
SA 3. Evaluate Band 6 “The WHO definition of health is too broad to be useful.” Assess this statement. (6 marks)
📖 Comprehensive answers (click to reveal)
Multiple choice: 1 → B. 2 → C. 3 → C. 4 → B. 5 → C.
Activity 1 model responses: 1 → Biomedical: health is read off the absence of diagnosable disease. The influence is most likely occupation or setting — this is the definition clinical contexts train people to use, and it is the one a test result can settle. 2 → Functional, with a management framing. The influence is experience of illness: a definition requiring nothing to be wrong would classify this speaker as permanently unhealthy and would give them nothing to act on. 3 → Holistic, expressed as social and emotional wellbeing, where the unit is the person together with family, community, culture and Country rather than the individual body. The influence is culture, which sets the unit the definition covers. 4 → Functional. The influence is age and life stage: independence is what is currently at stake, so the definition tracks it.
SA 1 (4 marks): The WHO defines health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity [1]. First difference: it is a positive definition, describing a state a person has rather than a gap where illness is absent, so health becomes something to attain rather than a default [1]. Second difference: it counts three dimensions rather than one, so mental and social wellbeing are inside health, which means conditions such as isolation or insecure housing register as health matters [1]. A creditable alternative for the second mark: the WHO definition supports action on the social conditions of health, whereas an absence-of-disease definition supports only clinical treatment [1].
SA 2 (5 marks): Analysis, not description. Under a strict biomedical meaning the person is not healthy, because a diagnosable condition is present [1]. Under a functional meaning they are healthy, because they can do what their life requires of them [1]. Under the WHO definition the answer is uncomfortable: “complete” wellbeing arguably excludes them, which is precisely the criticism most often made of that definition [1]. The disagreement is therefore not about the facts of the case — every meaning agrees on the diagnosis — but about where each draws its boundary [1]. What it shows is that meanings of health are built for purposes: the speaker is using the definition that describes a life they can act on, and a definition that would classify them as unhealthy for decades would not be useful to them even if it were consistent [1].
SA 3 (6 marks): A sustained judgement is required, and it should turn on purpose rather than preference. The statement has force: “complete” wellbeing is met by very few people at any moment, so as a test for sorting individuals the definition is close to unusable, and it sits badly with chronic illness and disability, classifying people who describe themselves as well as unhealthy [2]. Against the statement: breadth is what the definition was for. By counting mental and social wellbeing it makes housing, employment and isolation health matters, which licenses public health and policy action that a narrower definition cannot reach, and it was written as a statement of ambition for health systems rather than as a clinical test [2]. Judgement: the statement is right about one use and wrong about another, so it is too broad for individual assessment and appropriately broad for policy; the fair conclusion is that a definition should be judged against the job it is being asked to do, and the WHO definition is being criticised for failing a job it was not written for [2].
The whole of this lesson reduces to one habit: when you meet a definition of health, ask what it counts, what it leaves out, and whose work it makes possible. Before you move on, find a definition of health in the wild — a health service website, a sports brand, a government campaign — and run those three questions over it.
Then check your Practice answers against the model answers above. The commonest way to lose marks in this dot point is to rank the definitions instead of comparing them, and the tell is an answer that says one meaning is “better” without ever naming the purpose it is better for.
Mark lesson as complete
Tick when you've finished the practice and review.