Human health is determined by a wide range of factors. These include the condition of the environment we live in - for example, our air and water quality, and the health of the landscapes from which we grow or obtain food resources; social factors - such as social mobility and relationships, our ability to live and work in safe and peaceful communities, etc.; economic factors - including our ability to find decent work, afford medicine and medical care and healthy foods for ourselves and our families; our personal behaviours - e.g. our diet and whether we smoke or exercise; and our personal genetic make up and physiology, which may make us more or less prone to certain illnesses.
How these diverse factors interact to influence our health and well-being is a key question for the effective delivery of public health services. There is no one answer and no single solution or intervention that can meet the health needs of everyone. However, it is increasingly clear that the ecosystems in which we live and work and use for recreation are the settings within which all other factors interact. The role of biodiversity and the ecosystem services it provides, which support and maintain a healthy living environment, are increasingly clear and important in public health planning. .
Perhaps the most widely used definition for health comes from the Constitution of the WHO (1948), which considers health to be “a state of complete physical, mental and social well-being, and not merely an absence of disease or infirmity”. This definition was ground-breaking and of great significance when it came into use, giving clear recognition to mental health and recognising that health was not just determined by the biophysical status of the individual, but was also influenced by society. Health also interacts with and affects many other aspects of well-being – such as one’s ability to work and socialise, to participate in family life, and be an active part of the community. As such, in many cases it may be singled out as the most crucial element of well-being. Health is also an important component in self-reported assessments of well-being, and an important consideration in determinations of quality of life.
Health is also increasingly recognised as an important indicator of sustainable development. Today it is well understood that sustainable health care systems are a prerequisite for socially and environmentally sound development, not just a result of it. While social status and economic security are perhaps most important in determining one’s capacity to manage their health or that of their family and to maintain a healthy lifestyle, the role of environmental factors in determining health status is increasingly recognised within the health and environment communities and elsewhere.
It is worth noting that the continuing relevance of the WHO definition of health has been questioned by some experts in recent decades - is this definition still adequate in an increasingly interconnected world and in the face of pervasive human impacts on the global environment? Some commentators have indicated that the definition should also account for the ability to adapt to health challenges – suggesting that truly healthy individuals are not necessarily those who remain free from disease, but those that can recover from illness and return to active life. Whether one agrees with this perspective – and there are many who do not - this focus on adaptation has strong correlations with the concept of ecosystem health, with its similar notions of resistance and resilience, and therefore it may be particularly useful in terms of understanding the importance of biodiversity to sustaining health and well-being in the context of global change.
Cohab refers to the standardised definition in the 1948 Constitution of the WHO in all of its work, however we also acknowledge the increasing importance of resilience and the ability to adapt as a metric for health at the community level. Cohab will continue to explore this area through our work programmes.