Moving Beyond the WHO Definition of Health: A New Perspective for an Aging World and the Emerging Era of Value‐Based Care

• DOI: http://doi.org/10.1002/wmh3.221
• Published date: 01 March 2017
• Date: 01 March 2017

Moving Beyond the WHO Def‌inition of Health:

A New Perspective for an Aging World and the

Emerging Era of Value-Based Care

Alan J. Card

The WHO def‌inition of health is not f‌it for purpose, especially in the emerging era of value-based care.

Developed 70 years ago, it contributed to a very useful broadening of the lens through which we consider

health; however, it cannot provide clear and useful goals for the value-based care movement, especially given

the nuanced needs of an aging population. For the purpose of designing and evaluating systems to deliver

health (as opposed to merely delivering services), something more practical is required. This paper outlines

principles that should underlie an improved def‌inition of health, and proposes a new def‌inition: “Health is

the experience of physical and psychological well-being. Good health and poor health do not occur as a

dichotomy, but as a continuum. The absence of disease or disability is neither suff‌icient nor necessary to

produce a state of good health.” This def‌inition has implications for the goals and metrics of value-based

care. Specif‌ically, it highlights: (i) the need for patient-centered and goal-based metrics; (ii) the need to

include measures of overall health status; and (iii) the need to aim for improved and preserved health status,

as opposed to the impossible goal of “complete ... well-being,” as called forintheWHOdef‌inition.

KEY WORDS: definition of health, person-centered care, value-based care

Introduction

The World Health Organization’s (WHO) def‌inition of health is by far the

best known and most widely used. But it is not a practical def‌inition, and is

especially ill-suited to the emerging era of value-based care. As the objective of

health-care systems shifts from providing services to providing health, certain

questions become more relevant to policy and practice: What is health? What

outcomes should be measured to determine if health has been delivered? Where

do patients’ goals f‌it into the value equation? The answers to these questions

hinge on how health is def‌ined.

The WHO Definition of Health

The WHO def‌inition of health appears in their Constitution:

World Medical & Health Policy, Vol. 9, No. 1, 2017

127

1948-4682 #2017 Policy Studies Organization

Published by Wiley Periodicals, Inc., 350 Main Street, Malden, MA 02148, USA, and 9600 Garsington Road, Oxford, OX4 2DQ.