This article is about the general concept. For the prison located in Paris, see Prison de la Santé .
For the Stromae song , see Santé (song) .
Health is “ a state of complete physical , mental and social well-being , and not merely the absence of disease or infirmity ” . In this definition by the World Health Organization, WHO, since 1946, health represents " one of the fundamental rights of every human being, regardless of race , religion , political opinion, economic or social condition. » [ 1 ] , [ Note 1 ] . It implies the satisfaction of all the fundamental needs of the person, whether emotional , health , nutritional , social or cultural. [ 2 ] . But this definition confuses the notions of health and well-being [ 3 ] .
Moreover, " health results from a constant interaction between the individual and his environment " and therefore represents " this" physical, mental and social capacity of people to act in their environment and to fulfill the roles they intend assume in a manner acceptable to themselves and to the groups to which they belong ” [ 4 ] .
In 1973, René Dubos presented health as “ the situation in which the organism reacts by adapting while preserving its individual integrity. It is the physical and mental state relatively free from discomfort and suffering that allows the individual to function as long as possible in the environment in which chance or choice has placed him. » [ 3 ] , [ 5 ]
For René Leriche in 1936, “ health is life in the silence of the organs. » [ 3 ] , [ 5 ]
In traditional (“primitive”) societies, health is generally as much a matter for the individual as for the group. It is intertwined with animist and religious beliefs, and the role of healers (shamans, sorcerers, etc.) who use local pharmacopoeia, touch and practices relating to magic, divination, or psychology. .
From the 18th century , disease gradually ceased to be considered inevitable and the body once again became a subject of concern . This movement first concerns the elites, then gradually spreads to society as a whole. Health then becomes a right that States must guarantee.
Concepts, main health topics
The state of health is researched both for each individual, with clinical medicine , or for a population, with public health [ 6 ] .
The health of a population is conventionally assessed first by mortality and morbidity rates , along with life expectancy [ 7 ] .
Health is a relative concept [ 8 ] , “sometimes not presented as a corollary of the absence of disease: people with various conditions are sometimes considered to be “in good health” if their disease is controlled by treatment . On the other hand , some diseases can be asymptomatic for a long time , which means that people who feel healthy may not really be. »
“ Perceived health status ” : this is one of the health status indicators. It has been published every two years since 2002, for OECD countries . After an upward trend from 2002 to 2008, it fell by several points in 2010 . when considering all genders, the same is true for the highest income quintile ” [ 9 ] . In 2008, 74.9% of men considered themselves to be in good or very good health, compared to 70.6% in 2010. For women, this rate rose from 70.1% to 66.5% [ 9 ] .
Mental health can be considered a very important factor in physical health for the effects it produces on bodily functions. This type of health relates to emotional and cognitive well-being or an absence of mental disorder [ 10 ] . The World Health Organization (WHO) defines mental health as "a state of well-being in which the individual realizes his own capacities, can cope with the ordinary stresses of life, and is able to contribute to his community” [ 11 ]. There is no official definition of mental health. There are different types of mental health issues, some of which are commonly shareable, such as depression and anxiety disorders , and some that are not common, such as schizophrenia or bipolar disorder .
For the World Health Organization (WHO), reproductive health is a component of the right to health [ 12 ] .
This recent concept evokes the good transmission of genetic heritage from one generation to another. It goes through the quality of the genome , spermatozoa and ova , but also through safe motherhood , the absence of sexual and gender -based violence , the absence of sexually transmitted diseases (STDs), family planning , sex education , access to care , reduction of exposure to endocrine disruptors , etc.
A number of pollutants ( dioxins , pesticides , radiation , hormonal decoys , etc.) are suspected of being, possibly at low or very low doses, responsible for a deletion of spermatogenesis or an alteration of the ovaries or the processes of fertilization and then development of the embryo. Some are also carcinogenic or mutagenic (they contribute to the increased risk of malformation and spontaneous abortion).
Reproductive health care covers a set of services, defined in the Program of Action of the International Conference on Population and Development (ICPD) held in Cairo ( Egypt ) in : counselling, information, education, communication and family planning services; pre- and post-natal consultations, safe deliveries and mother and child care; prevention and appropriate treatment of infertility; prevention of abortion and management of its consequences; treatment of genital infections, sexually transmitted diseases including HIV / AIDS ; breast cancer and genital cancers, as well as any other reproductive health disorder; and active deterrence of harmful practices such as female genital mutilation.
Health at work
Occupational health is one of the main health topics identified by the WHO [ 13 ] .
Health and environment
A determinant of health is a factor that influences the health status of a population either alone or in combination with other factors.
Hygiene is the set of behaviors that contribute to keeping individuals in good health . In particular, they ask to be able to distinguish between “good microbes” and those which are pathogenic or may become so in certain circumstances. These circumstances hygiene seeks to make them less likely, less frequent, or suppressed. After a hygienist phase, the short-term effectiveness of which is indisputable, an increase in allergies, autoimmune diseases, antibiotic resistance and nosocomial diseases considered worrying appeared. Finding the right balance between exposure to risk and the usual medical solution is made difficult in a context of increased exposure to cocktails of complex pollutants (pesticides in particular) and hormonal disruptors , global societal and climatic changes (cf. emerging diseases , pandemic risk , zoonoses , risk of bioterrorism , etc.).
The fight against nosocomial infections in the hospital, or against food poisoning for example, was born after the discovery of asepsis under the influence of, for example, Ignace Semmelweis or Louis Pasteur . Individual and collective behaviors are of primary importance in the fight against epidemics or pandemics .
This discipline of hygiene therefore aims to control the environmental factors that can contribute to an alteration of health, such as pollution for example, with paradoxical problems to manage: for example, the improvement of hygiene conditions seems to have paradoxically been able to promote the recurrence of diseases such as poliomyelitis and various autoimmune diseases and allergies.
Diet and lifestyle
Many risk factors are intrinsically linked to lifestyle. Body care, physical activity, diet, work, drug addiction problems, in particular, have an overall impact on the health of individuals.
- Nutrition : Food - Trace element - Food
- Hygiene products: Sunscreen - Toothpaste - Condom - Soap
- Addictions & dependencies: Alcohol - Cannabis - Cocaine - Tobacco - Pathological gambling
Many risks and dangers are related to the field of health [ 14 ] , human evolution and also changes in his way of life are not without consequences. Food and new technologies are also risk factors in France and in the rest of the world. Rhythms, work rates; inappropriate gestures are very important factors on health. They cause psychosomatic disorders and sometimes lifelong disabilities.
Four factors would make it possible to lengthen the lifespan considerably [ 15 ] : absence of tobacco , consumption of alcohol equal to or less than half a glass per day, consumption of 5 fruits and vegetables per day, physical exercise of half a hour a day. The whole would give an increase in the life expectancy of 14 years compared to the non-respect of these factors [ 16 ] .
From the strict point of view of food, many concordant studies conclude that an exclusively vegetarian diet can limit the risk of cancer and cardiovascular disease, and therefore have a longer life expectancy in good health [ 17 ] , [ 18 ] . Studies highlight both the benefits of a diet high in vegetables and fruits and the relative risks of eating meat, fish, and dairy [ 19 ] , [ 20 ] , [ 21 ] , [ 22 ]. Synthetic dietary supplements would absolutely not be necessary [ 23 ] , [ 24 ] .
Other avenues are being explored to extend healthy lifespan: fasting [ 25 ] , intermittent fasting [ 26 ] and caloric restriction [ 27 ] .
Moreover, the trans-national "moral hygiene" begun in the 19th century ( not to be confused with the alternative medicine created by Herbert Shelton ) is a doctrine against the "laxity of morals", which would be the best way to guarantee health. It is this current which has for example declared the fight against syphilis or alcoholism as a national priority. It is also he who declares that if the obese are fat, it is that they are greedy and lazy, or that smokers have no will; It seems to persist in certain policies and campaigns to inform and educate citizens about hygiene.
This is a field, sometimes called " environmental health ", which has been developing since the end of the 20th century , following the realization that the environment , especially when it is polluted, is a major determinant of health.
Acute or chronic pollution , whether biological, chemical, due to ionizing radiation, or due to sound or light (these factors can add or multiply their effects) is an important source of disease.
In the European Union , the Commission has adopted () a " Community strategy on health and the environment " [ 28 ] , translated into, into an “ Action Plan ” [ 29 ] (2004-2010), which targets so-called “environmental” diseases in particular. This concerns asthma and respiratory allergies , seeking more generally to “ better prevent health alterations due to environmental risks ” (including exposure to pesticides and their residues). Permanent health monitoring systems must identify emerging threats (including nanotechnology , GMOs , emerging diseases, impacts of climate change, etc.) and assess the health impact according to actions carried out at community and national level. An “ environment and health action plan ” will be developed in order to implement this strategy; in addition, a consultation process has been launched. The action plan aims to take stock of existing scientific knowledge and to assess the consistency and progress made in the installation of the Community legislative framework in the field of health and the environment . A new health information system is planned " which will also work in the field of the environment " and wants to become " the most important source of reliable data for assessing the impact of environmental factors on health ” [ 30 ] . These aspects will be coordinated with rapid response systems and an integrated approach “ aimed at addressing the environmental determinants of health ”.
As regards France more specifically, a first National Health-Environment Plan was launched in 2004 and a second in 2009, following the Grenelle Environment Forum . The results of the actions carried out should be made in 2013.
Public health designates both the health status of a population assessed via health indicators (quantitative and qualitative, including access to care ) and all the collective means likely to treat, promote health and improve the living conditions.
Public health domains
The notion of public health covers several fields:
- occupational health including occupational medicine and sometimes epidemiological approaches ;
- the management of prevention campaigns , which must influence the other sectors of society to promote health there (economy, schools, traffic, housing, environment, lifestyle, etc.), vaccination , etc .;
- the organization of healthcare networks: first aid , hospitals , liberal medicine, emergency medicine, etc.;
- initial and continuing training for the medical and paramedical professions;
- social security and health insurance ( Social Security in France );
- medical and pharmacological research .
Health policies around the world
Health rules are the subject of international texts enacted by the WHO or the FAO ( Codex alimentarius for food).
The European Union has produced many directives , regulations or decisions to protect the health of consumers or animals consumed.
Health promotion as defined by the WHO is the “ process which gives people the means to ensure greater control over their own health, and to improve it ” [ 31 ] . This approach stems from a concept defining "health" as the extent to which a group or an individual can, on the one hand, achieve its ambitions and satisfy its needs, and on the other hand, evolve with the environment or adapt to it. -this.
Health is taken into account by the law , including from the point of view of working conditions .
Health crises are major pandemics , which affect between ten people (case of high-profile crises that affect developed countries , such as certain food crises ) and millions of people. They can have considerable economic, social and political costs.
The WHO was also created so that a pandemic such as that produced by the Spanish flu does not happen again with the same effects (30 to 100 million deaths depending on the source).
The sums at stake in the field of health are considerable, both for the costs induced by illnesses, pollution [ 32 ] and absenteeism, and by the market for care and drugs (in 2002, the world drug market was valued at $430.3 billion, compared to $220 billion in 1992). The pharmaceutical market increased by 203 billion euros. And medical consumption is growing faster than GDP in developed countries.
Health crises such as a pandemic can have considerable economic, social and political costs.
Health as a concept can be an object of anthropological study. As reported by Roy [ 33 ] , it is often conceptualized as a social construction by anthropologists since the relationship that societies have with it is very variable from one to another, and also according to time. Anthropological work will therefore seek to better understand the experience that social and cultural groups have of health. This object of study, to demonstrate methodological rigor, must be placed in its global context, particularly through social changes. We then seek to understand the phenomena of the health/disease relationship, although more and more the health/life schema takes place. To put it another way, according to Massé [34 ] , medical anthropology is interested in how social actors define good or bad health, and how diseases are treated in this context.
Some theoretical approaches were born in medical anthropology, reported by Roy [ 33 ] . Among them, that of medico-ecological theory, that of phenomenology and that of the criticism of medicine and international health.
- The medico-ecological theory was formulated by Alexander Alland [ 35 ] in the early 1970s, but was taken up by others a few years later. It assumes that human groups adapt their culture to the environment. This theory proposes the idea that cultural adaptation is intimately linked to biological adaptation according to the environment and milieu in which the group finds itself. Thus, health is linked to these external transformations.
- The phenomenological approach develops in parallel to the latter. Authors such as Kleinman [ 36 ] and Good [ 37 ] are a point of origin, seeking to restore subjectivity to the human experience of health, moving away from the objectivity advocated by medicine. To do this, experiential and semantic perspectives are mobilized.
- The critical approach to medicine and international health developed in the 1960s. Its object was the political and economic, and therefore global, conditions in which health and illness were experienced: social inequalities shaped access information, health maintenance resources and treatment. A key text to understand this movement is notably that of Baer, Singer and Johnsen [ 38 ] .
Many media and programs specialize in health topics. Here is a selection:
- The Health Magazine , on France 5
- 36.9 , on Swiss Radio Television
- What's new doc?, on TV5 Monde [ 39 ]
- Radio Public Health
- Radio France internationale , Priorité santé program [ 40 ]
- Radio Canada premiere chain , RDI Santé program [ 41 ]
- Make way for health [ 42 ]
- Health Magazine
- Alternative health
- Environment, Risks and Health
- Health On the Net Foundation is a foundation that tells Internet users which websites they can obtain accurate and serious information in the field of health.
- Health-EU Portal
- Carenity ( health social network on the internet for patients and their families).
Notes and references
- This definition is included in the preamble adopted by the International Conference on Health in New York (USA), from June 19 to 22, 1946; This preamble was signed on July 22, 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100 ); It came into force on April 7, 1948 with the Constitution of the World Health Organization. This definition has not been changed since.
- World Health Organization , " WHO Constitution: WHO remains firmly committed to the principles set out in the preamble to its Constitution " , su who.int/en (accessed)
- Bernard Basset, Jacques Chaperon, Marie-Odile Frattini and Pascal Jarno, Hospital and public health , Rennes, ENSP , ( ISBN 2-85952-746-X )
- Catherine Gourbin and Bernard Wunsch, Demography: Analysis and synthesis: III The determinants of mortality , Paris, INED ,, 478 p. ( ISBN 2-7332-2013-6 ) , p. 9-10
- Hervé Anctil, Health and its determinants: better understanding to better act , Quebec: Ministry of Health and Social Services, Communications Department, The Communications Department of the Ministry of Health and Social Services,, 26 p. ( ISBN 978-2-550-63957-2 , read online [www.msss.gouv.qc.ca Documentation section, Publications section.]) , p. 6 out of 26
- " Definitions of health by René Dubos " , on agora.qc.ca (consulted on)
- Guillaume Vincenot and Nicolas Brault, Health, society, humanity: L1 Health in files , Paris, Hachette , coll. “PAES in files”,, 400 p. ( ISBN 978-2-01-181310-7 , read online ) , record 122
- Jacques Chaperon, Marie-Odile Frattini, Pascal Jarno, Catherine Keller and Bernard Basset, Hospital and public health: Methodological introduction , Rennes, ENSP ,, 80 p. ( ISBN 2-85952-746-X )
- Maryse Gaimard, Population and health in developing countries , Paris, L'Harmattan , coll. "People",, 308 p. ( ISBN 978-2-296-56316-2 ) , p. 15
- Morbidity: Perceived state of health; Percentage of the population considering themselves to be in good or very good health Source: www.OECD Health Data 2012, Data: Irdes, ESPS survey).
- " What is Mental Health? " , on About.com , (consulted the) .
- “ WHO ” (consulted on) .
- “ WHO | Reproductive Health ” , on WHO (consulted on)
- WHO , “ Occupational Health ” (accessed)
- Danger Health - Effect Health - Risk Health - Cause consequence Health - Health EN .
- Public Library of Medicine , issue of the week of January 9, 2008, quoted in Le Figaro , January 9, 2008, page 12.
- Healthy living can increase longevity by 14 years , in Le Figaro , January 9, 2008, page 12.
- Vegetarian diet linked to longer lifespan
- Does low meat consumption increase life expectancy in humans? .
- Dietary fat and protein in relation to risk of non-Hodgkin's lymphoma among women .
- Meat and fat intake as risk factors for pancreatic cancer: the multiethnic cohort study .
- Intake of fat, meat, and fiber in relation to risk of colon cancer in men .
- Prospective studies of dairy product and calcium intakes and prostate cancer risk: a meta-analysis .
- High dose vitamin supplements may reduce lifespan by up to a quarter: Animal data .
- Antioxidant vitamins and mineral supplementation, life span expansion and cancer incidence: a critical commentary .
- Why Fast: Longevity .
- Signaling through RHEB-1 mediates intermittent fasting-induced longevity in C. elegans .
- Temporal linkage between the phenotypic and genomic responses to caloric restriction .
- Communication from the European Commission [PDF] .
- Action Plan (8 pages, [PDF] ).
- Information page from the commission on health and its environmental determinants .
- Definition given in 1986 , on the occasion of the Ottawa charter for the promotion of health.
- In France, Afsset launched a study in 2007 on the costs for health insurance of certain pollution-related pathologies.
- Roy Bernard (2018) " Health ", in Anthropen.org , Paris, Editions of contemporary archives.
- Massé, R., Culture and public health , Montreal, Gaëtan Morin editor,
- Alland, A., Adaptation in Cultural Evolution. An Approach to Medical Anthropology , London, Columbia University Press ,
- Kleinman, A., Patients and Heallers in the context of Culture?, An Exploration of the Borderland Between Anthropology, Medicine and Psychiatry , Berkeley, University of California Press ,
- Good, BJ, Medicine, Rationality, and Experience. An Anthropological Perspective , Cambridge, Cambridge University Press ,
- Baer, HA, Singer, M., and Johnsen, JH, " 'Toward a Critical Medical Anthropology' ", Social Science & Medicine , vol. 23, No. 2 ,, p. 95–98
- Website What's new doc? .
- Health Priorities website .
- RDI Health website .
- Place à la santé website .
See as well
- André Rauch, History of health , PUF , What do I know? , 1995
- Georges Canguilhem , Health, vulgar concept and philosophical question , Sables, Pin-Balma, 1990
- Health Resources :
- Medical Subject Headings
- NCI Thesaurus
- Research related resource :
- Records in general dictionaries or encyclopedias :
- List of health topics , WHO site
- (en) Global Health , Our World in Data website
- Health data
- List of diseases
- Environmental medicine
- National environmental health plan
- Health policy
- Prevention , of cancer
- Health promotion
- Quality of life
- Community Health
- Health in rural areas
- Environmental health
- Public health
- Sexual health
- All articles beginning with "Health"
- All pages with “health” in the title