The Basics Series is our starting point for those who may be new to exercise and training. In this series we will define and discuss some fundamental concepts in health and fitness.
What is Health?
The World Health Organization defines Health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. The WHO’s definition of health hasn’t changed since 1948, so we would assume they’re pretty satisfied with it.
As it is with Fitness, this definition is a bit nebulous and doesn’t give us much to use at face value, so we will need to spend a little bit of time unpacking each part of it in order to get some practical use out of it.
Let’s break the definition of Health down into four separate parts, define what each of those mean, and then discuss what we can do about improving them.
We can break the WHO’s definition of health down into four components:
1 – absence of disease or infirmity
2 – physical well-being
3 – mental well-being
4 – social well-being
The Absence of Disease or Infirmity
Of the four components of health, this component is the one that is usually the most apparent. The consequences of neglecting your social well-being may take years to materialize and even then be hard to quantify, but if you have a staph infection, it’s quite obvious. The immediacy may vary (heart attack vs chronic asymptomatic high blood pressure), but knowing whether or not you’re free from disease is usually pretty easy to evaluate:
“My leg is broken.”
“I have high blood pressure.”
“I had bronchitis, but now I don’t (ain’t nobody got time for that!).”
Physical Well-Being
Are you physically capable of pursuing and participating in all of the physical activities that you want to do or have to do? Do you maintain a healthy body weight? Do you pay attention to what you eat? Do you practice good sleep hygiene? Physical Well-Being is likely the component of health that most people think of when they consider what they should be doing to improve their health.
“I should exercise more.”
“I need to eat better.”
“It might be a good idea to stop smoking crack.”
Mental Well-Being
Once again leaning on the WHO, mental health can be defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. The significance of mental well-being shouldn’t be ignored, considering that almost 1 in 5 adults have some form of a mental health issue.
Social Well-Being
Being a little bit more elusive than the other components of health, social well-being refers to one’s ability to interact with people around them. Having supportive and meaningful relationships and being involved in the greater community can lead to a longer, healthier life, improved immune function, faster healing times, higher cancer survival rates, reduced risk of chronic illness, and more.
I tend to like the WHO’s definition of health. There are the obvious components like being free from illness and your physical well-being, but your mental and social well-being are also important. Now that we have a better grasp of what defines the different components of health, let’s look at how we can improve it.
Improving Health
So, we know health is composed of being free from illness and having good physical, mental, and social well-being, but how do we prioritize our efforts to make sure that we’re getting the most bang for our buck when we actually do try and make a change? We have a decent grasp of what each component of health looks like, but how do we decide which one to focus on first? The concept of health is a very large subject, but we can still draw some general recommendations by looking at health from a certain perspective.
Let’s start by defining what exactly we are trying to do when we are trying to improve our health? When you think about being “more healthy”, what does that mean to you? What advantages does a “healthy person” have over an “unhealthy person”? Likely, the main objective when trying to improve health is to increase longevity and quality of life, or, in other words, to reduce the risk of premature death.
To “improve health” is to therefore “reduce the risk of premature death”. How do we reduce the risk of premature death? Well, to put it bluntly, we have to find out what it is that is most likely to kill us and then do what we can to reduce the risk of that happening.
Leading Causes of Death
In 2017, the twelve leading causes of death in the US were as follows:
1 – Heart Disease – 23%
2 – Cancer – 22%
3 – Accidents – 6%
4 – Chronic Lower Respiratory Disease – 6%
5 – Stroke – 5%
6 – Alzheimer’s Disease – 4%
7 – Diabetes – 3%
8 – Influenza/Pneumonia – <2%
9 – Kidney Disease – <2%
10 – Suicide – <2%
11 – Septicemia – <2%
12 – Chronic Liver Disease – <2%
As you can see, heart disease and cancer are, by far, the most common causes of death, accounting for almost half of all deaths. If you add in accidents, chronic lower respiratory disease, stroke, alzheimer’s disease, and diabetes, then you’re up to approximately 70% of all deaths. From a general perspective, if we focus our efforts on reducing risk for the top seven causes, then we will likely improve our outcomes for health.
Reducing Your Risk
Before focusing on the top seven causes, the first step in reducing risk for you is to evaluate your specific circumstances. For example, if you have a family history of certain types of rare cancers, then that should take priority. Likewise, even though suicide is number ten on the list and only accounts for <2% of deaths, if you have a history of depression then then your priorities should be different. So and and so forth. This highlights the importance of visiting your healthcare provider often for “routine maintenance”.
Once you’ve evaluated your family history and particular circumstances, then it’s time to identify the risk factors for each of the leading causes of death and determine what you can do to reduce the likelihood of each one.
Let’s take a look at what the risk factors are for the top seven leading causes of death.
Heart Disease:
-High Blood Pressure*
-High Cholesterol*
-Diabetes
-Poor diet
-Physical Inactivity
-Obesity
-Excessive alcohol consumption
-Smoking/Tobacco use*
-Heredity/Genetics
-Age
-Sex
-Race/Ethnicity
*Key risk factor
Cancer:
-Age
-Heredity/Genetics
-Excessive alcohol consumption
-Cancer-Causing Substances
-Chronic Inflammation
-Poor diet
-Hormones
-Immunosuppression
-Infectious Agents
-Obesity
-Radiation
-Sunlight
-Smoking/Tobacco use
Accidents: (Three Leading Causes)
-Unintentional Falls
-Motor Vehicle Traffic Death
-Unintentional Poisoning
Chronic Lower Respiratory Disease:
-Smoking/Tobacco use
-Indoor/Outdoor Air Pollution
-Allergens
-Occupational Agents
-Poor Diet
-Physical Inactivity
-Age
-Heredity/Genetics
Stroke:
-High Blood Pressure
-High Cholesterol
-Smoking/Tobacco use
-Diabetes
-Poor Diet
-Physical Inactivity
-Obesity
-Certain Heart/Vessel Conditions
-Sickle Cell Disease
-Drug abuse
-Excessive alcohol consumption
-Poor sleep habits
-Age
-Heredity/Genetics
-Sex
Alzheimer’s Disease:
-Age
-Heredity/Genetics
-Head injury
-Heart Disease
-Diabetes
-Stroke
-High Blood Pressure
-High Cholesterol
Diabetes:
-Age
-Heredity/Genetics
-Race/Ethnicity
-Obesity
-High Blood Pressure
-High Cholesterol
-Physical Inactivity
-History of Heart Disease or Stroke
-Depression
-Polycystic Ovary Syndrome
Some of the risk factors are out of our control. For example, your age, family history, and genetics are risk factors for all seven causes of death, but there is nothing that you can do about them other than to not let them deter you from doing something about the risk factors that you CAN control.
When looking at the lists above, we start to see that certain conditions or behaviors are risk factors for most, if not all, of the top seven causes of death. These are the particular risk factors we should pay close attention to, as addressing them should provide us with a comprehensive reduction in risk.
The major risk factors to focus on are…
1 – High Blood Pressure
2 – High Cholesterol
3 – Obesity
4 – Smoking/Tobacco use
5 – Excessive Alcohol Consumption
6 – Poor Diet
7 – Physical Inactivity
At the very least, pay attention to these seven things before anything else. Once you have these dialed in, you can focus on other risk factors to further reduce your risk (safe driving, avoiding pollution, not accidentally poisoning yourself (DOH!), etc…).
Looking at these seven risk factors closely, we can see how they relate to one another, and we can begin to tie them together with the idea of health encompassing not just freedom from illness but also physical, mental, and social well-being.
For example:
-High blood pressure and high cholesterol are directly linked to obesity, which is directly affected by physical inactivity and poor diet.
-Someone with a strong support system of friends and family (social well-being) will likely be much more successful with giving up tobacco or starting a new exercise regimen.
-Someone with strong self confidence and good stress management skills (mental well-being) will likely be able to resist the temptation to cheat on their weight loss diet than someone who lacks self confidence and coping skills.
-And so on…
Rather than attempting to reduce the likelihood of literally every possible risk factor for every possible cause of death in order to improve health, it makes sense to concentrate on what the current data says is most likely to harm us. We focus our efforts on the factors that are most prevalent and that we can control, and we simply just don’t stress about the ones that we can’t control or that are extremely unlikely to affect us. This, to us, seems like a reasonable approach for most folks who want to maximize their health without getting to neurotic about things.
Putting It All Together
Want to maximize your health? Do the following. . .
1 – Find a good healthcare provider and see them regularly – this will ensure that you’re taking care of your specific needs as well as getting routine appropriate screening (blood pressure, blood work, etc).
2 – Manage your weight – A waist circumference of <40″ for men and <35″ for women is a good place to start.
3 – Don’t smoke.
4 – Limit alcohol consumption – No more than two drinks per day.
5 – Eat of sufficient quantity and quality – Eat enough to maintain a healthy weight, and, if possible, stick to lean meats, fruits, vegetables, whole grains, and unsaturated fats.
6 – Exercise regularly – The Physical Activity Guidelines for Americans is a great place to start. Here’s a free program that covers everything you need to know.
7 – Don’t neglect your mental well-being – pursue a challenging but rewarding career, practice good financial habits, make time for self-improvement and reflection, etc.
8 – Don’t neglect your social well-being – seek out positive relationships and toss out toxic ones, be active in your community, be a part of something bigger than yourself, etc.
Conclusion
Health, like fitness, is a vast subject that can be overwhelming if you’re not sure where to start. Pair this with the near infinite number of differing opinions on what health is and what you should do to improve it, and it’s easy to just say “forget it” and not even try.
We’ve spent a little time defining and breaking down the World Health Organization’s definition of health into understandable chunks, and we’ve provided a place to start and some direction for those interested in improving their health.
Thank you for reading, and let us know what you think!
Sources:
https://www.who.int/
http://www.mentalhealthamerica.net/
https://www.counseling.org/news/aca-blogs/aca-member-blogs/aca-member-blogs/2016/05/31/evidence-for-social-wellness—part-1
https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
https://www.healthline.com/health/leading-causes-of-death
https://www.cancer.gov/about-cancer/causes-prevention/risk
https://www.who.int/gard/publications/Risk%20factors.pdf
https://www.strokeassociation.org/STROKEORG/AboutStroke/UnderstandingRisk/Understanding-Stroke-Risk_UCM_308539_SubHomePage.jsp
https://www.alz.org/alzheimers-dementia/what-is-alzheimers/causes-and-risk-factors
https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
