Dear David:  I couldn't agree more with your insightful comments.  AND, it is  difficult to wrestle some of these concepts to the floor. Unlike the field of mathematics where it is crucial to have clear , unambiguous definitions, health promotion is still so much tied to individual life experience, cultural impact and expectations which may be markedly divergent. Still, a working definition is urgently needed to inform our practice. The present one under discussion does not do that.

Best Regards,
Grace Ross M Sc H. Prom
Manager, Youth Health programs
Waterloo Region Community Health Department
[log in to unmask]

>Dear All
>
>I tried to reply to the other list but without success.  I hope I'm
>not alone in my concern about this.  Here's what I tried to post:
>
>Dear Colleagues
>
>Excuse me butting in like this but I came across the following
>message posted on another health promotion listserve:
>
>> >     You might be interested to know that as part of the process of "Review
>> >     of the Constitution of the World Health Organization" the Exectutive
>> >     Board of WHO has proposed to propose the following definition of
>> >     health to the World Health Assembly in May 1998:
>> >
>> >     "Health is a dynamic state of complete physical, mental, spiritual and
>> >     social well-being and not merely the absence of disease or infirmity."
>> >
>> >     Ilona Kickbusch
>>
>
>I wonder if this is meant seriously?  If it is then I find it very
>hard to believe that the 'Executive Board', after years of
>intelligent debate by thoughtful health promoters about this
>supremely important notion, can come up with something so plainly
>vacuuous.
>
>The definition in the WHO Constitution 1948 has been
>extensively criticised, as everyone knows.  Does the WHO intend to
>ignore this criticism and the many accompanying constructive
>suggestions altogether?  This is not a trivial matter.  A definition
>of health is not something that one can 'knock together', nor is it
>something that should emerge as part of a political process (this
>would be like asking a mathematician to compromise about a proof
>because Arthur or Albert is unhappy).  The WHO's definition of health
>asserts - or at least ought to assert - the purpose of the
>organisation.  But what do we have?
>
>The only change to the 1948 effort is the addition of 'dynamic'.
>I must say I didn't think it possible to make the 1948 version _more_
>meaningless, but I was wrong.  So:
>
>"Health is a dynamic state of complete physical, mental, spiritual and
>social well-being and not merely the absence of disease or
>infirmity."
>
>What does this mean?  If health is dynamic then it is changing.  If
>something is changing it cannot at the same time be complete in the
>way indicated here.  The definition irrevocably confuses the ideas of
>process (the dynamic bit) and end (the state) bit.
>
>The 'definition' has limitless meaning and is therefore useless as a
>practical guide to health promoters.  What does 'spritiual
>well-being' mean for instance?  Obviously it depends what one means
>by 'spiritual'.  If you read the literature on spirituality you will
>find a host of different meanings in use - many of them incompatible
>with each other.  What does 'social well-being' mean?  Everyone knows
>that this is a contested notion - different societies, different
>cultures think of this idea in often widely divergent ways - social
>well-being to the nomad may not be social well-being to the arable
>farmer, or the greedy business woman, or the nun .....  Isn't this
>just obvious?  Any decent definition must at least explain what
>'social well-being' is taken to mean - if it is supposed to mean
>whatever different communities say it means then we should be told
>(and we should perhaps begin to think what we should so if 'their'
>idea is not 'ours').  If it is supposed to be a universal notion then
>we should be told its content (which would be fun, wouldn't it?).
>
>I could go on, of course, but any point I could make is very
>well-known already - at least outside the walls of the Executive Board
>committee room.
>
>It boils down to this.  Health promotion is a Magpie Profession
>which borrows ideas and methods from here there and everywhere, and
>which tries to welcome people with many different points of view.
>Given this there is an obvious - though superficial - advantage in
>having 'catch all' definitions - who cannot be initially attracted by
>definitions of limitless meaning after all?
>
>The trouble is that this cannot go on forever.  If health promotion
>is to become a profession or a serious discipline it has to start to
>develop intelligent theories about what it is, what it isn't, what
>it is alright to do and what is beyond its remit (nothing is beyond
>its remit on the latest definition by the way).
>
>Health promotion urgently needs to work out theories about itself -
>at the very least to help offer guidance to fieldworkers who can only
>be confused by the WHO's nebulous pronouncements.  How much longer
>are health promoters expected to put up with this nonsense?
>
>Sincerely
>
>
>
>David Seedhouse
>Auckland University
>New Zealand
>
>
>Any thoughts?
>
>