367. reimagining health

When people talk about health, they often assume it's a straightforward and easily definable concept: either you're healthy or you're not. But the moment you try to explain what health actually is, the idea becomes much less clear. Is it how you feel? Is it how your body performs? Or is it something broader that includes how you live, think, and function in the world?

There is a recognized field called the philosophy of medicine, or the philosophy of health and disease, but there isn't one dominant, universally accepted philosophy of health in the same way there are recognizable schools like Stoicism, utilitarianism, existentialism, or pragmatism. The closest thing we have to an official global definition comes from the World Health Organization, which defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

The WHO definition falls short as a complete philosophy of health and instead acts more like an ideal. It says health is more than “not being sick,” which is important, but it doesn't fully explain how a person should live, what tradeoffs matter, what the body is for, how much responsibility belongs to the individual versus society, or how to judge health when someone has pain, disability, disease, aging, trauma, or chronic stress.

A better way to frame it is this: there are many different ways to think about health, but no single definition or perspective fully captures what it means in practice.

The main reason is that health sits between biology, morality, culture, medicine, politics, economics, and personal meaning. It isn't purely objective, nor is it purely subjective. A blood marker can be objectively abnormal, but whether someone is healthy cannot always be reduced to that marker. A person can have perfect labs and still be miserable, addicted, socially isolated, weak, anxious, and unable to function. Another person can have a chronic condition but live with strength, purpose, connection, resilience, and high function.

This is why philosophers and physicians distinguish between disease, illness, and sickness. Disease can refer to biological dysfunction, illness to the lived experience of being unwell, and sickness to the social role or recognition of being unwell. Those categories overlap, but they are not identical. Someone can have disease without feeling ill. Someone can feel ill before a diagnosis appears. Someone can be treated socially as sick even when their deeper problem is environmental, psychological, relational, or behavioral.

The major split is usually between two views.

One view is the biological view. In this view, health means normal biological functioning. This is associated with thinkers like Christopher Boorse, who treated health as a theoretical biological concept. The strength of this view is that it keeps health grounded in physiology instead of preference, ideology, or vague wellness language. The weakness is that normal function doesn't fully capture pain, meaning, adaptation, environment, social conditions, or human flourishing. You could describe this view as functional, in the sense that it focuses on whether the system is operating as it is supposed to.

This view becomes more complicated when applied to aging, disability, or chronic conditions. If health is defined only by normal biological functioning, then many predictable features of aging or disability can be treated as straightforward defects. But that misses something important: a person may have limitations, adaptations, or medical realities and still possess a high degree of health in the lived sense if they can function, adapt, participate, and pursue a meaningful life.

The other view is the holistic view. In this view, health is about the person’s ability to live well, pursue meaningful goals, participate in life, and adapt to challenges. This includes thinkers like Georges Canguilhem and Lennart Nordenfelt, and it fits better with real life because health isn't only about whether the organism is working, it's also about whether the person can function in the world they inhabit. A useful parallel term here is integrative or adaptive, since this view looks at how different factors come together and balance to make health possible, rather than focusing only on isolated biological function.

That is why more recent definitions have moved toward health as adaptability. A widely cited proposal in the British Medical Journal defines health as “the ability to adapt and to self-manage” in the face of physical, social, and emotional challenges. That gets closer because health isn't a perfect static state — it's dynamic, requiring the capacity to respond.

So if we had to build a generally recognized philosophy of health from the broad consensus, it would probably be something like this:

Health is the cultivated capacity to function, adapt, and pursue a meaningful life through the integration of body, mind, behavior, environment, and community.

Or put more simply: Health is the capacity to live well in reality.

It's not endless optimization, perfect biomarkers, visible leanness, or total control. It also isn't static or universally experienced in the same way across all people, stages of life, or environments. A real philosophy of health would probably rest on a few core principles that account for both its biological realities and its lived complexity.

First, health is functional. The body should support life, not become the entire purpose of life. Strength, mobility, energy, sleep, digestion, cognition, and emotional regulation matter because they increase someone’s ability to act.

Second, health is adaptive. A healthy person is not someone who never experiences stress, illness, pain, or disorder. A healthy system can respond, recover, reorganize, and continue functioning. This is why the ability to adapt and self-manage is such a useful model.

Third, health is multidimensional. Physical, mental, social, and environmental health cannot be fully separated. The WHO definition gets this part right by refusing to define health as merely the absence of disease.

Fourth, health is both personal and collective. Individuals have responsibility for their habits, but people do not choose all of their conditions. Food access, income, stress exposure, education, neighborhood safety, healthcare access, and culture shape health. One criticism of the self-management model is that it can accidentally blame people who have fewer resources or lower capacity to adapt.

Fifth, health isn't the same as morality. Being healthy doesn't make someone virtuous, and being sick doesn’t make someone a failure. This matters because modern wellness culture often turns health into a moral hierarchy.

Sixth, health exists to support a good and meaningful life. The purpose of health is to expand what life allows: to love, work, think, create, endure, contribute, enjoy, and participate.

Part of what makes a philosophy of health so difficult is that health is too broad to belong to one discipline. Medicine wants diagnosis. Biology wants function. Public health wants population outcomes. Psychology wants resilience and behavior. Philosophy wants meaning and value. Fitness wants performance and body composition. Spiritual traditions often want wholeness, discipline, or harmony.

But the closest modern synthesis would be this:

Health centers on capacity rather than perfection. It reflects a person’s ability to meet life with enough physical function, mental clarity, emotional resilience, social connection, and environmental support to pursue a meaningful existence.

That is the most defensible starting point for a philosophy of health, but it still feels incomplete on its own. A philosophy of health cannot stop at defining what health is in theory; it also has to extend into practice. It needs to account for how health is actually built over time, how it's maintained, how it breaks down, and how it can be restored when it is lost.

Health, to me, isn't just the absence of disease, and it isn't something that can be fully understood through lab numbers, body fat percentage, or appearance alone. It is a state of bodily function, movement quality, emotional steadiness, and physiological resilience that gives a person the freedom, confidence, and capacity to live the life they want.

Someone can look fit and still be unwell. Someone can have impressive numbers and still lack energy, stability, strength, clarity, or peace. Real health is when the body works well, adapts well, and supports a high quality of life without constant limitation, discomfort, or dependency.

This is where my view becomes more specific. I believe health is built by living in alignment with what human beings fundamentally need. That includes movement, sunlight, connection, quality food, sleep, stress management, purpose, time in nature, and daily habits that work with our biology rather than against it.

I don't see the body as a machine that simply needs to be medicated whenever symptoms appear. I see it as a living system that needs to be understood, supported, and respected. Symptoms are not random inconveniences to suppress. They are often signals that something deeper may be out of order. That does not mean medicine has no place. It means medicine should not be the only lens. Real health, in my view, comes from addressing causes rather than only managing consequences.

This also means that health cannot be separated from behavior. The body is shaped by what it repeatedly experiences. The food someone eats, the way they move, the sleep they get, the stress they carry, the relationships they maintain, the light they see, the environments they inhabit, and the standards they live by all become information to the body. Over time, those repeated inputs either support function or erode it.

That is why I do not view health as a temporary intervention or a short-term fix. I see it as a way of living. It is built through sustainable habits, standards, and identity, not through quick fixes or temporary bursts of motivation. A diet only matters if it can actually be lived. A training plan only matters if it can be recovered from and repeated over time. A strategy only matters if it helps someone become the kind of person who can carry it forward.

Therefore, health is not just about what a person does once in a while. It is about what they repeatedly choose, what they value, and who they're becoming.

But health should also lead somewhere. It is not the final goal in itself. It is the foundation that gives a person the ability to act, choose, lead, and live with greater purpose. Good health allows someone to be more present, more capable, and more fully themselves. That is part of why confidence in one’s body matters. It reflects freedom, self-respect, and the ability to move through life with strength and agency.

In this sense, health is both biological and philosophical. It is biological because the body has real needs, real limits, and real consequences when those needs are ignored. But it is philosophical because the point of health is not merely to survive, optimize, or avoid disease. The point is to create the capacity for a fuller life.

Health is not perfection. It isn't a number, a look, a supplement stack, or a temporary state of discipline. Health is the cultivated capacity to live well in reality. It is the condition of the body and mind that allows a person to meet life with strength, adaptability, clarity, and purpose.

And if there is a philosophy of health worth building around, I think it's this:

The body is not the destination. It is the foundation. Health is the practice of building that foundation well enough that life can be lived with more freedom, presence, and meaning.