质疑健康定义Thinking about the definition of health of WHO
说起健康,众所周知的一个定义,就是1946年世界卫生组织提出的健康定义,定义是这么说的,"健康乃是一种在身体上、精神上的完满状态,以及良好的社会适应力,而不仅仅是没有疾病和衰弱的状态。"这里健康定义,至少表达了这样几个方面,1,躯体健康;2,心理健康;3社会适应;4,没有疾病和虚弱。这样的健康显然是很完美的状态。
Speaking of health, a well-knowndefinition is the one proposed by the World Health Organization in 1946. Thedefinition says, “Health is a state of complete physical, mental, and socialwell-being and not merely the absence of disease or infirmity" Thedefinition of health here at least expresses the following aspects: 1. Physicalhealth; 2. Mental health; 3. Good social adaptation; 4. No disease or infirmity.Such health is obviously a perfect state.
这样的健康定义,我很不喜欢。当然我不是什么大人物,也没有什么发言权。下面我来哈岗为何不喜欢。
I don't like this definition ofhealth. Of course, I am not a health expert. Although my research time in thefield of health psychology is not long, my observations and thinking are asfollows:
首先,完美的健康观。它的完美到了不仅仅是没有疾病和虚弱,还是躯体,心理,社会全方位,太不可思议了。就是说,它的健康是完美状态才行。你感冒了不是健康状态;心情抑郁失眠了,也不是健康;你生病中不是健康,只有当你治愈了,才是健康人。那么怎么才能保证健康恢复了?而身体和心理就没有潜在的病灶呢?身体和心理疾病发生是一个过程,在没有被检查出来以前,算健康的吗?譬如,一个癌症患者,被检查出来以前通常有很长的潜伏期,怎么看健康呢?以检查为标准吗?其实他在潜伏期也是不健康的状态。所谓的健康完美状态只是短暂的。完美可以是机械化的产品,不可以是动物的生命体。生命体是个性化的,成千上万的生命体没有一个是相同的,健康却用完美的定义去笼罩它,不可行。
First of all, a perfect view ofhealth. It is so perfect that it is not only free from disease and weakness,but also includes three aspects: physical, psychological, and social. In otherwords, its health is in perfect condition. If you catch a cold, you are not ina healthy state; if you feel depressed and insomnia, it is not healthy; you arenot healthy when you are sick. Only when you are cured can you be healthy. Sohow can we ensure that health is restored? And there are no potential lesionsin the body and mind? The occurrence of physical and mental illness is aprocess. Is it healthy before it is detected? For example, a cancer patientusually has a long incubation period before being detected. How do you thinkabout health? Is inspection as the standard? In fact, he was unhealthy duringthe incubation period. The so-called perfect state of health is onlyshort-lived. Perfection can be a mechanized product, not an animal body. Lifeforms are individualized. No one of thousands of life forms is the same. It isnot feasible to cover it with perfect health.
其次,健康的人群很少,据世界卫生组织调查,健康人仅占人群总数的5%。被确诊患有各种疾病的,占人群总数的20%,处于健康与疾病之间的亚健康状态约占人群总数的75%。既然人群数量很少,就不是健康的概念。健康是心理学和社会化的概念。一个社会中大多数群体的主流行为和状态构成了健康的概念。举例说明:5百年前的健康行为和5百年后的健康行为概念是不同的。中国唐代时候,女人们以胖为美,今天以瘦为美。在当下中国老年人染发是美和年轻,欧美社会不认同老年人染发。在中国染发的老年人不会感到有心理压力,但是在美国社会老年人染发可能会被人嘲笑。尽管人们也知道染发对身体不利,但是中国老人们还是选择使用它。结合今天新冠病毒大流行的案例来看,中国社会集体谨慎,把预防看得很重,于是政府执行封城居家的时候,老百姓就执行的很坚定和彻底,也不会有情绪抵触和焦虑。相反,如果个别人出门,不遵守居家隔离规则会处处受到压力。我们来看美国,社会上普遍的美国人不认同居家隔离的政策,因为社会文化就不认同居家隔离有必要。他们的文化就是自由更重要。他们认为上帝会保佑他们,尽管上帝没有能有效保护他们,死亡率位居世界首位。即使这样,没有看到美国人有所改变想法而情愿居家不出门。通过以上这些可以看到,健康是以大多数人的想法(集体潜意识)决定的并且有地域性的特点。
Secondly, there are very