Health reconstruction in the U.S. society
The dominant cultural understanding of health is a limited and negative one: health is the absence of (typically physical) infirmities. This is reflected not only in the way individuals think and speak about health, but in the dispositions of our healthcare practice and research. Our current health care system actively and enthusiastically develops and employs programs to treat and cure disease, but consistently fails to support disease prevention and health promotion efforts. We argue that this understanding of health is toxic, and must be replaced by a holistic and positive conception of health. Such a conception is adopted by the World Health Organization when it defines health as a state of " […] complete physical, mental and social wellbeing and not merely the absence of disease or infirmity " (WHO 1946), but has not been successfully communicated to the populace. This discordance results in a lack of funding for important preventative and promotional programs, encourages popular resistance to health-improving measures, and contributes to global health crises. We propose three definitive policy adjustments to ameliorate these challenges: (1) Reorient public health messaging to the pursuit of health rather than the avoidance of infirmity. The current image of health is partially sustained by the tendency of public health advertising to focus on the negative elements of illness rather than the positive elements of healthfulness, but recent research suggests this is not the ideal approach. (2) Increase spending on preventive and promotional health. The United States spent $3.0 trillion on health care in 2014 – more than any other nation. A large percentage of that was spent on the treatment of preventable illnesses. There is strong evidence that preventative and promotional methods are both economically and medically effective, but less than four cents out of every dollar spent on health care in the United States today goes towards public health promotion and prevention. (3) Improve funding for preventative and promotional health research. Funding for health research is disproportionately awarded to the treatment of illness, but little investment has been put in health prevention and promotion by comparison It is urgent to create a culture of health that requires a commitment to promoting optimal wellbeing. As Hippocrates said, " the function of protecting and developing health must rank even above that of restoring it when it is impaired ". By moving from a narrow and negative model of health to a holistic and positive one, we can better accomplish that function.
