What America Considers “Healthy”: Its Evolution Over Time
Pop Quiz!
There are two people in front of you:
A 25-year-old American man who runs several miles each week, maintains a lean build, eats a carefully balanced diet, and regularly monitors his weight and fitness.
A 25-year-old American man who eats hearty meals and spends much of his day performing demanding work, rarely thinking about tracking his weight or exercise.
Who is considered to be the healthier one?
The answer is…
It depends
Health is fluid: there is no universal standard to which being “healthy” abides by—the definition morphs and the practices to achieve such state are dynamic, both reliant on the place and time. The complexities behind the word ‘health’ is multidimensionally nuanced. Even the evolution behind the word ‘health’ within a single location is rich in history. For instance, the American conception of health has continually evolved alongside the country’s development in terms of medical knowledge and cultural values.
American medicine inherited elements of the broader Western medical tradition, whose roots can be traced to Ancient Greece and Hippocrates’ emphasis on maintaining balance within the body as a foundation of health. [1]. During the early stages of American medicine, medical systems were relatively decentralized: there was no standardized approach, and physicians often used home remedies. Practices such as bloodletting to treat patients were common [2]. During the nineteenth century, emphasis on a healthy environment became prominent. The Great Sanitary Awakening allowed illness to be seen as an indicator of poor environmental conditions and poor spiritual conditions—in fact cleanliness was not only seen as a path towards an optimal physical health but also as a moral one. The integration of ideas from the religious revival of the Second Great Awakening into health can be attributed to the ties between physical and spiritual health [3]. In the final years of the nineteenth century, Germ Theory developed, establishing that certain germs could result in distinct diseases. This marked America’s fundamental shift away from the belief that illness manifested from odors or evil spirits and toward a view that is recognizable today: disease can result from germs [4]. Chronic diseases became a major health challenge during the twentieth century. Germ Theory allowed for understanding in prevention, diagnosis, and treatment of infectious diseases, but the rise of noncommunicable diseases matched the decline of infectious diseases. Chronic diseases such as cancer, diabetes, and respiratory and cardiovascular diseases increased in frequency because of increased life expectancy and changing lifestyles (e.g. physical inactivity, poor nutrition, and excessive alcohol consumption) [5, 6]. The definition of being healthy shifted away from the absence of infectious diseases toward one that incorporated both the past definition and an increased focus on lifestyle.
Today health expands beyond the physical. Health has a focus on the physical, the mental, and the social well-being; indeed, health is seen as an innate human right. Today, health is understood as more than the treatment of illness—it is a collective responsibility to address the socioeconomic, environmental, and cultural conditions that shape health and to work toward a world in which the right to health is accessible to everyone [7].
To fully comprehend the history behind the evolution of health is a simple yet powerful first step towards understanding the present medical system. To understand the present system is the first step in highlighting the underlying sources of current issues, including systemic inequalities in treatment and the limitations of economic status and their effects on well-being, as well as the actions—in terms of medical practice and political decisions—to take to address current issues for the sake of the future. Health is fluid and can be molded if, and only if, it is understood how it came to be today.
Designed by: Samirah Bisht
Reviewed by: Landon Allmon
References
[1] National Library of Medicine. (n.d.). Greek medicine. https://www.nlm.nih.gov/hmd/topics/greek-medicine/index.html
[2] National Library of Medicine. (n.d.). 250 years of American medicine. https://www.nlm.nih.gov/hmd/collections/galleries/250-years-of-american-medicine/index.html
[3] National Center for Biotechnology Information. (n.d.). NBK218224. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK218224/
[4] National Center for Biotechnology Information. (n.d.). NBK24649. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK24649/
[5] Centers for Disease Control and Prevention. (2012). In search of a germ theory equivalent for chronic disease. Preventing Chronic Disease, 9. https://www.cdc.gov/pcd/issues/2012/11_0301.htm
[6] National Library of Medicine. (n.d.). PMC10830426. PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC10830426/
[7] World Health Organization. (1978). Declaration of Alma-Ata. https://www.who.int/teams/social-determinants-of-health/declaration-of-alma-ata
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