How do we measure the health of Canadians?

Defining Health: In 1948, the World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

By this definition - health is arguably unachievable...

According to the 2011 article published by the British Medical Journal (BMJ) titled Health: How should we define it? Huber et al. propose that the linguistic entrenchment of the word “complete” into the WHO’s definition of health renders the definition itself unviable “because ‘complete’ is neither operational nor measurable”. The authors also note that the rigidity of a “complete” definition of health also fails to forge the necessary biopsychosocial connection between health and a broader definition of overall well-being.

Approximately 40 years later the first international conference on Health Promotion was held in Geneva in 1986 which produced the Ottawa Charter for Health Promotion. Building on the WHO’s definition of health, the Ottawa Charter identified key fundamental circumstances for health that went beyond narrow physical indicators to also include “peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity” – all themes which interestingly parallel those identified in Abraham Maslow’s 1943 paper titled “A Theory of Human Motivation” – (more commonly known for it’s resulting pyramidal depiction known as “Maslow’s Hierarchy of Needs”). While Maslow’s theory focused on human motivation, interestingly these same “needs” invariably form the premise (in whole or in part) of recognized health determinants.

Measuring Health: As identified in Huber et al. 2011, of equal importance to defining health in Canada is how health is being measured. Currently, Statistics Canada conducts an ongoing national survey about the general health of Canadians called The Canadian Health Measures Survey (CHMS). The CHMS gathers data on physical measurements such as heigh, weight, blood pressure, lung function, and physical fitness as well as other generalized health indicators such as chronic diseases, infectious diseases, environmental exposures, and nutritional status. The indicators tracked through the CHMS allow little consideration to more subjective aspects of health - such as quality of life.

Future Direction: The COVID-19 pandemic brought quality of life issues to the forefront of not only the hearts and minds of Canadians, but also the dialogue and agendas of federal and provincial political parties. Canada (and other nations) are slowly evolving to recognize the need to move away from measuring health based on a medical model, moving instead towards a Quality-of-Life Strategy. The first report to this end, Toward a Quality-of-Life Strategy for Canada, was published by Canada’s Department of Finance, with the support of the Minister of Families, Children and Social Development and the Minister of Innovation, Science, and Industry in April of 2021.

This interdepartmental/inter-disciplinary collaboration is optimistically a positive indication that politics are catching up with social science, and that Canada’s Health Strategy is modernizing and moving towards a evidence-based approach lend supports to public health policy that recognizes and adequately balances policy the interconnectedness between biopsychosocial well-being - and the health of Canadians.