Health and disease on this interpretation are employed as scientific con-
cepts, not normative ones, despite the fact that, in general, human beings
value health and abhor disease.
A normative doctrine is exemplified in Georg Canguilhem’s The
Normal and the Pathological, which uses the terms ‘health’ and ‘disease’
as normativeterms: Health means that a person functions well, disease
means he or she functions badly.
Man feels in good health—what is health itself—only when he feels more
than normal—that is, adapted to the environment and its demands—but
normative, capable of following new norms of life.... for man health is
a feeling of assurance in life to which no limit is fixed. Valere, from which
value derives, means to be in good health in Latin. Health is a way of
tackling existence as one feels that one is not only possessor or bearer but
also, if necessary, creator of value, establisher of vital norms.^15Discussions of human health often address a particular dimension of
health and neglect others, for instance, emphasizing the capacity to
achieve one’s goals but overlooking the factor of resistance to disease.
Rather than proposing a ‘definition’ of health, I present a range of deter-
minants that can be used as criteria for evaluating states of health, and
that identify conditions for thinking about health. In using these determi-
nants as criteria to assess the health of a particular person, emphasis may
be placed on some determinants over others, depending on circumstances.
For example, in evaluating the health of a child who has no serious medi-
cal problems, growth and development are important criteria of health. In
the case of an elderly person with a chronic condition, the degree of pain
experienced by the person would be a significant criterion. The determi-
nants of health presented here are applicable across a range of instances,
with modifications for specific circumstances. For example, strength is a
criterion of health for both a child and an elderly person, though there are
differences in the particular set of abilities required by each.
DETERMINANTS OF HEALTHBiological and Ecological Determinants
Life, Development, and Longevity
Living, rather than dying, is a fundamental determinant of health. Health
can be ascribed only of living entities, and an essential criterion of health
is the organism’s prevailing in its life-functions rather than tending toward
50 religious therapeutics