We all spend a lot of time thinking about – any sometimes worrying about – our health. This is particularly true for those of us living with a chronic condition. But what does it actually mean to have good health? What does a healthy approach to eating or exercise actually look like? What about good mental health?

Diabetes educator NYAREE LAWLER looks at some of the complex factors that can influence our health and how we think about it.

Are you healthy? It’s a simple question, but not always an easy one to answer. Our personal idea of being healthy may be very different from the person asking the question. For those of us living with a chronic condition such as diabetes, assessing and managing our health can be a complicated business.

Can you tell if someone is healthy by looking at them? Or by looking at what they are doing? What does the media tell us is healthy? Does your family or GP think you are healthy or unhealthy? What information have they used to make that judgement? Do you think you are healthy? How do you know?

Being healthy isn’t simply the opposite of being unwell. Likewise, living with diabetes or another chronic condition doesn’t mean you are unhealthy. The classic definition from the World Health Organisation (WHO) is that health means ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.

The National Institute of Health (NIH) expands out this definition into three parts. The first one is that health is the absence of any disease or impairment. The second part refers to a state in which a person adequately copes with all demands of daily life, and the third suggests that health is a state of balance between an individual and their social and physical environment.

If we consider all three parts together, then a diagnosis of a chronic condition such as diabetes does not automatically mean that the person is unhealthy, but it may affect their state of balance or their ability to cope with the demands of daily life. The level of balance and ability to cope can vary from day to day, or over time and is different for everyone. A person with diabetes could be considered healthy when they are able to get the most out of their life. The WHO definition and the National Institute of Health definition also highlight that someone without a chronic condition such as diabetes, could still be considered unhealthy.

Health is not an individual choice, either. There are a number of factors that can influence health outcomes or can contribute to the progression of disease. Environmental factors such as access to affordable, healthy food, clean drinking water and health care services can impact on diabetes management.

Other economic factors, such as cost of medications, health care visits, and housing, also have an effect. Social and cultural factors can influence the decisions people make around managing their diabetes. Attitudes and beliefs not only influence people’s choices but also influence their perception of their health and how they are managing their diabetes.

While lifestyle behaviour can certainly impact our health, many of the individual factors that affect it are also things we have no control or choice about, age, genetics, sex, country of birth or ethnicity.

Other people’s idea of health can have a damaging impact on our own. Many people with diabetes experience judgement that the reason they have diabetes or complications from diabetes is because they are making poor decisions or have bad habits. This is called diabetes stigma and can happen within the family, at school, work, or in a health care setting. It can prevent people with diabetes from getting the care they need and can make it even harder to manage the diabetes. Diabetes stigma can impact on a person’s emotional and mental health, as well their physical health.

When making decisions around your health, aim for goals that are realistic, and take into account those factors that you have no control over. Healthy can look different for different people and isn’t something that we can gauge just by looking at someone.

Resources

The Meanings of Health and its Promotion – PMC (nih.gov)

What is health? – Australian Institute of Health and Welfare (aihw.gov.au)

Measuring Wellbeing: Frameworks for Australian Social Statistics, 2001 (abs.gov.au)

Diabetes Stigma: Learn About It, Recognize It, Reduce It | CDC