Why Defining Health Is Radical: Implications for Health Equity, Value, and National Health

Concepts matter. There is a current political struggle in the US over the meanings of "race," "racism," and "wokeness." In this presentation," I argue that defining "health" is a radical idea. The meaning of health has profound implications for how we organize research, healthcare, and ultimately society. For this reason, our nation has avoided defining health. This definitional void yields a default disease-based biomedical definition of health. The consequences of this default definition are profound: 1) enabling research and healthcare funding that supports the biomedical-industrial-healthcare complex; 2) obscuring deeper meanings of health equity; 3) trivialization of social determinants of health 4) marginalization of primary care; 5) contributing to unprecedented declines in national health, wellbeing; and 6) perpetuation of gross inequities in health. The concept of health has profound implications for what it means to be human, to care for self and others, and for the social conditions that enable people to optimize their full health potential. We need a national dialogue on the meaning of health and critically how to enable it through research, healthcare, and societal change.

Kevin Fiscella, MD, MPH, is a tenured professor in the Department of Family Medicine at the University of Rochester School of Medicine. He is co-director of the department research division and co-director of the equity-focused dissemination and implementation core within the University of Rochester Clinical and Transnational Science Institute. He has worked as a family physician in FQHCs caring for multigenerational families, including people living with HIV and substance use disorder, for 40 years. He is a health services researcher whose research career has addressed health and healthcare equity. His current research and mentoring involve the application of implementation science to promote health equity within health care and the community. Kevin is currently leading a scoping review for AcademyHealth on equity and value in US healthcare and a NASEM-commissioned review of trends in racial and ethnic inequities in healthcare access and quality in the US.

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Yes, speaking of health and equity, it has been reported in the news that UCSF did not select any white males to their freshman medical school class entering this year. That’s a little harsh.