Are you healthy? Are your blood tests normal?
It depends on the definition of healthy and normal at that time.
It's easy to forget that our labels are constructed. If there's one thing that history tells us, it's that dominant scientific theories, medical models and accepted beliefs change. Humans change their minds. This influences the terms that are used and the meaning of the labels put on things. And it's not just outdated thinking that doesn't matter. The broader history sets the scene for the meaning that concepts hold today.
For example, the definition of health itself has changed multiple times. Today, the definition of health is limited to, 'The state of being free from illness or injury.' That is, health is defined in terms of what it's not - it's the absence of disease. Health is defined in the negative. But just because you aren't unhealthy, it doesn't mean that you're healthy, right? The absence of disease isn't the same as excellent health. Our definition rigs the game. There's a recent article that illuminates our historical tendency to redefine health. It's a useful reminder that all labels are relative to a point in time.
Who calls the shots, here? The authority to construct our language is usually allocated to traditional professions and influential institutions. Medicine. Legal. Politics. Big Pharma. Big Food. They create and craft the categories that collect smaller ideas into bigger concepts. This matters because the language used in day to day life shapes our understanding of things. Our phrases and concepts fuel our assumptions and alter our actions. For example:
Think of the demonisation of dietary cholesterol. Our thinking on cholesterol has changed dramatically as recent studies and investigations continue to discredit decades of biased and incomplete information.
And Type II diabetes. It used to be called Adult onset diabetes or Late onset diabetes, but these names are no longer used because the condition is increasingly seen in young people, even children.
Then there's our understanding of DNA and the 'Genes or Environment' debate. For decades, scientists maintained that our genetic code determines our body, traits and experiences. Ie, you are your genes. In 2003, scientists completed a mammoth project to sequence the human genome. That's less than 20 years ago. The findings didn't paint a simple picture. We now realise that the environment in which your genes live is more important than your genes alone. Studies have found that epigenetic mechanisms are a factor in diseases like cancer, CVD and diabetes, and that 70 to 90 % of your disease risk is related to your environment and not directly attributable to heredity.
This has implications. Have you noticed that people (and doctors) tend to assess their health in the negative? For example:
My blood test results are fine because they aren't outside of the range;
My diet is ok because my BMI isn't high;
My back hurts a bit but I'll push on because it's not an injury;
I don't need a day off because I'm not actually sick; or
I don't need a rest day because I'm not that tired.
Did you spot a theme? All of the above examples share the same attitude: 'My current health is acceptable because I'm not sick or injured. I am 'normal'. Ie, there's lots of other people like me in the same boat. Therefore, I don't need to make any changes and I can continue as usual, unless I do become sick or injured.' As a result, it's acceptable to ignore the signs and sit on our hands until the alarm bells sound. Then it's time to 'fix' things, at the precise moment that it's a lot more difficult to do that.
The message is simple. Think about the meaning that sits behind the terms and concepts that you use. Our definitions of healthy and normal are tied to the status quo - popular beliefs, the information that exists and the accepted state of things. It's easy to think that something's fine because it's common. But common is not the same as optimal. Should you aspire to the average?
Badash et al, 'Redefining Health: The Evolution of Health Ideas from Antiquity to the Era of Value-Based Care' (2017) 9(2) Cureus.
Lipton, Bruce, The Biology of Belief: Unleashing the Power of Consciousness, Matter and Miracles (2005).