This blog post examines the connection between health and human rights and discusses why addressing the health issues of the socially vulnerable should be an important goal.
The Definition of Health and Social Inequality
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” — Constitution of WHO, 1948
When the international community established the WHO, recognizing the need to address global health, the first matter for discussion was the definition of health. Not merely the absence of disease or infirmity, but a state of complete physical, mental, and social well-being! This was the conclusion reached through discussion, and this definition was prominently placed at the very beginning of the WHO Constitution. Since the WHO’s founding in 1948, this definition has become a truth known to anyone working in health-related fields.
This definition was revolutionary for its time. Traditionally, health tended to focus almost exclusively on the physical aspect. For example, in the Middle Ages, responses to epidemics or diseases were primarily limited to physical treatment, and the importance of mental or social well-being was scarcely recognized. However, in modern society, the understanding that health is not merely the absence of disease, but rather the condition enabling individuals to lead a full life, has taken root. This shift significantly influenced approaches to healthcare and welfare systems. An integrated and comprehensive understanding of health plays a crucial role across various domains, from healthcare policy and public health strategies to even individual health management.
Yet, even today, seventy years after this definition was established and the WHO founded, the vast majority of people worldwide remain in an unhealthy state. And it is readily apparent that the overwhelming majority of those in poor health are socially disadvantaged. The relationship between the socially disadvantaged and health is deeply intertwined. Economic inequality, educational attainment, living conditions, and access to healthcare all directly impact health status. Particularly, low-income or uneducated groups have fewer opportunities to prevent or adequately manage health issues, making them more susceptible to disease and creating a vicious cycle.
The Relationship Between the Socially Disadvantaged and Health
While the concept of ‘socially vulnerable groups’ is difficult to define precisely, it is a widely shared societal understanding that certain social groups are perceived as ‘vulnerable’ and that the general health status of these groups tends to be poor. Concepts related to health are frequently associated with socially vulnerable groups, but it is relatively rare for health issues to be linked to groups commonly perceived as ‘upper class’. Are the socially disadvantaged unhealthy simply because they are disadvantaged?
In discussions about the relationship between health and social status, the impact of social status on health has been a subject of constant debate for a long time, but the reverse scenario has been discussed less frequently. However, we can easily find historical examples where people who were unhealthy experienced a decline in their social status. The most representative examples are those with Hansen’s disease and AIDS. These are unhealthy groups that fail to meet the conditions for physical well-being. Regarding mental well-being, one need only look around to see how numerous individuals with mental illnesses are treated socially. The unhealthy become the socially vulnerable. This is why class and health should be interpreted not as unidirectional but as mutually influencing each other.
The History of Health = The History of Human Rights?
Human history has progressed toward the restoration of status for the unhealthy. In the case of AIDS patients in the United States, though they faced discriminatory views since the first clinical cases were reported in the 1980s, over thirty years of struggle have gradually improved their rights and public perception. Similarly, social perceptions of those with mental illness have progressively improved compared to the past. Moreover, the history of marginalized groups like women asserting their human rights through their health issues cannot be overlooked. Women’s health rights extend far beyond mere physical health, deeply intertwined with issues like childbirth, sexual violence, and mental health. These problems could be brought into public discourse and addressed precisely because women persistently demanded their rights and raised their voices.
So, can the advancement of health be equated with the history of human rights expansion? Many would consider this claim a leap. The concept of human rights being equivalent to the concept of health is difficult to accept intuitively. The most representative counterexample is racial discrimination against people of color. Despite people of color not being physically or mentally unhealthy, they endured extreme discrimination for decades, even centuries. Yet, despite this conceptual dissonance, the history of human rights is the history of health. As seen earlier, health is ‘physical, mental, and social well-being’.
Health, a Human Right Rooted in Daily Life
This definition tells us that the history of human rights is the history of health. Yet our society still seems very unfamiliar with the social concept of health. The reason the three domains are presented in the order ‘physical, mental, and social well-being’ in the definition of health is because we intuitively grasp physical well-being first, followed by mental well-being, and find social well-being the most alien.
It hasn’t been long since mental health began to be accepted in our society. How many people in our society actively take care of their own mental health? If acceptance of mental health is still at this level, there’s no need to even mention social health.
If the two are fundamentally the same concept, why must we re-emphasize awareness of social health? The answer lies in our attitude toward human rights and health. The impression each word conveys is that ‘health’ feels more immediate and routine than ‘human rights’. This is not mere wordplay. The moment human rights become part of health, they can come closer to our lives.
The history of advancing human rights continues to this day. Compared to the past, it is undeniable that the rights of various socially vulnerable groups, such as women and people with disabilities, have improved. However, human rights remain an object of education, enlightenment, and achievement; they are not readily accepted into the realm of everyday life. There is still much work to be done before everyone can be considered ‘healthy’. Until now, the image of health has primarily focused on physical and mental well-being. Now is the time to pay attention to social health alongside these two. And the result of these efforts will be a ‘healthy society’.
