ASK THE DOCTOR: What Is Good Health?
ASK THE DOCTOR
BY JENNIFER HEIDMANN, M.D
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There is no precise definition for being in good health. In allopathic health care, we think of good health as a lack of disease, or perhaps disease that is not significantly impacting someone’s well-being. We can measure blood tests or do imaging studies to search for treatable illness. Then we can offer treatments with the hope that they make a positive difference.
Good health is nuanced and fluctuating for all of us. Most people will have some kind of illness, accident, injury or disease in their lifetime. All people will die. Aging brings special challenges to well-being, but these challenges can vary depending on people’s genetics and life experiences, lifestyle and exposures.
We know that certain things lead to health problems — cigarettes, alcohol, drugs, poverty, loneliness, stress, pollution, crowding, processed foods and violence. While we may think ourselves lucky to avoid most if not everything on that list, we are still impacted by others among our families, friends and community who are less fortunate.
Currently, immigrants are under a great deal of stress, even those who are citizens. Nationwide, clinics and hospitals are seeing a decrease in visits requiring an interpreter, and some waiting rooms in clinics serving primarily immigrant or diaspora populations are empty. Not being able to access primary or urgent care is likely to lead to problems that will ultimately land people in the emergency room. If you have been to an ER in recent years, you know that they are already overburdened, as those without easy access to primary care tend to use the ER for problems normally addressed in clinic, or for diseases that have turned into emergencies because of lack of basic care.
Maybe good health is defined by the rankings of organizations that look at worldwide populations and outcomes. If so, our nation ranks high for technology and innovation (though this is likely to change if we continue to discourage scientific funding, pushing our brightest scientists to other countries). But the U.S. consistently ranks last among developed nations in overall health care, with the highest cost and the worst outcomes compared to other wealthy countries. This relates to poor access to basic care, inequity (a word we are no longer supposed to use) and an insurance system so complicated it (and all its customers) gets lost in its own absurdity.
On an individual level, I would bet there are as many definitions of “good health” as there are people in the world. I have served many people who carry terrible diagnoses but feel good about their lives and live as fully as they can. People who feel afraid or who have suffered trauma may feel horrible even when all their labs and other medical tests look “normal.” In 2023, the U.S. Surgeon General declared a loneliness epidemic, with data showing isolation can be as bad for health as smoking almost a pack of cigarettes daily. This is worrying in a time when the country has become ever more divided, and where many people turn to the internet and social media for a connection that is driven by advertising algorithms and that tends to make people feel lonelier than ever.
As a physician, I can give advice on how to reduce the risk of disease, concentrating on what can be controlled. Do not use drugs, smoke, drink alcohol, eat processed foods. Do move your body regularly in any way you can. Hang out with other people. Volunteer or find ways to be part of a community. Get immunized for infectious diseases and wash your hands frequently. As a medical doctor, I am officially licensed to nag.
As a human and as an American, I hope for a more encompassing vision of good health that extends to our neighbors, friends, family and even those we do not much like. It would be nice to rank better than last in the world rankings for health care, and to do that we have to revise our thinking to include everyone in our country. If people cannot afford health care, we all will suffer. If people want what is best for their children or parents, they must support a system that is best for everyone’s children and parents. It is financially possible and sensible to have a national healthcare program where every human in our country receives needed care. In fact, it will save money and improve outcomes.
Good health is, at its simplest, the ability to do things that bring you joy. A society’s good health is defined by its care and respect for everyone. May we strive to be a healthier society, following the long arc of history that ultimately wants to bend toward justice for all.
Dr. Jennifer Heidmann
is medical director and primary care provider at Redwood Coast PACE (707-443-9747) at the Humboldt Senior Resource Center. This column should not be taken as medical advice. Ask your medical provider if you have health questions. Send comments to SN@humsenior.org.
