The Healthy5

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The Evolving Concept of Health: A Personal Reflection Across Cultures and Life Stages

By Edward I.O. Sakwe, RN, BSN

Health is an inherently complex term to define, especially in today’s interconnected 21st century where people are often more connected through technology and social media than in person. The evolution of the understanding of health has been influenced by culture, economics, personal experiences, and social norms. Growing up in Cameroon, health was not a concept I consciously pondered. It was intertwined with everyday activities like food and play. As I transitioned into adulthood, moved across countries, and encountered different socio-cultural contexts, my understanding of health became more nuanced, reflecting the intricate relationship between well-being and one’s environment, state of mind, and socio-economic factors.

Health in Childhood: A Simplicity of Needs

As a child in Cameroon, my concept of health was incredibly simple. Like many children, my primary needs were food and play. If I could eat when I was hungry and spend my day playing, I felt I was in top health. According to developmental psychology, children often associate well-being with their ability to engage in activities they enjoy, such as playing with friends. The World Health Organization (WHO) describes health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1948). As a child, however, I did not have the capacity to think about my health in such holistic terms. My only concern was to avoid disruptions to my playtime.

When I occasionally fell ill, my focus was not on regaining health for its intrinsic value but on recovering enough to return to my games. This perception is common among children, for whom play is an essential part of physical, emotional, and cognitive development. Research supports this view, indicating that play is critical for social skills and cognitive development (Ginsburg, 2007). During this time, I only had vague, indirect interactions with sickness. I saw other children cry because they were sick, and I occasionally visited the hospital, but illness was not a central theme in my life. Health, to me, was an unspoken, unexamined condition that allowed me to engage fully in the activities that brought me joy.

Adolescence: A Shift in Perspective on Health

As I grew older and transitioned into high school, my awareness of health began to deepen, though it was still tied largely to my external observations of others rather than introspection. I started noticing how sickness affected not only the patients but also their families. In particular, I observed the anguish on the faces of parents, especially mothers, who worried about affording medications for their children.

This was my first encounter with the socioeconomic aspect of health. In Cameroon, as in many developing nations, healthcare access is often limited, and the ability to afford necessary treatment can be the difference between life and death. The World Bank and WHO estimate that at least half of the world’s population lacks access to essential health services, and approximately 100 million people are pushed into extreme poverty due to health expenditures (World Bank, 2017). For the families I witnessed, the cost of healthcare introduced an additional layer of stress, compounding the emotional toll of having a sick child.

This phase in my life highlighted the intersection of health and economics. Health was no longer just about the ability to avoid illness but also about having the financial means to seek treatment and alleviate suffering. This realization led me to a more complex understanding of health as not just a biological state but also one shaped by external factors like access to medical care and the ability to afford it.

College and the Emergence of Fear Around Health

My transition to college brought about a new understanding of health, particularly through my exposure to the global AIDS epidemic. For the first time, I was confronted with the notion of a disease that could not be easily cured or treated. As college students, my peers and I were deeply afraid of contracting AIDS, a disease that threatened not only our immediate well-being but also our entire futures.

The fear of AIDS was deeply rooted in the stigma surrounding the disease during the late 20th century. At that time, there was limited information available about HIV/AIDS, and the lack of a cure made it seem like an imminent death sentence. We were young, and we had dreams for our future. AIDS, which disproportionately affected young adults during its peak, seemed to steal that future away. Studies have shown that the fear of contracting incurable diseases like HIV/AIDS significantly impacts people’s perceptions of their health, sometimes leading to anxiety and stigma (Herek, 1999). This period of my life represented a significant shift in my understanding of health as something that could not only be lost to illness but also something that could be permanently altered or ended by a single disease.

A New Cultural Context: Health in the United States

After moving to the U.S., my understanding of health shifted once again as I observed the lifestyles and attitudes of people at a ski resort in Breckenridge, Colorado. The people I encountered seemed to live on a different spectrum of life. They were constantly busy with recreational activities like skiing, snowboarding, drinking, and socializing. Their lives appeared vibrant and full of joy. Even when injuries occurred on the slopes, people took them in stride, almost as if they were expected. This level of nonchalance toward injury was foreign to me, coming from a background where even minor illnesses could evoke significant concern due to the cost and access to care.

In Breckenridge, health seemed more closely associated with the ability to engage in physical activities and maintain a positive mindset rather than merely the absence of illness. This aligns with research that suggests health is often viewed differently in wealthier nations, where physical fitness and mental well-being play a larger role in the cultural conception of health (Whitehead, 1992). In these environments, health often revolves around personal fitness, lifestyle choices, and resilience, rather than just medical treatments and disease prevention.

Health as a State of Mind

Through these diverse experiences, I have come to realize that health is more of a state of mind than simply the presence or absence of disease. In Cameroon, where access to medical care is limited, health was often viewed in terms of survival, financial capacity, and the ability to function despite illness. In contrast, in the U.S., health is often seen as a resource that supports an active, fulfilling lifestyle. The WHO definition of health as not just the absence of disease but as a state of complete physical, mental, and social well-being, aligns more with my perception of health as observed in Breckenridge, where well-being was closely tied to lifestyle, activity, and mental outlook.

In conclusion, my understanding of health has evolved dramatically over time. It has shifted from a simplistic childhood notion of being able to play without disruption, to a more complex recognition of health’s economic, emotional, and social dimensions. Observing the impact of illness on families in Cameroon, experiencing the fear of AIDS as a young adult, and witnessing the vibrant, active lives of people in the U.S. has led me to a more holistic view of health.

This brings me to the conclusion that health is Ultimately not just about avoiding illness; it is a state of mind, influenced by one’s socio-cultural environment, economic standing, and personal outlook on life.

References

Edward I.O. Sakwe, RN. BSN.

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