Wednesday, December 14, 2011

Are you measuring Illness, or Healthiness? Healthiness does not exist.

To be ill is to be afflicted with a specific sickness, disease or other health condition.
An illness is a specific sickness, disease or other health condition.

To be sick is to be afflicted with a specific illness, disease or other health condition.
A sickness is a specific illness, disease or other health condition.

Healthy is enjoying vigor and health of body, mind or spirit.  (Merriam-Webster)

according to Merriam-Webster, the word 'healthiness' does not exist - you are re-directed to 'healthy' in the online version of the dictionary. Similarly, Wikipedia does not have an entry for healthiness - it simply re-directs you to healthy.

Healthiness needs to be defined if we are to measure it.

Healthiness is a specific incidence, or measurement, of health. Overall healthiness is a summary of measurements of health. 

There are another words that may cause confusion.  Ill-health and unhealthiness, for example. What do they mean? What should they mean? I will deliberately avoid these words when possible.  Ill-health is actually, according to Merriam-Webster "some disease is present, but".  It is a state of illness, not a state of health.  Unhealthiness is also, according to Merriam-Webster "not in good health, sickly or diseased". e.g. Both words can be replaced with ill or illness - of varying degrees.

We are very familiar with some specific illness/health measurements, most notably, the four vital signs - body temperature, pulse rate, blood pressure and respiratory rate.

In each case there is a healthy range - and two unhealthy ranges, deficient and excessive. A measurement of your vital signs can be a measurement of your healthiness - or your unhealthiness.

How can we tell if we are measuring healthiness or illness? We find what we are looking for.

When scientists were studying light, trying to understand the behavior of light, they found an interesting result.  There were two competing theories.  Light consists of particles.  Light consists of waves. Scientists found that, if they tested for particles - they were able to prove that light consisted of particles.  And when they tested for waves - they were able to prove that light consisted of waves.

Then it got more complicated. Scientists were able to design a door that only let one particle of light through at once.  Then they tested for waves - and waves were found.

They concluded that whether light acts like a particle or a wave - the nature of light depends on what you measure, not on a fundamental property of light.

And so it is with healthiness and illness. If we are searching for health, we measure healthiness. If we are searching for ills - we measure illness.

Almost every time someone measures your temperature, temperature, blood pressure, or respiration - they are checking for illness.   If we ask someone to check our health status - and they start by testing our temperature, our pulse, etc... We might assume they are checking for illness.

In isolation, a single measurement, or even all four measurements provide minimal information about your level of health - although each might, even in isolation, provide significant information or indication about your level of sickness.

If you are healthy, all four measurements; pulse, respiration, blood pressure, and temperature might be in the 'normal range' - you will have no useful information about your level of healthiness. If you are sick - one or more of these measurements may be outside of the normal range, indicating illness.

Specific healthiness measurements may indicate illness or sickness, suggesting further investigation and diagnosis - but specific measurements do not effectively measure healthiness.

An interesting detail about these four measurements is that they are compared to 'normal ranges', not to 'healthy ranges' nor to 'optimal ranges'. These so called 'normal ranges', are 'ranges that indicate no illness has been detected'.

Healthy ranges, and optimal ranges have not been identified - and it may be that optimal ranges are different, narrower or broader than the normal range - optimal ranges have not been studied scientifically for individuals nor groups.

Let's look at Resting Pulse Rate in more detail. A normal adult pulse rate ranges from 60 to 100 bpm.  This might lead you to assume, incorrectly, that the optimal rate is the mid-point between 60 and 100, e.g. about 80 bpm.

Actually, lower 'normal' measurements, for all four vital signs, indicate healthier status than higher 'normal' measurements - when we are measuring healthiness. Athletes have a normal pulse rate much lower than 'normal adults'.  Athletes however, put their focus on strength, and in competitions on 'peak performance' which may actually be detrimental to overall healthiness.

It is very difficult to identify an 'optimal pulse rate' for the general population - and many qualifiers might be required when applying this rate to individual persons. e.g. It might depend on height, weight, blood pressure, an even 'size of the heart'.

How might we measure health? How might we measure 'overall healthiness'?

Like the scientists searching for waves, or particles, we must know what we are searching for.

If we are searching for illness - we will not measure healthiness. We will not find healthiness - we will only find illness or 'normal' e.g. 'no illness'.

The way to measure healthiness - is to ensure that our goal is healthiness.  If our goal is the elimination of disease or illness - we need to measure illness.

When our goal is optimization of health - we will measure healthiness.  When we suspect illness - we can switch our goals back to measuring and fighting illness.

When we are healthy - our goal should be to measure, and to improve our healthiness.

Actually, we need to measure healthiness and illness, both - throughout our lives. It is important to measure our illness - even when we think we are healthy, with prevention as our objective.  Similarly, it is important to measure our healthiness when we are ill - to determine the most effective treatments.

But we should not confuse the measurement of illness with the measurement of healthiness. Even the exact same measurement - pulse for example, will give different information and recommendations, depending on our goal - optimization of healthiness vs detection of illness.

A measurement of pulse from an illness point of view might detect a rapid pulse, in an emergency situation. If your illness pulse is too high, further investigation is required. You may need some medication and relaxation to lower your pulse. Or perhaps you have lost blood and need an injection of fluids.

A measurement of pulse from a healthiness point of view might observe that your pulse is high, that it could be lower. If your health pulse is to high, exercise might be recommended to reduce your pulse, by increasing your healthiness.

The illness researcher (medical doctor) detects rapid pulse - recommends calmness, further investigation and possibly treatment.  A healthiness researcher measures rapid pulse and recommends exercise. Almost exactly opposite recommendations - based on different measurements of pulse, which detected - 'rapid pulse'.  Note: the medical, or illness definition of 'rapid pulse' is a different, higher number, than the healthiness definition of 'rapid pulse'.

Our current measurements of illness are very sophisticated. Our current measurements of health are of very poor quality - almost non-existent.  Our measurements of illness can be summarized, creating meta-information, to distinguish between many different diseases, and variations of disease.  Our measurements of healthiness are seldom summarized to create useful meta-information. The field of medicine is very well developed.  The field of health is just in its infancy.

We need to measure healthiness, to optimize our health. 

yours in health,
Tracy is the author of two book about healthicine: 

Personal Health Freedom