In part 1 we met Alice and Zizi two women, between 30 and 40 years old, similar height and weight. Neither Alice nor Zizi has any health problems – they are both normal and healthy.
The question posed: Who is healthier, Alice – or Zizi. But with no other information – and no experts on healthiness (as opposed to experts on illness) – we cannot even guess who is healthier.
We need some more information. Let’s suppose, for example, that Zizi has a cold. And Alice does not have a cold. Does this mean Alice is healthier?
No. Alice is more ‘well’ than Zizi – wellness being the opposite of illness. But we still don’t know who is healthier. The fact that Zizi has a cold affects her ‘wellness’ in relation to Alice, but healthiness is broader, deeper and richer than ‘illness vs wellness’.
We query Alice and Zizi about colds, and learn that:
Zizi – has one to three colds, every couple of years.
Alice has three to five colds every year.
Alice is sick more often than Zizi and, on average, Zizi is more ‘well’ than Alice.
Does this mean Zizi is more healthy than Alice?
What is healthiness? Is healthiness closely related to illness? What if two people are not sick for many years – which one is healthier? How can we tell. We can easily know how tall Alice and Zizi are. We can measure their weight, and calculate their BMI to several significant digits. But how healthy are they?
We question Alice and Zizi further, and we learn that when Alice gets a cold, it typically lasts about 7 days (a week if she takes cold medicine). Zizi, on the other hand, reports that her colds seldom last longer than 3 days. The first day she is getting sick, the second day she has a cold – and begins recovery on day 3.
Who is healthier – Alice or Zizi?
If we look closer, we might find that Zizi is less sick on the worst day of her cold, day 2, than Alice is on the first day of her cold – and that on every day of Alice’s cold she is sicker than Zizi is on any day of her cold. Is Zizi healthier?
“Wait just a minute”, the skeptic intrudes. “Health is much more than just cold symptoms. We don’t know who might have a healthier heart, a healthier mind, a healthier spirit, a healthier diet… We have no idea who is healthiest if we only ask about colds!”
“Maybe it’s just“, the skeptic continues “that Alice’s immune system is not as healthy as Zizi’s immune system. So Alice gets more colds. But she could be healthier in many other ways.”
Maybe that’s it?
Maybe Alice’s immune system is simply weaker than Zizi’s immune system. Maybe Alice works in a school, with many young children – and lots of cold viruses floating around – while Zizi works in a factory and doesn’t have much contact with other people to catch colds.
Who is healthier?
We are confused about health. There seem to be more questions than answers. Each answer seems to raise new questions. We are getting more and more confused.
It reminds me of a quote that a co-worker kept over her desk:
“We have not succeeded in answering all our problems. The answers we have found only serve to raise a whole set of new questions. In some ways we feel we are as confused as ever, but we believe we are confused on a higher level and about more important things.”
This should be the goal of a science of healthicine. To learn more answers, answers that help us to be as confused – but at a higher level, and about more important things. Our current confusion about health is not an advance of knowledge, we are more often jumping from one ‘factoid’ to another with no structure and no agreement.
Red wine is good. Alcohol is bad. What is healthy?
But today, our confusion about health seems to be very erratic. We are not asking questions, and finding answers that raise our confusion to a higher level. We are jumping from one answer to another. From one confusion to another.
We need a science of healthicine.
What do you think? Is Zizi’s immune system healthier that Alice’s immune system? Is a stronger immune system a healthier immune system?
Is the person with a healthier immune system the person who is most healthy? What factors of healthiness are most important? Which are the least important?
Stay tuned for a surprise in Part 3.
to your health, tracy
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