It’s as simple to measure illness, as it is to measure a hole. We can measure the depth, the breadth, the growth rate, without reference to the whole around the hole. In some cases, a single measure can diagnose an illness – although in principle several are required. One of the reasons diagnosis is error prone is the fact that measurement of symptoms is simple. Measurement of illness is also simplified by the fact that we don’t need to ‘understand’ illness to diagnose it. We only need to detect it, and once it is detected, we begin to fight against it.
Measurement of healthiness is much more challenging. With an apple, for example, we can measure the health of the apple from an apple’s perspective, or from a human perspective, where apples are food. Healthiness can be measured in many dimensions. We might measure the healthiness of the skin of the apple, is it of consistent depth and strength, does it protect the interior, is it clean and clear of pesticides, is it strong, does it protect the interior? We can also measure the health of the flesh. Is it ripe? Is it bruised or beginning to rot or mould? For each measure of healthiness – we can define perfection, or 100 percent healthy, and then measure against perfection. If the skin is 99 percent free of pesticides, then that aspect of skin health receives a score of 99 percent healthy, and one percent unhealthy. Each aspect of healthiness can be expressed as a percentage, because healthiness is whole. Healthiness includes the healthy score and the unhealthy score, which adds up to 100 percent, the whole score. Health is whole.
The illness, the worm and the worm hole are also part of the measure of healthiness – they are unhealthy scores. If there are no worms, the worm health score is 100 percent. If there are worms, the worm health score is less than 100 percent.
There are many other aspects to the healthiness of an apple, including the seeds, the ability to reproduce, and even the tree it came from. It is not possible to take one, or a few single measurements to create a complete measure of health.
People too have many aspects of healthiness. If we want to create a complete measurement of a person’s healthiness, we must measure the entire hierarchy of healthiness, from genetics, to nutrients, to cells, tissues, organs, systems, body, minds, spirits, and communities.
Our medical systems work very hard to fight illness. We cannot measure healthiness without working hard to understand health. We can only improve our measurements of healthiness, by continually improving our understanding of health.
People often confuse measures of illness with measures of healthiness. Measures of illness are often single measurements. The vital signs: resting pulse, body temperature, blood pressue, breathing rate, and pain, are often used to determine level of illness. But single measurements are not measurements of health. Because health is whole, a measure of healthiness should be expressed as a part, or a percentage of a ‘whole’. If you are measuring healthiness – you need a target, a goal, to measure against, and the goal will have large or small variations depending on the individual. With the apple, one goal is ‘no worms’, zero worm illness equals 100 percent worm healthiness. Measures of pulse rate, temperature, blood pressure, breathing and pain are not measures of healthiness without a goal. No pain, for example, is not a health goal – if you are “feeling no pain”, your health is less than perfect.
Several single measurements can be combined to create a diagnosis of illness. But measuring the depth, breadth, width, and growth rate of a hole – tells us nothing about the surrounding wholeness of health.
Measures of strength, speed, performance, etc. might also look like measures of healthiness, but these single measurements do not measure health. Measurements of performance when made in a medical setting, or in a competitive setting, are often measures of deficiency or excess. We notice when someone has a weakness. We also notice when someone is excessively strong – but excessive strength is often an indication of unheathiness. Bobby Fisher was able to win the World Chess Championship, because his brain was unhealthy – in a way that made him a powerful chess player. It seems that he never recovered his health. Weight lifters can lift more than normal humans, due to an unhealthy excess of strength, resulting from unhealthy diet and exercise. Of course we know that the fastest runners, cyclists, etc. are not the fastest because of their healthiness, but because of their drug pipeline. We should not confuse performance with health. Health is about balance, not about excess.
So what does a measure of healthiness look like? What are some examples? Well… truth be told, there are no examples in common use. We don’t study health, we study illness instead, and we don’t measure healthiness, we measure illness.
What about BMI? Can’t BMI be used as a measure of healthiness? BMI combines more than one measurement into a formula.
BMI is a useful ratio, although it was created to measure the unhealthiness of groups of people – not individuals. For BMI to be a measure healthiness of an individual, there must be a goal for that individual. A standard BMI test gives a range of ‘healthiness’ that is quite wide, in fact, it ranges from deficient to excessive. Like many measures of illness, BMI lists a ‘normal’ ranges from 18.5 to 24.9. People who score below 18.5 are underweight, and those who score over 24.9 are overweight. Those who score over 30 are listed as obese – an illness. BMI is limited to ‘normal’ people, giving potentially false results for athletic persons and elderly persons. Inside the ‘normal range’ your BMI makes no statement about your health. Like all medical measurements – ‘normal’ results are ignored, because doctors search for illness.
If we want to use BMI to create a measure of healthiness – we need a goal. If your target BMI is 22.3 and your BMI is 24 – you are still ‘normal’ according to the illness measurement of BMI. Your BMI Health score is about 93 percent. There is seven percent ‘potential for improvement’ in your BMI score. “Potential or improvement” in a health score can also be named “unhealthiness”. Your BMI is 93 percent healthy, and 7 percent unhealthy. Of course there are many ways to calcualte a healthiness percentage of BMI, which might result in different scores. The impotant thing is to have healthiness expressed as apart of the whole, so that we can measure our goals and our success in moving towards those goals. Note: Unhealthiness is a normal result of measuring healthiness. It is the inverse of healthiness, and unless you are perfectly healthy, you will always have some level of unhealthiness. Unhealthiness is not a moral judegement, it is simply a fact of life, living, and a result of measuring healthiness.
Your BMI is one small measure of your healthiness. You might have an excellent BMI, a lousy diet, a crappy attitude, a liver suffering from alcohol toxicity, and poor relationships with friends and family. Each of these is a measure of your healthiness, and your unhealthiness. There are many measures of healthiness – all throughout the hierarchy of healthicine.
Is it possible to create a complete measure of your healthiness? Maybe not. Certainly not today. But we can try. And as we try, we will learn more about health, and more about ourselves. It is possible to create useful measures of healthiness, and learn from them. We can start now.
to your health, tracy
This post is based on the concepts in the book: Healthicine, the Arts and Sciences of Health and Healthiness.