The essential value(s) of heath: Implications for global health equity

One cannot sensibly discuss effective strategies to achieve health equity without an understanding of what health is.  Simply put, surely the means for realizing the goals of “healthy people and healthy populations” are inevitably a function of what we understand “health(y)” to be.  Thus we ought to insist that the best account of health be employed to underpin current — and future — public health education, research and practice.
After discussing the World Health Organization’s account of ‘health’, and the problems facing this view, I suggest we should talk about the account of ‘health’ that ought to be explicitly employed.  Because we require an understanding of what health is, I propose we first turn to a philosophical conception of health.
There are two major positions in the literature: naturalism and normativism.  Naturalists contend that ‘health’ is an empirically and an objectively discernible concept.  The alleged upshot of the naturalist’s ‘realist’ account is that ‘health’ has a theoretical foundation in value-free science.  Normativists contend that ‘health’ is an inextricably value-laden concept — a healthy population is necessarily connected with human value choice.
I consider the leading naturalist account of health and argue that it is formally unfit to underpin public health research and practice.  The implication is that the best account of ‘health’ will be inextricably value-laden.  But what values (and whose?) ought to play a fundamental rôle in health judgments?  I contend there is a pressing need to make explicit the essential values of ‘health’: how else can one be sure that the concept of health we employ does not, in fact, perpetuate the very health disparities we seek to reduce?  Most importantly, it is time to leverage global health as a special right and, crucially, a matter of social justice.  How and where to go — this talk will endeavor to say.