Prevention Is One Thing, Wellness Is Something Else Altogether
Donald B. Ardell
Worksite Wellness Can Boost Quality of Life As Well As Reduce Illness
Prevention Is One Thing, Wellness Is Something Else Altogether: Here's How to Tell Them Apart
Daniel Dennett, a distinguished professor, author and outspoken secularist, stirred up a bit of a fuss in academia recently when he wrote:
A great deal of philosophy doesn't really deserve much of a place of the world. Philosophy in some quarters has become self-indulgent, clever play in a vacuum that's not dealing with problems of any intrinsic interest. Much if not all philosophical work... is willfully cut off from any serious issues... is little more than a luxury decoration on society... much of it idle - just games. (Source: David Koepsell, Daniel Dennett is Not Wrong (mostly), Center for Inquiry, August 29, 2016.)
In his radio show, A Prairie Home Companion, Garrison Keillor often employed the phrase life's persistent questions when introducing one of his many Lake Wobegon characters, Guy Noir, private eye.
The meaning of the terms health, prevention and wellness are not among life's persistent questions, and the differences that distinguish these terms, each from the other, probably don't take up a lot of space in the world. For that matter, I suspect only a small number of those toiling in the medical system or promoting healthy lifestyles focus much on such definitions or word distinctions. Insisting upon arcane interpretations may seem a bit like medieval Catholics debating the number of angels that can dance on the head of a pin, that is, an exercise in rather self-indulgent ontological scholasticism, not one of life's truly serious issues, a luxury and bit of a game, to use Dennett's words about philosophy.
Think what you like about Dr. Dennett's opinions on philosophy (in some quarters), or of the significance of definitions about the nature of health, prevention and wellness. The fact remains that, for some, present company included, these are indeed among life's persistent questions, largely because at least one of them (wellness) is badly misused, exploited, abused, distorted and maligned. And some of us are in a high dudgeon about it!
True, most people who work in the health care industry and even many who promote lifestyles conducive to well being and improved quality of life are not as concerned about this matter as some of us. Like me.
Well, everyone should pay more attention.
A Review of Basic Definitions
The most familiar definition of health is that of the World Health Organization (WHO): A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. Merriam-Webster's (MW) definition of health is as follows: The quality or state of being healthy. The MW take on well being is equally rudimentary: a state of being happy, healthy or successful.Besides being circulatory, these two definitions are useless. Pitiful, in fact. The MW consultants, employees, lexicographers and others who served on committees that drafted these bromides should be prosecuted. Clearly, they were not immersed in, dedicated to or knowledgeable about the wellness concept and movement. We can do better than MW.
MW also took a turn at defining wellness. Here it is: The quality or state of being in good health, especially as an actively sought goal. In parenthesis, MW goes a bit further, adding the word lifestyles. Also pitiful. In my opinion.
Advances in the Last 50 Years
I presented wellness (in High Level Wellness: An Alternative to Doctors, Drugs and Disease, Rodale, 1977 - and ever since) as a mindset and lifestyle, a conscious choice to pursue advanced states of physical and mental well being. Unlike MW, I never considered wellness as being happy, healthy and/or successful but rather as living life in ways that increase the odds of advancing toward these three states and many, many additional positive states of well being.
I like the NWI definition of wellness as an active process through which people become aware of, and make choices toward, a more successful existence. The NWI website features this short definition, and adds words to that effect that wellness is a process that evolves, is deliberate, self-directed, multidimensional and life affirming.
Nearly all wellness promoters who write books, give lectures and otherwise promote the concept make clear that wellness is more than preventing illness, reducing risks of disease, managing medical conditions or taking steps to boost longevity, though of course proactive initiatives that enhance well being invite these and other positive, welcome side effects.
Wellness was introduced by Halbert L. Dunn, M.D. in the 1950s and enshrined in his 1961 book entitled, High Level Wellness (R.W. Beatty, Ltd.) as a positive focus on quality of life for its own sake, not a way to prevent anything, or as a way to save money on health insurance costs, treat problem areas and/or dodge other adverse consequences of bad habit patterns. Problem avoidance outcomes are all consistent with quality of life enrichment choices, but are attractive side effects, not the primary basis for learning and practicing wellness skills and choices.
Neither MW, NWI or Dr. Dunn defines or even recognizes REAL wellness, yet, which is fine with me. For now, I have that field all to myself.
Why Care About Wellness-Related Meanings and Distinctions?
Extremism in defense of understanding is no vice; moderation in pursuit of the future of wellness is no virtue. (A slogan like that and Barry Goldwater might have won.) If insisting on a definition or understanding of wellness that does justice to the utility and promise of the wellness concept seems a bit extreme, well, I shall pay any price, bear any burden, meet any hardship, support any friend, oppose any foe to assure the survival and the success of... this compelling and much needed philosophy for living well and wisely. (Kudos to the memory of JFK for these timeless words of tribute to liberty.)
Language evolves to reflect our cultures, but we can delicately, graciously and usefully nudge change in the characteristics we believe are properly associated with key terms (i.e., prevention and wellness) during these brief times when we're on stage. In this way, an understanding and usage of certain words we hold secularly sacred will not be left entirely to the processes of unnatural selection.
Yes, I meant unnatural in that forces shaping the application of terms associated or confused with wellness are more often driven by profit, market share, sales and other medical, spa or other industry imperatives than logical, functional territorial boundaries. The latter alone will lead to wellness as originally advanced.
So, with all this in mind, let's return to the eternal, or at least half century-plus, task of finding a way to get everyone or as many as we can to distinguish wellness from all the rest associated with or confused by it.
Maybe, at least to a point that most of the principal definers and users of the term wellness will find sensible. And will utilize, more or less. Alas, this mission may make me seem Don Quixote-like, having some kind of impossible dream in a hopeless quest to separate at least prevention and wellness. This is a mighty challenge. There are some who will go to DEFCON 3 over whether there should be a dash between well and being in well being.
Prevention - MW once again: Prevention is the act or practice of stopping something bad from happening; the act of preventing or hindering.
Now go back and check what MW, the NWI or Halbert L. Dunn offered as definitions of wellness. See anything in there about preventing bad things from happening? Of course not. Make no mistake - it's good to prevent bad things from happening but not so good to call that wellness.
Prevent confusion, have fun and be well.