3. What Does “Health” Mean?

Often in Western culture, health is seen as a simply defined binary state - people are either “healthy” or “unhealthy.” Health is also seen as a sign of personal virtue or morality, thus “healthy” and “unhealthy” too easily become “good” and “bad.” The contemporary framework of 'preventive medicine’ has its roots in the conceptualization of infectious disease in the 19th Century. This led to the development of the public health paradigm which sees the prevention of disease as a public responsibility. However, in practice, when combined with Western individualism, the prevention paradigm too often places the responsibility for preventing disease or poor health on the individual and it frames poor individual health as a threat to the public. Moreover, disease, illness, and disability are framed as fundamentally “bad,” which reflects a culture of ableism that devalues and neglects sick and disabled people. Fat and disabled activists call this framework of individualizing health and blaming a person for their own health problems “healthism” and argue that it is a form of oppression. On the other hand, in their book Belly of the Beast, Da’Shaun Harrison argues that health, itself, has historically been defined as “a Thing unobtainable by Black fat” people, precisely because health has been used to "legitimize race, sex, and class statuses.” ³ So, is there a way to define health that doesn’t reinforce oppression? We’re going to try!

In truth, health is a complex, amorphous, multifactorial characteristic that varies from person to person. Rather than trying to create a definition that is used to categorize people as “healthy” or “unhealthy,” health must necessarily be defined as the information, systems, and policies which fully support the wellbeing and flourishing of all people, within their communities. As such, health must be understood to be both a communal and individual property which requires collaboration between healthcare providers and diverse communities to ensure that care is based on the values and priorities of the people receiving care. Based on this definition, public health should focus on improving social drivers of health, creating access to supportive and affirming care, and reducing barriers to health, including stigma and oppression. We must also be clear that health, by any definition, is not an obligation, barometer of worthiness, or entirely within individual control. Higher-weight people deserve access to the world, including healthcare, without shame, stigma, bullying or oppression regardless of why they are higher weight, if there are health impacts of being higher weight, or if they could or even want to become thin.

3. P. 36  https://dashaunharrison.com/shop/belly-of-the-beast/