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‘Language can educate and inform or confuse and mislead’, your editorial states (October 2006, JRSM), as it goes on to describe problems in medical care and patient-carer communication. I suggest that the major ‘alienating language of health care’ is the substitution of ‘health’ for ‘medical’. It is unlikely that the quest for health will be expedited by the confusion of health and treatment of the sick. Health of individuals and of groups is affected by many social, economic and environmental factors and the search for causes and the amelioration of differences between groups requires clear definition and measurement of the target. At present uses of the word health are exemplified by health care (i.e. care of the sick), health services, health insurance, health centres and so on, diverting attention from the promotion of health and leaving research into the nature and measurement of health and equity outside the purview of medicine.
‘Health’ is an OK word and confers added value to the descriptions on packages of the plants and nostrums of alternative treatments, on centres for physical exercise and on spas. Even the latest guide to membership services and benefits of the British Medical Association, which includes advice on careers and information on the new credit card, has the words ‘improving health’ on its cover.
Absence of an operational definition of health makes it difficult to measure and health status of nations and groups is inferred from rates of diagnosed disease or from self appraisal questionnaires with all the problems of personality, culture and education in interpreting such estimates. The World Health Organization definition of health, and others like it, are inspired but not quantifiable. Precision in language, with the necessary effort to achieve an agreed definition, could be a first step to objective measurement and scientific study of health itself.
Competing interests None declared.