The Fragile Balance: What Is Health, Really?

Human organizations exist because coordinated action exists. That is, because people perform actions whose meaning depends on the actions of others. Actions that, when added together, contribute to a common purpose that none could achieve alone. More than that—those actions wouldn’t even be carried out if they weren’t oriented toward some higher end.

 Think of something simple: a bridge. No individual could build it alone. You need the engineer who designs it, the workers who raise the structure, those who make the materials, those who transport them, and the institutions that regulate and finance the work. Why would a worker lay one block upon another if not to raise something larger than himself? Without the others, his action would lose its meaning—and yet, theirs too would make no sense without a shared purpose: for the bridge to hold the crossing. In that sense, every human organization is also a complex system, a web of interdependencies that only makes sense in relation to the goal that gives it coherence.

That coordinated action can be so intricate that it involves millions of people. Think, for instance, of the healthcare system. Developers, doctors, nurses, cleaning staff, administrators, researchers, lawmakers, pharmaceutical companies, medical sales reps, insurers, tech firms, builders, international agencies, academic journals, YouTube channels—and the list goes on. All of them act in different ways, in different places, with different tools and forms of knowledge, yet under the assumption that their actions contribute, in one way or another, to a shared end.

And what is that end? Health.

What Is Health?

If the entire system stopped contributing to health, it would lose its meaning. It would no longer fulfill its reason for being. It would be like a bridge that carries no one, or a justice system that fails to deliver justice. The healthcare system, with all its complexity, only holds legitimacy as long as what it protects and produces remains recognizable as health.

But what is health?

If we don’t clearly understand what the system is meant to care for, how can we know whether it’s succeeding? When doctors tell us we’re healthy, which definition are they using? When the media talks about health, what are they really talking about? And when we say we’re healthy—what do we actually mean?

For us, in our daily work at ON Care, this question is not theoretical—it’s existential. It’s a question we return to constantly, to make sure that what we do, and why we do it, still makes sense.

Some would say that health is simply the absence of disease. By that logic, the role of the healthcare system is to intervene when something stops working as it should—a tissue, an organ, a function, a behavior. In practice, this is the definition most people seem to live by: we only worry about health when illness appears. The rest of the time, we assume we’re fine, healthy, and move on.

When we think this way, the doctor’s role—and by extension, the system’s role—is clear: to restore what has deviated from proper function. The system activates when something breaks down. Its engine is not health itself, but illness. Some people go for annual checkups, looking for early signs of imbalance, but even those preventive acts revolve around the fear of disease. Prevention means avoiding sickness. Health, in this view, is simply what remains when disease is gone.

What’s the problem with this definition of health as the absence of disease?

At first glance, none—except that it’s superficial. For a doctor—and for the system that supports her—to heal us, she must understand what happens when we fall ill: what has changed within us that allowed illness to appear, what it is that we have lost. If we don’t understand that, how could we ever hope to restore health?

What we lose, when we fall ill, is balance—the balance of the system we are.

Every living being, from a single cell to an ecosystem, moves—and does so, beautifully—to remain in motion; that is, to stay alive. We are biochemical structures that must preserve certain internal conditions to continue existing. When temperature changes, we adjust our metabolism. When the environment turns hostile, we alter our behavior. When food becomes scarce, we shift our energy use or search for new sources.

What forces us to make these changes? The environment itself, which—like us—is also a chemical structure in constant transformation. Illness occurs when that external disturbance exceeds our capacity to adjust. We can sustain a reduced energy expenditure for a while, but not forever. A trauma can break the organism’s basic structure. When that ability to readjust is lost or overwhelmed, what appears is what we call disease—or, at its limit, death.

When we understand health at that level, the definition of health as the absence of disease stops being merely superficial—it becomes imprecise. We fall ill because we could not adapt, because our circumstances exceeded our ability to adjust. In that sense, it would be more accurate to say that health is not the absence of disease, but our capacity to adapt.

Adapting to What?

If we understand health as our ability to adapt, it’s worth asking: adapt to what? Understanding that relationship is essential if we hope to restore and sustain it.

Human beings are singular in both the breadth of our relationships and the diversity of levels on which they occur. We relate to the natural world, as all living beings do: changes in temperature affect us; so do changes in oxygen or food availability. Trauma, bacteria, and viruses disrupt our balance. But we also relate to other human beings, to ourselves, and—for many—to God.

In that sense, we might say that health means maintaining our adaptive capacity across all these dimensions. That’s why people speak of biopsychosocial health.

To be a doctor—or an active participant in the healthcare system—ultimately means contributing to that adaptive capacity: biologically, psychologically, and socially.

The challenge is intellectual, practical, and political.

Intellectual, because it requires building a kind of science—in the broadest sense of the word, a wisdom—that helps us understand the nature of our relationships across each of those dimensions.

Practical, because it means developing a medical, psychological, and social practice capable of accompanying the patient—to help them restore their balance and strengthen their ability to sustain it through change.

And political, because the healthcare system is part of a larger web that both shapes it and is shaped by it: society, the economy, culture. Many people live in conditions that exceed their capacity to adapt—not because they lack will, but because the circumstances themselves are overwhelming. Any human being exposed to violence, poverty, or discrimination will eventually find their limits tested.

Or, put differently: if health is our capacity to adapt, how do we cultivate that capacity—individually and collectively—to sustain life in balance?

And then we might ask ourselves: Is our system truly doing that?

Are you cultivating that capacity—for yourself, and for your family?

So that’s where we are.