‘Health and well-being’: Questioning the use of health concepts in public health policy and practice

In recent years, health and well-being have been ‘mainstreamed’ as a policy issue and have become the concern of a widening range of agencies. Simultaneously, increasing weight has been placed on the measurement of population health status, the implementation of evidence-based practice in public health and the more effective evaluation of policy interventions targeted at health gain and health inequalities. Thus, at a time when greater conceptual clarity is crucial, there are more stakeholders in ‘health’, each with a potentially different perspective and understanding of what ‘health’ is. In this study, we explore the need for greater conceptual clarity in relation to health, using the term ‘well-being’ as an exemplar. We draw on findings from a research project undertaken with community and professional groups in the Black Country and Shropshire that explored shared ways to measure aspects, and determinants, of health. We suggest a lack of attention to health concepts and their clarification, as indicated by the use of ‘well-being’ as an ill-defined tag to health, is having a negative impact on public health's ability to deliver health gain, and that commitment to clarifying concepts would lead to a range of benefits. At present, however, the term ‘well-being’ muddies the waters, acting more as an open-ended catch-all category than a clearly considered component of ‘health’.