The Definition and Measurement of Health and Disease

PUBLIC HEALTH, as in most fields, morale and job satisfaction rise when goals can be defined clearly.When we can also gauge success in reaching these goals, usually termed "evaluation of effectiveness," we can see how well we are performing tasks.Moreover, when all members of an agency agree on its goals and know how progress toward them is measured, administering the agency becomes easier.Decisions about future activities can then be made lower in the oiganizational hierarchy, and there is a greater con- census on the correctness of these decisions than when goals are intangible.However, health services administrators may have more difficulty than other administrators in using the guide- lines of "management by objectives" because they lack a clear picture and good working definition of health.Despite the health administrators' plight, not everyone agrees that a good definition is needed or, indeed, that a clear definition is possible.Admittedly, some concepts or bodies of experience are too elusive to submit to definition, and health may be such a concept.A neat but inadequate definition, moreover, may serve as an excuse to stop further thought.In addition, a strict definition may cramp the growth of a field and make it difficult to justify new and