Overview
While the National Cancer Institute defines disease as:
“an abnormal condition that affects the structure or function of part or all of the body and is usually associated with specific signs and symptoms.”
“Disease” has been used in enough ways that a discussion of its usage in contexts outside of references to physiological etiologies for suffering and dysfunction is warranted. A 2004 report from the European Molecular Biology Organization (EMBO) opens with a succinct analysis:
“The World Health Organization’s claim that health is “a state of complete physical, mental and social well‐being, not merely the absence of disease or infirmity” (WHO, 1946) has been praised for embracing a holistic viewpoint, and equally strongly condemned for being wildly utopian: the historian Robert Hughes remarked that it was “more realistic for a bovine than a human state of existence” (Hudson, 1993)”
“Notions of health are highly context‐dependent, as human diseases only exist in relation to people, and people live in varied cultural contexts. Studies in medical anthropology and sociology have shown that whether people believe themselves to be ill varies with class, gender, ethnic group and less obvious factors such as proximity to support from family members.”
“What counts as a disease also changes over historical time, partly as a result of increasing expectations of health, partly due to changes in diagnostic ability, but mostly for a mixture of social and economic reasons…” 1
In that sense, defining the dichotomy of “disease” vs “health” is a lot like attempting to articular the distinction “art” and “pornography.” As Justice Potter Stewart wrote in a concurring opinion for Jacobellis v. Ohio (1964), “I shall not today attempt further to define the kinds of material I understand to be embraced within that shorthand description [hard-core pornography]; and perhaps I could never succeed in intelligibly doing so. But I know it when I see it, and the motion picture involved in this case is not that.” Intuitively, we are strongly convinced that someone unable to get out of bed while running a fever after coming into contact with someone else with a fever may not be “healthy,” whereas an athlete who hits a PR at the gym and passes regular medical screenings may come across as a picture perfect model of health. Yet, the latter may have a gambling addiction that hasn’t financially ruined them or caused disruption in their life just yet, so we may just declare them to be healthy with a bad habit rather than unhealthy with a ticking time bomb. In that case, we really won’t know that someone’s healthy or not based on a physiological examination, and we’d have to contextualize their gambling within normal financial decisions in the society they’re in. Is buying a volatile, risky asset a form of gambling that we might call a disease or a disorder?