Words matter. Over the past 60 years, we have changed the language describing our approach to health, wellness and well-being. At face value, this transition seems simple. We were first advised to seek “health” in the 1950s and then “wellness” in the ‘70s, ‘80s, and ‘90s. Now, we have moved on to “well-being.”

These terms evolved from the old notion of health as simply the absence of disease, to wellness as health and stress resilience. Ultimately, the term “well-being” now encompasses the broader social and environmental aspects of our lives.

It’s a nice story. But even in the late 1940s, the World Health Organization defined health as a state of complete physical, mental, and social well-being — not merely the absence of disease or infirmity. This includes various elements as peace, shelter, education, food, income, a stable eco-system, sustainable resources and social justice.

This sounds a lot like our modern definition of well-being.

As for the term “wellness,” Dr. Bill Hettler and the National Wellness Institute developed the idea of lifestyle dimensions in the 1970s, which had to be achieved in order to have true wellness. These dimensions included physical, emotional, spiritual, intellectual, environmental and social elements. Here and there, others tacked on other components such as relationship, finances or community.

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Again, like the term “health” before it, “wellness” was defined in the same very broad holistic way.

What’s odd about this chronology is how we keep re-writing history. For example, compare two quick internet searches: the difference between the terms health and wellness and the difference between the terms wellness and well-being.

Health and wellness are not synonyms. Health refers simply to a physical body being free from diseases, but wellness is an overall balance of your physical, social, spiritual, emotional, intellectual, environmental and occupational well-being.

Likewise, wellness and well-being are not the same thing. Well-being refers to a more holistic whole-of-life experience, whereas wellness refers just to physical health.

It’s like the film “Groundhog Day.” Health, wellness and well-being are all defined pretty much the same way. But every 30 years or so we trash the prior term as too limiting, adopt a new one that looks just like the old one and feel rejuvenated.
How can we make sense of this?

The changes that have occurred over time are actually meaningful. In the 1950s and 1960s, even though the definition of health was expansive and inclusive, the approach was nevertheless constrained. Companies weren’t concerned about how employees felt, just whether they were sick or not. In other words, there was a difference between the theoretical definition of health and its practical application.

This is likely the reason that practitioners wanted to broaden what they saw as an overly narrow approach. Because the definition did not square with what was actually being practiced, it seemed that there needed to be an entirely new framework to rejuvenate the tired and incomplete approach.

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So, new wellness wine was put into old bottles, and health became wellness.

The perception was that wellness was a new idea that broke from the past, moving beyond the idea that health represents just the absence of disease. This re-framing worked to popularize its more holistic aspects: the importance of stress, resiliency and better time management.

Today, the same transitional cycle is happening again as the new buzzword, well-being, takes the baton from wellness. Well-being is said to include the social, financial, and environmental elements that wellness lacked. But those who advocate turning from wellness to well-being make the same mistake as their predecessors did 40 years ago.

This kind of linguistic rebirth seems to be necessary to create a renewed sense of purpose and possibility. Yes, it’s self-delusional about its own history, but the new term nevertheless results in fresh elements added into the cultural conversation; that process has helped us to approach the original intent of “health” almost 70 years ago.

In the end, the answer to the original question about “semantics vs. substance” is that it is both, as language pushes the culture to realize the promise of its original nature. The semantics, in this case, help create substance.