The classic Roman aphorism mens sana in corpore sano, or “a healthy mind in a healthy body,” reflects the belief that both types of health are important for a rich and meaningful life. But today, “health” often refers exclusively to physical health. Indeed, an estimated 75 percent of studies related to health have primary end points that address physical health only,1 while other critical components of health—mental, social, and spiritual (spiritual health including meaning, belonging, purpose, and identity, not strictly religious belief2)—have been largely ignored.3
The McKinsey Health Institute (MHI) has found that countries and societies would benefit from adopting a modernized, holistic framework for health that encompasses multiple dimensions.4 Such a broad definition of health, with a greater emphasis on well-being, was proposed as far back as 1948 by the World Health Organization (WHO), which defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”5
In 2022, MHI conducted a global survey of approximately 1,000 respondents in each of 19 countries to understand how communities around the world define health and what factors they believe influence it. Overall, respondents placed value on all four dimensions of health—physical, mental, social, and spiritual—adopting a much broader view than the health systems in the countries in which they live. Results also showed that feeling healthy is not constrained to the absence or presence of disease, indicating that people all over the world may focus more on how they can live a full and functional life on their own terms.
At the same time, the survey results revealed substantial differences in individual views, needs, and support received, often based on country, gender, age, or income. For example, even though more than 70 percent of respondents rated their overall health as good or very good, this percentage ranges from about 30 percent in Japan6 to about 90 percent in Nigeria.7 Less than 7 percent of total respondents rated their health poor or very poor.
Key survey findings
This article highlights the most meaningful survey findings as a starting point for an ongoing dialogue and exploration (for more information about the survey, see sidebar, “Survey scope and methodology”).
All dimensions of health matter
The presence of disease doesn’t always align with perceptions of health
Age does not always equate to perceptions of health
There is a negative correlation between life expectancy at birth and perception of health
Health perception and household income are positively connected in most countries
Overall, people feel best supported in their health needs by family and friends
People who feel well supported in their health needs report better health
Women and men report equivalent health support, despite evidence of inequities
Overall, male and female respondents reported comparable levels of health support and attributed similar importance to support categories such as healthcare systems and family and friends. Interestingly, men in countries with higher median incomes reported higher health support from private- and public-healthcare systems than women did. Although women and men reported the same level of health support, recent research provides evidence that across countries, women are less likely to receive comparable support.8 For example, despite suffering more severe and frequent pain over longer periods of time, women are less likely than men to be treated for pain and their symptoms are at times described as “emotional” or “psychosomatic.”9 In the United Kingdom, women are 50 percent more likely than men to be misdiagnosed following a heart attack and more likely than men to die from heart attacks.10 In the United States, one analysis of gender-specific procedures found that physician reimbursements by Medicare led to a bias in procedure selection. This reflected that reimbursements for male procedures were higher than for female procedures more than 80 percent of the time. Reimbursements were 28 percent higher on average, even though male procedures were typically no more complex.11
Individuals with a disease report lower health support than those with no disease
If individuals, businesses, and countries widen their understanding of health, they may reap the benefits of gains in life expectancy and quality of life.
Toward a modernized approach of health
Our survey suggests that people define their own health much more broadly than the presence or absence of a disease—physical and mental health matter, but so does the degree to which people feel connected, socially valued, or have a sense of purpose. This broader definition of health, encompassing physical, mental, social, and spiritual dimensions, is relevant but still nascent.
The adoption of a more comprehensive approach is likely necessary to create the lasting, meaningful, and material shifts in societal attitudes and actions to reach the full potential from improved health. If individuals, businesses, and countries widen their understanding of health, they may reap the benefits of gains in life expectancy and quality of life. This change in viewpoint may take time and may require unprecedented collaboration with a much broader set of stakeholders; more comprehensive and better data; and new ways to measure and evaluate interventions intended to improve the health of individuals.
At its heart, MHI was created to help people live longer, fulfilling lives. One facet is engaging with other stakeholders to further understand each dimension of health and the linkages between them, to identify the barriers to adopting more holistic views of health, and how to address them.