General concepts of disease
Main Article Content
Abstract
The World Health Organization’s definition of health describes a state of complete physical, mental, and social well-being, shifting the perception of disease from an accepted part of life to a deviation from an ideal of optimal wellness. This contrasts with the biomedical model, which defines health as merely the absence of disease, often overlooking psychological, societal, or environmental influences.
The definition of "disease" continues to present conceptual challenges within both societal discourse and clinical practice. Its boundaries are fluid, shaped over time by shifting cultural expectations of health, advances in diagnostic technologies, and complex socio-economic dynamics. Despite the emergence of various theoretical frameworks, ranging from statistical abnormality and functional impairment to social valuation and clinical categorization, a universally accepted definition has yet to be established.
Under the leadership of Robert F. Kennedy Jr. at the U.S. Department of Health and Human Services, the concept of disease is being reshaped to emphasize environmental factors, such as food additives and seed oils, over established biomedical causes. This shift challenges healthcare providers to integrate new frameworks into their practice while raising concerns about diverting focus from evidence-based medical interventions.
With global healthcare expenditures reaching US$9.8 trillion in 2021, accounting for one in every ten dollars of GDP, disease classification has substantial economic and societal implications. A universally applicable and holistic definition is necessary to guide healthcare providers, policymakers, and patients in navigating these evolving perspectives while ensuring the delivery of adequate medical care.
Keywords:
Disease and illness, normality, diagnosis, caregiver, philosophy of medicine
Article Details
How to Cite
GONZALEZ-FISHER, Ricardo F; RISSMAN, Steve; PRESTRIDGE, Paris Theresa.
General concepts of disease.
Medical Research Archives, [S.l.], v. 13, n. 8, aug. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6912>. Date accessed: 06 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i8.6912.
Section
Editorial
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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18. Bhattacharya S, Pradhan KB, Bashar MA, Tripathi S, Thiyagarajan A, Srivastava A, Singh A. Salutogenesis: a bona fide guide towards health preservation. J Family Med Prim Care. 2020;9(1):16 -19. doi:10.4103/jfmpc.jfmpc_260_19
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27. Kotsopoulos J. BRCA mutations and breast cancer prevention. Cancers (Basel). 2018;10(12):52 4. doi:10.3390/cancers10120524
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29. Amzat J, Razum O. Health, disease, and illness as conceptual tools. In: Medical Sociology in Africa. Springer; 2014:21-37. doi:10.1007/978-3-319-03986-2_2
30. Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA. 2013;310(13): 1353-1368. doi:10.1001/jama.2013.278040
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32. Huo S, Scialli AR, McGarvey S, et al. Treatment of men for “low testosterone”: a systematic review. PLoS One. 2016;11(9):e0162480. doi:10.1371/jour nal.pone.0162480
33. Wehmeyer ML. Disability, disorder, and identity. Intellect Dev Disabil. 2013;51(2):122-126. doi:10.1 352/1934-9556-51.2.122
34. Moynihan RN, Cooke GPE, Doust JA, Bero L, Hill S, et al. Expanding disease definitions in guidelines and expert panel ties to industry: a cross-sectional study of common conditions in the United States. PLoS Med. 2013;10(8):e1001500. doi:10.1371/journal.pmed.1001500
35. Spitzer RL, Endicott J. Medical and mental disorder: proposed definition and criteria. Ann Med Psychol (Paris). 2018;176(7):656-665.
36. Calvo F, Karras BT, Phillips R, Kimball AM, Wolf F. Diagnoses, syndromes, and diseases: a knowledge representation problem. In: Proceedings of the AMIA Annual Symposium. 2003:802.
37. Kraus A. Sufrimiento de los enfermos, ¿dónde quedó la empatía médica? Editorial. Vanguardia (Saltillo). June 29, 2025.Available at: https://vanguardia.com.mx/opinion/sufrimiento-de-los-enfermos-donde-quedo-la-empatía-medica-MF16463359. Accessed June 29, 2025
38. Hofmann B. Disease, illness, and sickness. In: The Routledge Companion to Philosophy of Medicine. Routledge; 2016. Accessed September 19, 2023. https://www.routledgehandbooks.com/doi/10.4324/9781315720739.ch2
39. King LS. Signs and symptoms. JAMA. 1968; 206(5):1063-1065.
40. Charlin B, Boshuizen HPA, Custers EJF, Feltovich PJ. Scripts and clinical reasoning. Med Educ. 2007; 41(12):1178-1184. doi:10.1111/j.1365-2923.2007.02924.x
41. National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Health Care. Washington, DC: The National Academies Press; 2015. doi:10.17226/21794
42. Kahneman D. Thinking, Fast and Slow. London, UK: Allen Lane/Penguin Books Ltd; 2011:19-30.
43. Hess B, Lipner RS, Thompson V, Holmboe ES, Graber ML. Blink or think: can further reflection improve initial diagnostic impressions? Acad Med. 2015;90(1):112-118. doi:10.1097/ACM.0000000000000550
44. Kosack CS, Page AL, Klatser PR. A guide to aid the selection of diagnostic tests. Bull World Health Organ. 2017;95(9):639-645. doi:10.2471/BLT.16.187468
45. Herman C. What makes a screening exam "good"? Virtual Mentor. 2006;8(1):34-37. doi:10.1 001/virtualmentor.2006.8.1.cprl1-0601
46. Custers EJFM. Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning. Acad Med. 2013;88(8):1074-1080. doi:10.1097/AC M.0b013e31829a3b10
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48. Zhang Q, Liu Y, Liu G, Zhao G, Qu Z, Yang W. An automatic diagnostic system based on deep learning, to diagnose hyperlipidemia. Diabetes Metab Syndr Obes. 2019;12:637-645. doi:10.2147 /DMSO.S198547
49. Undru TR, Uday U, Lakshmi JT, et al. Integrating artificial intelligence for clinical and laboratory diagnosis—a review. Maedica (Bucur). 2022;17(2): 420-426. doi:10.26574/maedica.2022.17.2.420
50. Haroz EE, Goklish N, Dillard A, et al. Enhancing health equity through community engagement in artificial intelligence–driven prevention science. OSF Preprints. Published April 2025. doi:10.31235/ osf.io/y9r75_v1
51. Swenson JR, Clinch JJ. Assessment of quality of life in patients with cardiac disease: the role of psychosomatic medicine. J Psychosom Res. 2000;4 8(4-5):405-415. doi:10.1016/S0022-3999(99)00092-6
52. Jilch S, Sel R, Shariat S. Medical practice and placebo response: an inseparable bond? Wien Klin Wochenschr. 2020;132:228-231. doi:10.1007/s005 08-020-01626-9
53. Chipidza FE, Wallwork RS, Stern TA. Impact of the doctor-patient relationship. Prim Care Companion CNS Disord. 2015;17(5). doi:10.4088/PCC.15f01840
54. American Medical Association. What is physician burnout? Published 2023. Accessed January 3, 2024. https://www.ama-assn.org/practice-management/physician-health/what-physician-burnout
55. Sanchez-Reilly S, Morrison LJ, Carey E, Bernacki R, O'Neill L, Kapo J, Periyakoil VS, Thomas Jde L. Caring for oneself to care for others: physicians and their self-care. J Support Oncol. 2013;11(2):75-81. doi:10.12788/j.suponc.0003. PMID:23967495; PM CID:PMC3974630
56. Underdahl L, Ditri M, Duthely LM. Physician burnout: evidence-based roadmaps to prioritizing and supporting personal wellbeing. J Healthc Leadersh. 2024;16:15-27. doi:10.2147/JHL.S389245
57. Ruksakulpiwat S, Zhou W, Phianhasin L, Benjasirisan C, Fan Y, Su T, Chiaranai C. The experience of caregivers of chronically ill patients during the COVID-19: a systematic review. Chronic Illn. 2022;18(3):488-502. doi:10.1177/17423953211064854
58. Weintraub WS. The economic burden of illness. JAMA Netw Open. 2023;6(3):e232663. doi: 10.1001/jamanetworkopen.2023.2663
59. van der Linden R, Schermer M. Health and disease as practical concepts: exploring function in context-specific definitions. Med Health Care Philos. 2022;25(1):131-140. doi:10.1007/s11019-021-10058-9. PMID:34783971; PMCID:PMC8857121
2. Sartorius N. The meanings of health and its promotion. Croat Med J. 2006;47(4):662-664.
3. World Health Organization. Global spending on health: Coping with the pandemic. Geneva, Switzerland: WHO; 2023. Accessed June 27, 2025. https://www.who.int/publications-detail-redirect/9789240086746
4. The Guardian. RFK Jr praises beef tallow on Fox News show with burger and fries. The Guardian. March 12, 2025. Accessed March 13, 2025. https://www.theguardian.com/us-news/2025/mar/12/rfk-jr-hannity-interview-beef-tallow
5. Laurel SJ. Medicine as a sacred vocation. Proc (Baylor Univ Med Cent). 2018;31(1):126-131. doi:1 0.1080/08998280.2017.1400318
6. Hardy K. Paleomedicine and the evolutionary context of medicinal plant use. Rev Bras Farmacogn. 2021;31(1):1-15. doi:10.1007/s43450-020-00107-4
7. Spikins P, Needham A, Tilley L, Hitchens G. Calculated or caring? Neanderthal healthcare in social context. World Archaeol. 2018;50(3):384-403. doi:10.1080/00438243.2018.1433060
8. Gonzalez-Fisher R, Flores-Shaw P. El papiro quirúrgico de Edwin Smith. Anales Médicos. 2005; 50(1):43-48.
9. Patwardhan B, Warude D, Pushpangadan P, Bhatt N. Ayurveda and traditional Chinese medicine: a comparative overview. Evid Based Complement Alternat Med. 2005;2(4):465-473. doi:10.1093/ ecam/neh140
10. Lagay F. The legacy of humoral medicine. Virtual Mentor. 2002;4(7):206-208. doi:10.1001/ virtualmentor.2002.4.7.mhst1-0207
11. Craik EM. Hippocratic bodily “channels” and oriental parallels. Med Hist. 2009;53(1):105-116. doi:10.1017/s0025727300003331
12. Karabatos I, Tsagkaris C, Kalachanis K. All roads lead to Rome: aspects of public health in ancient Rome. Le Infez Med. 2021;29(3):488-491. doi:10.53854/liim-2903-21
13. Starr, P., (1984). The social transformation of american medicine : the rise of a sovereign profession and the making of a vast industry (Updated). (2017). Basic Books. May 30 2017
14. Svalastog AL, Donev D, Jahren Kristoffersen N, Gajović S. Concepts and definitions of health and health-related values in the knowledge landscapes of the digital society. Croat Med J. 2017;58(6):431-435. doi:10.3325/cmj.2017.58.431
15. Mellor D. What exactly is a disease? Simple question but complex answer. Times of Malta. July 25, 2019. Accessed September 6, 2023. https://timesofmalta.com/articles/view/what-exactly-is-a-disease-simple-question-but-complex-answer.724471
16. Scully JL. What is a disease? EMBO Rep. 2004;5(7):650-653. doi:10.1038/sj.embor.7400195
17. Kishan P. Yoga and spirituality in mental health: illness to wellness. Indian J Psychol Med. 2020;42(5 ):411-420. doi:10.1177/0253717620946995
18. Bhattacharya S, Pradhan KB, Bashar MA, Tripathi S, Thiyagarajan A, Srivastava A, Singh A. Salutogenesis: a bona fide guide towards health preservation. J Family Med Prim Care. 2020;9(1):16 -19. doi:10.4103/jfmpc.jfmpc_260_19
19. Kraus A. ‘En el mismo río entramos y no entramos’: Enfermedad: leer a Heráclito. Vanguardia (Saltillo). March 16, 2025. Accessed March 16, 2025. https://vanguardia.com.mx/opinion/en-el-mismo-rio-entramos-y-no-entramos-enfermedad-leer-a-heraclito-CP15295564
20. Burrows W, Scarpelli DG. Disease. Encyclopedia Britannica. September 6, 2023. Accessed June 27, 2025. https://www.britannica.com/science/disease
21. Catita M, Águas A, Morgado P. Normality in medicine: a critical review. Philos Ethics Humanit Med. 2020;15(1):3. doi:10.1186/s13010-020-00087-2
22. Canadian Medical Association. How to read clinical journals: II. To learn about a diagnostic test. Can Med Assoc J. 1981;124(6):703-710.
23. Sandler A. The legacy of a standard of normality in child nutrition research. SSM Popul Health. 2021; 15:100865. doi:10.1016/j.ssmph.2021.100865
24. Kotchen T. Developing hypertension guidelines: an evolving process. Am J Hypertens. 2002;27(6):7 65-772. doi:10.1093/ajh/hpt298
25. Lin JD, Chen YL, Wu CZ, Hsieh CH, Pei D, Liang YJ, Chang JB. Identification of normal blood pressure in different age group. Medicine (Baltimore). 2016;95(14):e3188. doi:10.1097/MD.0000000000003188
26. Lombardi L, Bramanti SM, Babore A, Stuppia L, Trumello C, Antonucci I, Cavallo A. Psychological aspects, risk and protective factors related to BRCA genetic testing: a review of the literature. Support Care Cancer. 2019;27(10):3647-3656. doi:10.1007/ s00520-019-04918-7
27. Kotsopoulos J. BRCA mutations and breast cancer prevention. Cancers (Basel). 2018;10(12):52 4. doi:10.3390/cancers10120524
28. ten Have H. Bizarre Bioethics: Ghosts, Monsters, and Pilgrims. 1st ed. Baltimore, MD: Johns Hopkins University Press; 2022.
29. Amzat J, Razum O. Health, disease, and illness as conceptual tools. In: Medical Sociology in Africa. Springer; 2014:21-37. doi:10.1007/978-3-319-03986-2_2
30. Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA. 2013;310(13): 1353-1368. doi:10.1001/jama.2013.278040
31. Mehta J, Kling JM, Manson JE. Risks, benefits, and treatment modalities of menopausal hormone therapy: current concepts. Front Endocrinol (Lausanne). 2021;12:564781. doi:10.3389/fendo.2021.564781
32. Huo S, Scialli AR, McGarvey S, et al. Treatment of men for “low testosterone”: a systematic review. PLoS One. 2016;11(9):e0162480. doi:10.1371/jour nal.pone.0162480
33. Wehmeyer ML. Disability, disorder, and identity. Intellect Dev Disabil. 2013;51(2):122-126. doi:10.1 352/1934-9556-51.2.122
34. Moynihan RN, Cooke GPE, Doust JA, Bero L, Hill S, et al. Expanding disease definitions in guidelines and expert panel ties to industry: a cross-sectional study of common conditions in the United States. PLoS Med. 2013;10(8):e1001500. doi:10.1371/journal.pmed.1001500
35. Spitzer RL, Endicott J. Medical and mental disorder: proposed definition and criteria. Ann Med Psychol (Paris). 2018;176(7):656-665.
36. Calvo F, Karras BT, Phillips R, Kimball AM, Wolf F. Diagnoses, syndromes, and diseases: a knowledge representation problem. In: Proceedings of the AMIA Annual Symposium. 2003:802.
37. Kraus A. Sufrimiento de los enfermos, ¿dónde quedó la empatía médica? Editorial. Vanguardia (Saltillo). June 29, 2025.Available at: https://vanguardia.com.mx/opinion/sufrimiento-de-los-enfermos-donde-quedo-la-empatía-medica-MF16463359. Accessed June 29, 2025
38. Hofmann B. Disease, illness, and sickness. In: The Routledge Companion to Philosophy of Medicine. Routledge; 2016. Accessed September 19, 2023. https://www.routledgehandbooks.com/doi/10.4324/9781315720739.ch2
39. King LS. Signs and symptoms. JAMA. 1968; 206(5):1063-1065.
40. Charlin B, Boshuizen HPA, Custers EJF, Feltovich PJ. Scripts and clinical reasoning. Med Educ. 2007; 41(12):1178-1184. doi:10.1111/j.1365-2923.2007.02924.x
41. National Academies of Sciences, Engineering, and Medicine. Improving Diagnosis in Health Care. Washington, DC: The National Academies Press; 2015. doi:10.17226/21794
42. Kahneman D. Thinking, Fast and Slow. London, UK: Allen Lane/Penguin Books Ltd; 2011:19-30.
43. Hess B, Lipner RS, Thompson V, Holmboe ES, Graber ML. Blink or think: can further reflection improve initial diagnostic impressions? Acad Med. 2015;90(1):112-118. doi:10.1097/ACM.0000000000000550
44. Kosack CS, Page AL, Klatser PR. A guide to aid the selection of diagnostic tests. Bull World Health Organ. 2017;95(9):639-645. doi:10.2471/BLT.16.187468
45. Herman C. What makes a screening exam "good"? Virtual Mentor. 2006;8(1):34-37. doi:10.1 001/virtualmentor.2006.8.1.cprl1-0601
46. Custers EJFM. Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning. Acad Med. 2013;88(8):1074-1080. doi:10.1097/AC M.0b013e31829a3b10
47. Briganti G, Le Moine O. Artificial intelligence in medicine: today and tomorrow. Front Med (Lausanne). 2020;7:27. doi:10.3389/fmed.2020.00027
48. Zhang Q, Liu Y, Liu G, Zhao G, Qu Z, Yang W. An automatic diagnostic system based on deep learning, to diagnose hyperlipidemia. Diabetes Metab Syndr Obes. 2019;12:637-645. doi:10.2147 /DMSO.S198547
49. Undru TR, Uday U, Lakshmi JT, et al. Integrating artificial intelligence for clinical and laboratory diagnosis—a review. Maedica (Bucur). 2022;17(2): 420-426. doi:10.26574/maedica.2022.17.2.420
50. Haroz EE, Goklish N, Dillard A, et al. Enhancing health equity through community engagement in artificial intelligence–driven prevention science. OSF Preprints. Published April 2025. doi:10.31235/ osf.io/y9r75_v1
51. Swenson JR, Clinch JJ. Assessment of quality of life in patients with cardiac disease: the role of psychosomatic medicine. J Psychosom Res. 2000;4 8(4-5):405-415. doi:10.1016/S0022-3999(99)00092-6
52. Jilch S, Sel R, Shariat S. Medical practice and placebo response: an inseparable bond? Wien Klin Wochenschr. 2020;132:228-231. doi:10.1007/s005 08-020-01626-9
53. Chipidza FE, Wallwork RS, Stern TA. Impact of the doctor-patient relationship. Prim Care Companion CNS Disord. 2015;17(5). doi:10.4088/PCC.15f01840
54. American Medical Association. What is physician burnout? Published 2023. Accessed January 3, 2024. https://www.ama-assn.org/practice-management/physician-health/what-physician-burnout
55. Sanchez-Reilly S, Morrison LJ, Carey E, Bernacki R, O'Neill L, Kapo J, Periyakoil VS, Thomas Jde L. Caring for oneself to care for others: physicians and their self-care. J Support Oncol. 2013;11(2):75-81. doi:10.12788/j.suponc.0003. PMID:23967495; PM CID:PMC3974630
56. Underdahl L, Ditri M, Duthely LM. Physician burnout: evidence-based roadmaps to prioritizing and supporting personal wellbeing. J Healthc Leadersh. 2024;16:15-27. doi:10.2147/JHL.S389245
57. Ruksakulpiwat S, Zhou W, Phianhasin L, Benjasirisan C, Fan Y, Su T, Chiaranai C. The experience of caregivers of chronically ill patients during the COVID-19: a systematic review. Chronic Illn. 2022;18(3):488-502. doi:10.1177/17423953211064854
58. Weintraub WS. The economic burden of illness. JAMA Netw Open. 2023;6(3):e232663. doi: 10.1001/jamanetworkopen.2023.2663
59. van der Linden R, Schermer M. Health and disease as practical concepts: exploring function in context-specific definitions. Med Health Care Philos. 2022;25(1):131-140. doi:10.1007/s11019-021-10058-9. PMID:34783971; PMCID:PMC8857121