Laura Menatti

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO-'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity' (WHO in Preamble to the constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)-and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as 'coping with the environment'. We develop the idea of 'coping with the environment', by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop * Laura Menatti.

Salutogenesis is a theory of health and disease that emphasises the promotion of beneficial measures besides the prevention of risk factors and counteracting pathogens. This paper reframes salutogenesis by situating it within the account of biological autonomy and adaptivity, drawing on recent developments in organisational accounts of living systems. By doing so, the paper provides new insights into the relational, situated and continuous nature of health, and it introduces the importance of supportive ‘salutogenic environments’ to foster adaptivity as the individual and collective capacity to change ourselves, including our environments, to promote health.

All living systems need to regulate themselves and coordinate the activities of their parts to maintain themselves under changing conditions. Historically, homeostasis is one of the central ideas that have been employed to understand biological regulation. In this article we examine the application of the concept of homeostasis to medicine and its implications for understanding health. We argue that while using homeostasis to characterize health is in line with current criticisms of ideas of health as a complete state of well-being or absence of disease, such an endeavor has been hindered by the adoption of a narrow cybernetic interpretation of homeostasis based on feedback mechanisms and setpoints. This latter interpretation emphasizes stability and balance as the hallmarks of health: a stable physiological state that needs to be preserved or to which an organism needs to return after a perturbation, with change or imbalance as something to be counteracted. William Bechtel has contributed to criticizing this view and reframing the concept of homeostasis by focusing on the organism as a whole. By building on this work and looking at regulation beyond error correction as the organism’s ability to modify its internal dynamics in response to varying conditions, we apply this interpretation of homeostasis to health by advocating for a change of perspective: from a notion of health based on stability and balance to one based on adaptive change. We propose an alternative perspective that emphasizes the capability for change as a new lens through which to understand health.

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO—‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO in Preamble to the constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)—and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as ‘coping with the environment’. We develop the idea of ‘coping with the environment’, by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings.

Rosario Assunto, an Italian philosopher of aesthetics begins one of his most interesting and dense essays with a terrifying image about the Earth where we live—“calvizie della terra dissacrata” (1983, 15)—meaning that the Earth becomes bald because of the actions of the man and loses every characteristics of beauty and sacredness. According to Assunto’s theory the homo oeconomicus is the author and the promoter of a Promethean, titanic, industrial, and malodorous town where the sense of art, beauty, and the harmony in landscape are forgotten and erased. The Modern homo oeconomicus is satisfied in his thoughts and works with such a desecrated and raped Earth, rather, he desires this kind of landscape as a symbol of his own progress. I remember that when I first red this essay I asked myself what kind of philosophy I could propose in such a horizon and what kind of analysis I could develop. Maybe geophilosophy could now give some answers. Geophilosophy, according to the version I will propose, deconstructs the usual and reductionist grammar about the concept of space and place, suggesting a new expressive, perceptive and, finally, ethic possibility for the relation between human beings and places. In this article I provide my interpretation of geophilosophy, inspired by Gilles Deleuze’s words, the first philosopher of XX century who wrote about this concept. Then I will analyze nonplaces according to the famous definition proposed by the Marc Augé and I will go beyond the French anthropologist’s definition suggesting a new interpretative model for places and non-places by linking my idea of geophilosophy to Deleuze’s concept of rhizome. The aim of this article is to demonstrate the complexity of the concept of place and finally put into evidence that places, which constitute our roots, are all the spaces we have around, even non-places. The Post-modern era mainly producesnon-places: geophilosophy has to explain the philosophical and cultural reasons for this production by pointing out which possible modalities of connection we can find between contemporary human beings and places.

In this paper we address a frontier topic in the humanities, namely how the cultural and natural construction that we call landscape affects well-being and health. Following an updated review of evidence-based literature in the fields of medicine, psychology, and architecture, we propose a new theoretical framework called “processual landscape,” which is able to explain both the health-landscape and the medical agency-structure binomial pairs. We provide a twofold analysis of landscape, from both the cultural and naturalist points of view: in order to take into account its relationship with health, the definition of landscape as a cultural product needs to be broadened through naturalization, grounding it in the scientific domain. Landscape cannot be distinguished from the ecological environment. For this reason, we naturalize the idea of landscape through the notion of affordance and Gibson’s ecological psychology. In doing so, we stress the role of agency in the theory of perception and the health-landscape relationship. Since it is the result of continuous and co-creational interaction between the cultural agent, the biological agent and the affordances offered to the landscape perceiver, the processual landscape is, in our opinion, the most comprehensive framework for explaining the health-landscape relationship. The consequences of our framework are not only theoretical, but ethical also: insofar as health is greatly affected by landscape, this construction represents something more than just part of our heritage or a place to be preserved for the aesthetic pleasure it provides. Rather, we can talk about the right to landscape as something intrinsically linked to the well-being of present and future generations.