At first, finding the words pandemic and health in the same sentence might feel strange. After all, the word pandemic is almost always associated with diseases.
Upon closer examination, the possibility of the existence of a pandemic of health makes sense. Etymologically, for instance, the word has nothing to do with diseases. It comes from the Greek terms pan and demos, which mean all, and people, respectively (53).
From a policy and academic perspective, the case is also easy to make. Although the word pandemic was used for the first time in 1666, the need to interest in achieve consensus about its meaning was spurred by the confusion that became evident during the influenza outbreak of 2009 (54). Nowadays, there is really a single criterion to declare something to be pandemic, derived from a careful analysis of historical instances in which the word has been associated with outbreaks of infectious diseases. This criterion is wide geographic extension (55), usually involving multiple countries or continents, and usually affecting a substantial proportion of the population (56). The World Health Organization (WHO) would declare a pandemic when there are communities affected in at least two countries in one of its regions, and affects at least another continent (57).
If widespread geographic presence is the mainstay of pandemics, then health qualifies as such, and could even be considered as the one of the most extensive of all cases ever reported. A good foundation for this assertion is the World Health Survey, a cross-sectional study coordinated by the WHO from 2002 to 2004, which involved 69 representative nations in the world, and included 271,371 people over the age of 18 years (58). One of the questions in the survey asked people to judge their own health. When the answers are analyzed in aggregate, 62% of people reported their own health to be good or very good (59).
The prevalence of health judged by people to be good or better - which could be regarded in a more general sense as "positive health" (60-62) - is much higher than any of those recorded for the worst pandemics of infectious diseases reported to date. The Black Death was responsible for around 50 million deaths (63), representing 11% of the global population of 450 million people (64). The Spanish Flu pandemic was responsible for the deaths of 3% of the world's population during the late 1910s (65). Even the death toll of the infectious diseases that killed more than 90% of the indigenous peoples of the Americas after the arrival of the European colonizers is estimated at up to 45 million, which is equivalent to 9% of the total world's population in the 15th century. Even if 100% of the native population had been infected, the latter proportion would have increased by just 1% (64).
Perhaps the only condition that has a higher prevalence than positive health is dental caries, which is present in 60% to 90% of school children and 100% of adults, worldwide (66). All other chronic ailments which have been suggested as pandemic (67) pale in comparison with them. Overweight, for instance, is present in 1.9 billion people, representing only 25% of the world's population (68).
In countries like Canada, the figures of positive health are staggeringly high. In 2015, for instance, 89% of the population surveyed reported their own health to be good, very good or excellent (69). Even when faced with multiple chronic conditions, most Canadians perceive themselves to be healthy, as indicated by survey of over 3,000 people aged 65 years or older showed that 77% of those with two chronic diseases, and 51% of those with three or more diseases regarded their health to be good, very good, or excellent (70). An Australian study further illustrated not only that most people (62%) living with advanced incurable cancer consider their health to be good or better, but also that self-assessments are powerful predictors of their survival (47,71,72).
These data confirm that every person has the opportunity to experience positive health, making a complete pandemic of health - one affecting every human being - feasible and potentially viable.