Health in the noise context: the relativity of absolute health

摘要

Noise remains a potent degrader of health in many contexts, capable of inducing severe annoyance and sleep disturbance. However, quantifying the impact of noise on health involves methods that are neither standardized nor always agreed upon. One issue centers on the conceptualization of health, and whether the WHO's guidelines suggesting that noise impact is best measured using health-related quality of life indices is in fact valid. The WHO recommendation is largely based on the fact that, unlike diseases, disability, terminal illnesses or explicit physical insults, health impacts from noise are more insidious and covert, and difficult to disentangle from other processes impacting function. Arguably, however, the WHO's 1948 seminal definition of health represents the prerequisites of good health, and does not necessarily provide a definition of health itself. More holistic definitions can be entertained, for example, good health is the ability of an organism to remain viable and successfully engage goal-directed behaviors within a host environment. Acknowledging that how health is conceptualized determines how health is measured, this paper argues that health-related quality of life has been unfairly marginalized in noise research. Furthermore, rather than being an adjunct to biomedical measures, health-related quality of life measures should be central to noise research. Interestingly, the challenging nature of quantifying the impacts of noise upon health provides a context to examine the broader meaning of health and suggest amendments to those advanced by the WHO.