The multivocality of health merits a closer look at habilitation of the disenfranchised worker.

The word healthy can be traced back through Old German to its common origins with the words hale and whole. The word hale brings to mind thoughts of endurance, fitness, strength, and physiologically combined bodily function. Whole draws upon images of integration of mental and physical processes. Whole signals a harmonious interplay between the individual and society. Being healthy, then, is a deceptive proposition in that it entails more that just biologically operative flesh. Being healthy is, in great measure, derived from epoch-specific social comparison. Individuals in every era perceive the culturally correct body-being, form and functioning, through comparison with other body-beings within their respective social networks. Health is part of our construction of the self. It entails perceptions of "normal" in bodily form and in social functioning that are subculture-specific norms of being and of doing. "Healthy" is a socially derived notion. Medicine, on the other hand, has long looked at "function" as a measure of health. Functional skills support independent living, participation in society, and quality oflife. Functional assessments are used to determine disability ratings for welfare and insurance benefits; but health is more than mere functional ability, more than a repertoire of performance skills. The individual's relative state of health can be gleaned from their purposeful occupation within society. Purposeful occupation, then, not potential ability alone, is a more certain measure of individual health. Despite biologically operative flesh and functional potential, the depressed person, as an example, is not considered a model of health or function largely because he/she is unable or unwilling to become purposefully and adequately engaged in activity. Commonly, even routine activities such as appropriate grooming and bathing may not be adequately undertaken. In contrast, a person with a physical disability, such as blindness, may not be perceived as unhealthy because he/she is purposefully engaged in the daily routines of living. The person is purposefully engaged in leisure and work, albeit by compensating for the lack of vision in ways the sighted may not employ. Therefore, the individual, although blind (disabled), IS healthy. In U.S. culture, purposeful occupation is largely conceived of as income-producing work for adult members of society. With this conception of purposeful occupation as work, work can be seen as health enabling. Work provides for the engagement of functional skills and forms a major component of the individual's personal and social identity. Herein, a question arises as to whether the disenfranchised are in fact healthy. To illustrate this concept of purposeful occupation, let me describe my experience of Sawyer Brown's pop musical hit, "The Cafe Down At The Corner." As an itinerate therapist, I often stopped off in neighboring towns to prepare for that afternoon's teaching assignment. As I gazed about at