This is getting more academic & philosophical than practical, but these are still important questions. Breaking it down, there are two ways equity securities, henceforth called stocks, deliver returns to their owners. The first, as we are currently discussing, is through higher prices. Buy a stock today at $50, sell it tomorrow at $60, $10 gain. Easy-peasy.
The second way is through dividends. I will only concentrate on cash dividends. Firms distribute cash dividends to the owners of their stocks. In its most simplistic form, think of the cash the company has left over after paying all expenses. The company can give the cash to its owners and is also calculated in the return. In the example above, the company pays a $10 dividend on each of its shares. The share price is reduced to $50 and the owner receives $10.
The holding period return in both is exactly the same, 20%. At the end of the day, the stock price in example 1 is $60, the stock price in example 2 is $50. It's just a difference between how the returns are received.
Regarding the second part of your post. A "healthy" (subjective term) market doesn't always have to increase prices, if it is delivering cash dividends. Remember in example 2, the stock price is exactly the same, but the owner still received the same return.
It doesn't have to have perpetual stock price growth. Utility companies are a good example of this. They don't deliver great capital gains (stock price increases) but continually have good dividend yields to their owners.
Let me know if you have more questions.