essay on holistic health

Essay on Holistic Health

Students are often asked to write an essay on Holistic Health in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

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100 Words Essay on Holistic Health

What is holistic health.

Holistic health is about caring for the whole person. This means looking after your body, mind, and emotions. It’s not just about not being sick; it’s about feeling good in every way.

Taking care of your body is important. Eating healthy foods, being active, and getting enough sleep are all part of this. When your body feels good, you can do your best at school and play.

Mind and Emotions

Your thoughts and feelings are also key. Talking to friends, writing in a journal, or doing things you enjoy can keep your mind and heart happy.

Together as One

Holistic health means all parts of you work together. When your body, mind, and emotions are in harmony, you’re truly healthy. It’s like a team where every player is important.

250 Words Essay on Holistic Health

Understanding holistic health.

Holistic health is about caring for the whole person. This means not just focusing on one part of the body when someone is sick, but looking at everything—body, mind, and spirit. It’s like seeing a person as a big puzzle, and each piece is important to make the whole picture.

First, let’s talk about the body. When we think of health, we often think of eating right, exercising, and getting enough sleep. These are key parts of keeping our bodies working well. Eating fruits and vegetables, playing outside, and going to bed on time help us grow strong and stay healthy.

Next is the mind. This is about our feelings and thoughts. Being happy, worrying less, and doing well in school are signs of a healthy mind. It’s important to talk about our feelings and not keep them inside. Reading books, playing games that make us think, and spending time with friends can keep our minds sharp.

Lastly, there’s the spirit. This can mean different things to different people. It might be feeling calm, being kind, or believing in something bigger than ourselves. Some people find peace in nature, others in drawing or music, and some through faith. It’s about what makes us feel good inside.

Bringing It All Together

Holistic health means taking care of all parts of ourselves. It’s like a team, where the body, mind, and spirit work together. When all parts are cared for, we feel our best. Remember, every piece of the puzzle is important to be truly healthy.

500 Words Essay on Holistic Health

When we think about staying healthy, we often picture eating right and exercising. But there’s more to health than just that. Holistic health is about caring for the whole person. It means looking after our bodies, minds, and spirits all at the same time. Imagine you’re like a puzzle, with pieces that fit together to make you whole. Holistic health is about making sure all those pieces are in good shape.

First, let’s talk about the body. This part is about eating foods that are good for you, like fruits and vegetables, and staying active. When you run, play sports, or even walk, you help your body stay strong. It’s also about sleeping well so your body can rest and repair itself. Think of your body like a car; it needs the right fuel and regular maintenance to keep running smoothly.

Next is the mind. Just like you exercise your body, you need to keep your mind active too. This can be through reading, solving puzzles, or learning new things at school. It’s also important to talk about your feelings and not keep them bottled up inside. When you’re sad, worried, or angry, talking to friends, family, or a teacher can make a big difference. Your mind is like a garden; it needs to be looked after and given room to grow.

Then there’s the spirit. This doesn’t just mean religion, although for some people, that’s a part of it. It’s about feeling happy, loving yourself, and enjoying life. You can feed your spirit by doing things you love, like playing music, painting, or spending time in nature. Your spirit is like a bird; it needs space to soar and explore.

Connecting the Pieces

Holistic health is about connecting all these pieces. It’s like when you help a friend, you’re not just being kind; you’re also making your own spirit feel good. Or when you learn something new, you’re not just making your mind sharper; you’re also giving your spirit a boost because it feels great to learn.

Everyone Together

Holistic health isn’t something you do alone. Your family, friends, and community are all part of it. They can support you, cheer you on, and help you stay on track. It’s like being on a team where everyone wants you to win.

Small Steps

You don’t have to make big changes all at once to be more holistic. Small steps can make a big difference. Choose a fruit instead of a candy bar, take a walk instead of watching TV, or tell someone how you feel instead of keeping it to yourself. Each little choice adds up to a healthier you.

In Conclusion

Holistic health is a big idea, but it’s made up of small, simple parts. It’s about taking care of your body, mind, and spirit, and making sure they all work together. It’s like a team, where each player has a special job, but they all need to work together to win the game. By looking after all parts of yourself, you can feel your best and do your best in everything you do.

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The Holistic Health Promotion Model Overview Essay

Introduction, a holistic health promotion strategy, the importance of the preparation of a holistic health promotion strategy, assessment of data in the development of a holistic health promotion strategy, effective communication of the health promotion strategy to patients, reference list.

The holistic health promotion model offers better therapy, is very logical but at the same time narrow. It disqualifies other measures that are “like Cures”. The holistic approach takes the best possible perception of sickness, addressing the various possible causes, offering a therapy process that is multi-dimensional that is opposed to the cures that target specific illnesses. The model is concerned with an individual’s susceptibility towards disease as well as the transmission. The approach also assesses how people can try to get more hardy or disease-resistant before seeking intervention by medication or become more resilient before catching a disease. This paper will therefore address the concerns in a holistic approach that will include spiritual support and beliefs, physical concerns, and the possible distress in the context of a family; the significance of a holistic health strategy; the importance of the holistic approach, and development of the strategy.

Holistic support of health is an intervention strategy that takes into account factors that affect the wellbeing of human beings and these include the physical body, the emotional aspect, the mind, and the spiritual perception of human beings. The strategy also combines the best service in modern medicine about the diagnosis, monitoring, and prognosis as well as intervention (Berg, 2002, p. 385). In this case, ancient and innovative means of intervention can be used to support modern therapy in achieving better results.

The patients seem to be strict believers and therefore staunch followers of their religious beliefs as well as their cultural principles. This is evidenced by the fact that Manam who is a male aged 55 years of age suffers depression, anxiety as well as painful urination but does not want his wife to be notified of his condition. He also finds it very hard to discuss his problem with the female nurses. When asked questions that related to his other urinary symptoms, the patients feel very reluctant to inform the female nurses. In the first year, he had denied hematuria but he ultimately came to admit having experienced hematuria.

Shuba, the wife of Manan states that she had been using herbal drugs which have not worked for her, however. During the examination, the patient hesitated to take off her gown due to issues of modesty. Furthermore, she has continued taking foods that are high in carbohydrates and fats despite having been on high blood pressure drugs. The strategy of intervention, in this case, will be very critical since the patients will need to be monitored and treated in a way that they would feel that their spiritual or cultural beliefs are not infringed.

The holistic approach will work on the basis that good health is a very strong social and economic resource (Berg, 2002, p. 385). As a result, this would call for advocacy of better health. The patients will be counseled to understand that their cultural, environmental, social, and economic life dimensions can be tuned to favor good health. Otherwise if not properly managed, it could be very harmful.

‘Enabling’ will be the process of making the patients understand that the cultural and spiritual differences with the current medication state and ensure that the patients get the opportunity to utilize the resources that will make them achieve full health potential rather than focus on the herbal medicine that has not been working (Berg, 2002, p. 385). After understandings that medical problems are not just about the symptoms, the patients will be more likely to discuss with family members and as a result, actively get involved in the process of healing rather than sit back and be passive recipients of care.

A holistic approach is very important to the 21 st century as a way of achieving health intervention since it offers a solution to the entire problems that are underlying in this case. Good health is considered the most realistic and inalienable resource that can help an individual meet his/her social, economic, cultural, and even political satisfaction (Berg, 2002, p. 389). When the disease is healed then the patient will not only enjoy that absence of the symptoms but the dieses itself will be healed. And since the approach also covers the aspects of emotions and society, the patients experience a state of complete mental, physical and social comfort.

The process can integrate very well with moderns scientific discoveries in the medical practice. Therefore their preparation can go a long way in enhancing tee process of healing the patient. The process needs proper preparation since it involves some activities that could be tasking. This is because some of the intervention measures include exercise, observing a natural diet, relaxing, using an herbal medication, and use of additional nutrition supplements, spiritual and mental counseling as well as other self-regulated practices (Naidoo & Wills, 2000, p. 45).

The significance of a holistic approach in this process is that it will be able to address not only the symptoms but rather the whole person. As a craftsman, Manan will be able to get back to his work comfortably while his wife will b able to manage her weight and the cases of fatigue she suffered on exertion. The two granddaughters Achala and Gara will be helped to manage behavior problems and emotional issues due to the loss of parents respectively. The holistic process will address the current state of the patients who need counseling like in the case of Gara and Achala for them to get to terms with the life condition at home considering that their parents are dead and the grandparents are ailing. The process will be in this case addressing the prevention of further problems, emphasizing on maintenance of good health, achieving a very high degree of wellness and life longevity (Naidoo & Wills, 2000, p. 45). The process is a very successful paradigm in medication as it ensures the patient is an active participant in the process of healing.

Data assessment is very important in developing a holistic health plan as the strategy usually approaches the problems from a multi-dimensional perspective. It would be therefore very beneficial when the practitioners or the person administering therapy have a full understanding of the patients. To begin with, it’s imperative to understand how the lifestyle of the patient impacts the physical, emotional, economical intellectual, and spiritual elements (Naidoo & Wills, 2000, p. 49). From that, the practitioner can be able to find out how to develop a plan that would be effective and very appropriate in achieving the required results. This is of course after assessing the patient’s beliefs about such an 8intervention and counseling them on the process which would be very easy to attain since holistic intervention blends well with many forms of therapy (Naidoo & Wills, 2002, p. 78). The main focus here will be on personal resources which include mental aspects, physical wellbeing, and spiritual growth. Since the family in this context seems to be very religious and strict observers of their cultural beliefs, counseling, and understanding of the new therapies will be highly needed (Naidoo & Wills, 2000, p. 45). Knowing that Manan has a history of depression, anxiety and does not want to tell their wife about his problem that affects his urinary and reproductive system is evidence that he is somehow conservative due to culture or religion. The same goes for the wife, Shuba who feels uncomfortable undressing for the medical examination for modesty reasons. Achala has a character problem and hence finds a problem making new friends. Gara suffers emotionally and therefore develops a negative attitude towards medication due to the way they make her feel, “weird and different”.

Since the health promotion strategy in holistic healing involves covering several dimensions that affect the wellbeing of an individual, it’s usually a problem to communicate the aim of the process. Many people will be that their privacy is being infringed especially when discussing some spiritual matters they are not comfortable sharing out or are not allowed by religion (Naidoo & Wills, 2002, p. 78). For modesty reasons, Shuba feels uncomfortable taking off her gown, Manan on the other hand feels hesitant to tell female nurses about his urinary problem.

To effectively communicate that health promotion is important to patients, guiding and counseling will need to be used. Patients have to be made to understand that being healthy is the greatest resource a human being can ever have. From here, they need to be made to appreciate that all efforts have to be employed to ensure that health status is restored despite the conditions one has to go through (Naidoo & Wills, 2002, p. 78). There could be ethical concerns but when it comes to health issues the trained medical practitioners are required to assist as much as possible to save a life. The spiritual concerns of the patients can be compromised for life’s sake. The type of care to be administered is evidence-based and the patients have to be given the reassurance that the process serves in their best interests at heart (Naidoo & Wills, 2002, p. 78).

From ancient times, many communities have struggled to come up with several explanations or adopt new justifications and philosophies in their enthusiastic quest for better health. In some instances, sickness has been associated with evil spirits, microbes, and divine retribution. The contemporary approach on the other hand bases its arguments on the contagion illness theory and symptom control in diseases and hence promotes medicine and other measures that counter any damaging agents to the body. Health promotion and holistic approach hence aims at changing certain behaviors, managing risk factors, offering intervention and alleviating fears, and thus giving individuals alternative ways of life and medication that will enable them to achieve healthier lives.

Berg, G.V. (2002). A Holistic-Existential Approach To Health Promotion Scandinavian Journal Of Caring Sciences, 17 (4): 384 – 391

Naidoo J, & Wills J. (2000). Health Promotion : Foundations for Practice . 2 nd Ed. Edinburgh & New York: Baillière Tindall Pub.

Naidoo, J., & Wills, J. (2002). Complementary Therapies: A Resource for Integrated Practice . London: Elsevier Science Publishers.

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What Is Holistic Health and Why Is It so Important?

Last Updated: June 8th, 2021

Holistic health has become a popular topic lately. Many medical practitioners and self help gurus are adopting the holistic approach, but it is more than just an ephemeral trend. Holistic healthcare is an integrative approach to health and wellbeing, which sees the person as a whole, not just a symptom to treat.

• What Is Holistic Health?
• Why Does Holistic Health Matter?
• What Is Holistic Medicine?
• The Holistic Approach to Work Life Balance During the COVID 19 Pandemic
• How to Build Our Own Pillars of Holistic Health and Wellness While COVID-19 We Are Stuck at Home

1 . What Is Holistic Health?

Holistic health is an approach to wellness that views the human being as a whole. To achieve holistic health, a certain harmonious interaction is needed between the body, the mind, the soul, the emotions, the environment, and all the other factors that influence living. Holistic health doesn’t believe in curing one symptom, instead it aims to elevate the whole living system, which is traditionally made of 8 key components. They are known as the 8 pillars of holistic health :

Physical health : It involves taking care of the physical body, by making sure to get enough sleep, to move and to exercise regularly.

Nutritional health : You are what you eat. Nutrition influences physical, emotional and intellectual health. It’s important to consume a diet rich in vegetables and fruits, and low in processed products. Pure and clean drinking water is also a must.

Intellectual health : Making sure to challenge the brain daily is essential, either by completing puzzles, or by constantly learning something new.

Emotional health : It means developing emotional awareness and intelligence. Allowing emotions to be expressed, recognized and honored. But also being aware of one’s emotional tank, what fills it up and what drains it.

Spiritual health : This pillar may mean different things to different people, but we all have that feeling of longing for more in common. Tending to our spiritual side gives us a sentiment of belonging and of purpose.

Environmental health : It means being ecologically conscious, honoring the blue planet and its resources while being aware that we are only visitors of this earth.

Social health : Humans are naturally social creatures. Tending to our social side makes us feel a part of a pack and a community. Having a trustworthy support system and a fulfilling social life are important aspects of social health.

Financial health : Money is an important resource for security and goal-attainment. Financial health means cultivating a positive relationship with money, and mindfully managing financial resources.

2 . Why Does Holistic Health Matter?

According to the World Health Organization, health is defined as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.  

Conventional medicine only cares about disease and infirmity and doesn’t guarantee the full spectrum of health as defined above. In order to achieve this state of complete wellbeing, a holistic approach is mandatory, hence the importance of holistic health.

No one can contest with how much life has improved thanks to conventional medicine. But at the same time, we cannot deny the feelings of dissatisfaction, void, and loneliness that conventional medicine alone isn’t able to fix. Holistic health matters because conventional models of care are no longer enough.

3 . What Is Holistic Medicine?

Holistic medicine is an approach to healthcare that uses both conventional western medicine and alternative medicine as tools to ensure optimal health and wellbeing. Alternative treatments include nutrition and lifestyle interventions, therapies derived from traditional Chinese or Indian medicine, hypnosis, phototherapy, aromatherapy, meditation, and various self-development techniques.

Furthermore, in holistic medicine, the goal isn’t to cure a symptom, but rather to elevate the whole system. As a result, not only is the person healthy, but they are also the best version of themselves.

4 . The Holistic Approach to Work Life Balance During the COVID 19 Pandemic

Having a healthy work life balance is an essential part of healthy living . This has become even more important during our current situation.  During the pandemic, many of us will continue to work from home, taking on multiple roles at the same time. Consider these tips to stay healthy and productive.

The COVID 19 pandemic has changed so many things in our lives. It has pushed us out of our comfort zones, and it made us face our doubts and deepest fears. Furthermore, since most people are either working or studying from home, it has made the line that separates life and work blurrier than before, hence the need now more than ever, to set healthy boundaries for work life balance.

Most people have already heard the mainstream advice about keeping a healthy work life balance, but the holistic approach would be to examine each health pillar individually. By adopting the holistic approach to work life balance, the goal isn’t simply to avoid burnout or disease, but it’s rather to become the most healthy, vibrant, and ideal version of yourself.

5 . How to Build Our Own Pillars of Holistic Health and Wellness While COVID-19 We Are Stuck at Home

We are living in unprecedented times. The current lockdown means that we are forced to live differently and work differently. Coronavirus can stir up all sorts of feelings, like fear, anxiety or stress. In this scenario, destress technique becomes crucial. This is the best time to find simple destress technique and build your own pillars of holistic health. Here are 11 tips to get holistic health . Keep reading to find out what they are.

Instead of viewing this time of quarantine and working from home as a period of boredom and loneliness, we can view it as a chance to learn and start practicing holistic wellness.

Whether you work or study from home, there are some common pillars for holistic wellness. First you need to take care of your physical body, by taking breaks during the day, going for walks, working out and keeping a healthy sleep schedule. Being stuck at home is also a great opportunity to cook healthy meals made from fresh in season ingredients. It’s helpful to be mindful of the environment you spend most of your day in, and to ensure it is clean and tidy. Keeping in contact with friends and family is important, since spending all day at home can make us long for human warmth. Emotionally, it’s essential to be aware of how you’re feeling, and to take the necessary steps to prevent burnout and mental health issues. Keeping a steady spiritual practice can immensely help with the doubt and uncertainty that plague us all. And last but not least, it’s important to be financially aware, and to avoid overspending (or overeating for that matter) to fill any emotional void you may carry.

If you work from home:

Prioritize self care! Tend to your needs before you take care of your job, because what good is a salary at the end of the month if you feel bad about yourself?

Due to the COVID-19 pandemic, more people are working from home than ever before. Whether you are new to working remotely or just want to upgrade, these tips from remote working professionals can help you stay productive and keep your balance.

If you study from home:

We have all seen the news and are currently understanding the world situation, so we need to find effective ways to study or work at home. Take this time to reflect on your future and the things you want to become. Remember that studying is just one way to make your dreams come true. Also take this time to learn other skills that will help you in your career.

Studying at home does not have to be boring or unnecessarily complicated. Here are 5 study tips and you can combine with your own tips and tricks and set a schedule to make the most productive entrepreneurs jealous.

Remember to take regular breaks and use your free time to do things that will make you smile and feel good. There are many things you can do during the quarantine period, including cooking, playing video games, completing online courses, etc. So this is an excellent time to develop on all levels.

6 . Conclusion

Holistic wellness is an approach to healthcare that sees the person as a whole and not just a symptom. The goal of holistic wellness is to ensure optimal wellbeing and not just being free of disease. Being stuck at home because of the COVID 19 pandemic is a great opportunity to become more aware of our health, and to learn and incorporate more holistic wellness into our daily life.

Use the Wellness Wheel Worksheet to help you to identify what areas of your life are fulfilled and healthy and what areas need improvement and attention

Let Start to Practice Holistic Health

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• Published: 18 March 2020

A philosophy of health: life as reality, health as a universal value

• Julian M. Saad   ORCID: orcid.org/0000-0002-9323-1021 1 &
• James O. Prochaska 1  

Palgrave Communications volume  6 , Article number:  45 ( 2020 ) Cite this article

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• Health humanities
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Emphases on biomarkers (e.g. when making diagnoses) and pharmaceutical/drug methods (e.g. when researching/disseminating population level interventions) in primary care evidence philosophies of health (and healthcare) that reduce health to the biological level. However, with chronic diseases being responsible for the majority of all cause deaths and being strongly linked to health behavior and lifestyle; predominantly biological views are becoming increasingly insufficient when discussing this health crisis. A philosophy that integrates biological, behavioral, and social determinants of health could benefit multidisciplinary discussions of healthy publics. This manuscript introduces a Philosophy of Health by presenting its first five principles of health. The philosophy creates parallels among biological immunity, health behavior change, social change by proposing that two general functions— precision and variation —impact population health at biological, behavioral, and social levels. This higher-level of abstraction is used to conclude that integrating functions, rather than separated (biological) structures drive healthy publics. A Philosophy of Health provides a framework that can integrate existing theories, models, concepts, and constructs.

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A philosophy of health

What is health? Is it a state of the body or the mind? Is health primarily a natural, biological state or a holistic, value-laden state? Naturalistic and holistic philosophies of health have provided very important, but very different, perspectives of population health. Naturalistic views (e.g. as seen in Boorse, 1997 ) provide insight into physical, natural, biological, or physiological processes that are tangible (in the material sense), observable, and measurable with modern technology. Complementarily, holistic views contend that value-laden phenomena (e.g. vital goals, meaning, and purpose) play a central role in population health (Nordenfeldt, 2007 ).

A dialog, or as we see it, an important dialectic among naturalistic and holistic perspectives plays out between the Biostatistical Theory of Health (BST) and the Holistic Theory of Health (HTH). The BST posits that a person is healthy if and only if, all natural organs function normally given a statistically normal environment (Boorse, 1997 ). The HTH posits that a person is healthy if and only if (given standard circumstances) he/she has the ability to attain their vital goals (Nordenfeldt, 2007 ).

In addition to defining health, each philosophy defines disease. The BST poses that disease is the internal state of impairment to the normal functioning of organs (Boorse, 1997 ). In the HTH, an organ dysfunction is a disease if and only if the organ’s process reduces the person’s ability to pursue vital goals or life-purpose (Nordenfelt, 2007 ). In BST health is the absence of disease; and in HTH, health is not the absence of biological disease, but is the whole person’s ability to function in relation to vital goals.

Both naturalistic and holistic perspectives guide important observations of health and disease. When one considers health through the BST one pays close attention to the functions of the internal, biological functioning of the human being. When one considers health through the HTH, one pays close attention to the functioning of an individual, in relation to their external, societal/cultural functions. Is there a hybrid model that accounts for both internal and external functioning?

Wakefield’s ( 2014 ) harmful dysfunction analysis (HDA) creates a hybrid model that integrates natural- and value-laden phenomena when conceptualizing disease. HDA asserts that a person suffers from a disorder/disease if (1) the condition causes harm (as judged by the standards of the person’s culture); or if (2) the person’s internal, natural processes cannot perform normal functioning (as judged by the standards set by evolution). HDA creates a hybrid model that can integrate perspectives of the BST (i.e. by considering internal organ functioning); and the HTH (i.e. by considering external societal/goal functioning). However, while HDA may define health processes in relation to disease, it serves primarily as an integrative model of disease . Is there an integrative model of health that can account for natural and value-laden functions?

Schroeder ( 2012 ) identifies a significant, common thread among these competing (or perhaps complementing) philosophies: functionalism . The researcher suggests that each philosophy is concerned with the functioning of organisms. Although the BST, HTH, and the HDA might not agree on which functions inform the first principles of health, Schroder ( 2012 ) uses higher-level abstraction to identify one common first principle: the state of functioning in an organism impacts its state of health . When paralleling the three philosophies based upon functioning one might observe that (1) BST declares an individual healthy if its organs function normally; (2) HTH declares an individual healthy if he/she can function in relation to vital goals; and (3) HDA declares an individual unhealthy if internal mechanisms cannot perform natural, evolutionary functions, and/or when a condition prevents a person from functioning in relation to goals/norms/values. Through this higher-level abstraction, an integration of seemingly separate philosophies of health is made possible.

Learning from leaders in the field

As we attend to these philosophies of health, we too observe how discussions about functions and functioning produce integrative perspectives. Although a definition of “function” is not explicitly stated in the above research, it appears that Nordenfeldt ( 2007 ), Boorse ( 1997 ), Wakefield ( 2014 ), and Schroeder ( 2012 ) are each discussing functions as pre-existent (i.e. either from evolution, personal goal-setting, cultural tradition) processes - with - purposes . Whether one is describing a value-laden function (e.g. decision-making in pursuit of a valuable career) or an evolutionary-biological function (e.g. the heart beating for circulation), each process (i.e. decision-making processes or cardiac processes) serves identifiable purposes (e.g. maintained financial stability or maintained blood flow). Whether an organ is functioning normally in relation to the body or a human being is functioning in relation to vital goals, it appears that both perspectives consider if an active “process” (i.e. an organ’s activity, an individual’s activity) can express its “purpose” (i.e. evolutionary-purpose, life-purpose).

In the present manuscript we will propose that naturalistic and holistic perspectives can be integrated within a single philosophy of health. We will propose two universal functions—termed precision and variation —that can account for both natural functions and value-laden functions of the existing philosophies. This functional language will support a higher level of abstraction that integrates, rather than separates, biological functions, behavioral functions, and social functions under A Philosophy of Health.

The need for new perspectives in population health

The chronic disease crisis beckons the need for an updated philosophy of health that can account for biological, behavioral, and social functioning. Why? Chronic diseases, which account for 60% of all-cause deaths worldwide (Chartier and Cawthorpe, 2016 ), do not emerge from naturalistic, biological, or physical contact with an illness. Rather, chronic diseases do emerge in biological functions (e.g. tumor proliferation in an organ) after prolonged contact with health risk behaviors and lifestyle factors that active the conditions (Mokdad et al., 2018 ; Edington, 2009 ; Li et al., 2018 ). Chronic diseases are not curable by purely naturalistic or biological means (e.g. pharmaceuticals). Rather, some diseases may be effectively prevented or intervened on through healthy behavior (Dansinger et al., 2005 ; Daubenmier et al., 2007 ).

Population health risk behaviors are unique determinants of population health because researchers can actively observe how they simultaneously alter biological functioning (e.g. chronic smoking alters cells in lung tissue), behavioral functioning (e.g. chronic smoking alters decision-making and daily habits) and social functioning (e.g. chronic smoking creates an economic, social, and healthcare burden) of the population. These behaviors not only have biological, behavioral, and social implications for the individual doing the behavior, but also have intergenerational and interpersonal effects. The individual who binges on refined sugar not only puts themselves at risk of diabetes, but can put their future offspring at risk. The individual who smokes two packs of cigarettes per day not only puts themselves at risk of lung cancer, but can put their housemates at risk of lung cancer from second-hand smoke. Therefore, the chronic disease crisis is neither purely naturalistic, nor purely value-laden; rather it reflects an integration of natural and value-laden phenomena. There remains a real need for principles of health that can integrate existing naturalistic and holistic perspectives of population health.

The principles

Since April 7, 1948, the Constitution of the World Health Organization ( 2010 ) has utilized an intuitive definition of health by suggesting that health is “a state of complete physical, mental, and social well-being.” While this definition might be intuitive and even accessible to a wide audience; the defininition is not necessarily researchable across health disciplines. Integrating principles of health might begin with a common-sense definition of health that can also be upheld across existing naturalistic and holistic perspectives. Without operationally defining functions that drive physical, mental, and social well-being, it is a challenge for multidisciplinary collaborators to unite under the WHO mission. Further, without a common definition of health, important communications from patients to doctors, from subjects to researchers, from researchers to collaborators, and from peer-reviewers to peer-reviewees, can become fragmented or lost in translation. In the proceeding sections, a common-sense definition of health is used to present the first principles of A Philosophy of Health.

Principle 1: “Health” is the state of maintainable-ease of functioning . A “disease” is a state of prolonged-dysfunction that prevents ease

Chronic diseases emerge from prolonged exposure to dysfunctional behaviors like smoking, alcohol abuse, unhealthy diet, and inactivity (Mokdad et al., 2018 ) that also create dysfunctional expressions of life functions. Smoking creates dysfunctional breathing; alcohol abuse creates dysfunctional drinking; sugar binging creates dysfunctional eating; and sedentary behavior creates dysfunctional moving. When these health risk behaviors lead to chronic disease, they have already prolonged dysfunctional breathing, drinking, eating, and/or moving.

The chronic smoker breathes in smoke so frequently that he no longer experiences an ease-of-breathing. Rather, his breathing becomes short and shallow. Prior to the emergence of lung tumors, the chronic smoker prolongs dysfunctional patterns of breathing. The “couch potato” sits so frequently that he no longer experiences an ease-of-movement. Rather his movement becomes rigid and limited. Prior to the emergence of cardiovascular dysfunction or obesity, the sedentary person prolongs dysfunctional patterns of movement.

If chronic smoking facilitates prolonged-dysfunction in breathing, and sedentary behavior facilitates prolonged-dysfunction in movement, what do functional breathing and moving look like? Healthy breathing and moving (as well as eating and drinking) are characteristic of an ease of one’s functioning that can be maintained in normal conditions. For example, the chronic smoker and the “couch potato” might report momentary-ease in breathing and posture when engaging in their health risk behaviors; but they do not maintain that ease outside of smoking or sitting. Conversely, the yogi might report that their yoga practices expose them to momentary dis-ease in breathing and moving that lead to maintainable-ease in breathing and movement in everyday life. In contrast to disease as a prolonged-dysfunction, healthy functioning can be commonly sensed as a maintainable - ease of functioning .

When observing a disease, perhaps we are observing a prolonged-dysfunction that prevents ease. Rather than define health as the absence of disease (as seen in BST), notice here how we instead define disease in relation to health; and we define health in relation to maintainability , ease , and functioning . Consideration of “maintainable-ease of functioning” will allow us to consider how not all “dis-ease” is bad (i.e. exposure to acute dis-ease/stress maintains healthy functioning in the long-term); and not all “ease” is good (i.e. avoidance of stress and prolonged “comfort” creates fragility seen in sedentary behavior). We propose that:

Dysfunction parallels a state of “dis-ease”; and prolonged -dysfunction parallels the state of Disease.

Function parallels a state of “ease”; and maintainable-ease of functioning parallels the state of Health.

This definition of health will be applied in the proceeding principles to integrate naturalistic and holistic perspectives of population health.

Principle 2: Health emerges from maintainable-ease of functioning at multiple levels . Maintainable-ease of functioning in the general population can be observed at the level of the cell , the self , and the society simultaneously

Cooperation across multiple levels of functioning is required for the organization and adaptation of living systems (Nowak and Sigmund, 2005 ; Antonucci and Webster, 2014 ). When developing an integrative model of health, it is important to consider how biological cells, individuals, and the larger society simultaneously play a role in population health (Xavier da Silveira dos Santos and Liberali, 2019 ; Antonucci and Webster, 2014 ). In this philosophy, we define health from three levels: cells , selves, and societies . What happens when these levels do not function in cooperation?

When the functioning of cells disrupts the functioning of the self, a state dis-ease in the self can follow. For example, prolonged dysfunction in autoimmune conditions can lead to prolonged dysfunction for the (individual’s sense of) self by triggering depression, decreased motivation, or anxiety (Lougee et al., 2000 ; Garud et al., 2009 ). The reverse can also be true. When the functioning of the self (i.e. one individual) disrupts the functioning of their cells, a state dis-ease in the cells can also follow. For example, prolonged sugar binging and addictive eating can lead to prolonged high blood sugar and pancreatic dysfunction seen in diabetes (De Koning et al., 2011 ; Imamura et al., 2015 ). Cells and selves are not separate.

When the functioning of the self disrupts the functioning of the society we observe a state dis-ease in the society. For example, one person’s unprotected sex with multiple partners can also lead to epidemics and social conflicts. The reverse can also be true. When the functioning of the society disrupts the functioning of the individual, a state dis-ease in the self can follow. For example, dysfunctional social conditions (as seen in Rutter, 1998 ), can lead to prolonged psychological and behavioral dysfunctions of individuals. Selves and societies are not separate.

When the functioning of society disrupts the functioning of cells, a state of dis-ease in the cells can also follow. For example, prolonged dysfunction in society in the form of misguided values about cleanliness, can lead to over-sanitization practices that create superbugs and antibiotic-resistant bacteria (Zaccheo et al., 2017 ; Finkelstein et al., 2014 ; Bower and Daeschel, 1999 ). The reverse can also be true. When the functioning of cells disrupts the functioning of the society, a state of dis-ease in the society can follow. Prolonged dysfunction in cells from naturally occurring parasites (e.g. Yersinia pestis [Cui et al., 2013 ]) can lead to prolonged dysfunctions like the economic collapse following 14th century Black Death (Haensch et al., 2010 ). Cells and societies are not separate.

What does health look like when these levels work together? Recent reports on the Blue Zones (i.e. the areas of the world where populations live significantly longer and healthier than the average) demonstrate that healthy functioning at these levels enhances physical longevity and mental wellbeing in populations (Buettner, 2012 ; Poulain et al., 2013 ). Buettner ( 2012 ) reports on how Blue-Zone populations intentionally and habitually enrich their physical bodies with healthy eating and physical activity. In addition to integrating physical and behavioral practices, these communities also integrate behavioral and social practices, such as, goal-setting, meditations/prayer, social engagement, pursuit of purpose, and community gathering. Humor is used by individuals and groups as a means to practice ease when challenges present themselves (Buettner, 2012 ). Blue Zone communities place value upon physical/natural, behavioral and social processes, generating them intentionally and habitually.

Both states of ease and dis-ease can teach us about the contributions of cells, selves, and societies to population health. Although it is important to be able to observe the levels separately to describe their contributions, it is also important to consider how the levels integrate to impact healthy publics. We acknowledge that meaningful changes can be observed above and below these levels (e.g. at the level of the biosphere and genome). However, this initial paper will introduce levels that are most proximal and accessible to the experience of a general readership (Fig. 1 ).

Principle 3: Health emerges from systems whose primary purpose is to generate maintainable-ease of functioning at a respective level

We propose that systems exist at each level with the purpose of generating maintainable-ease of functioning at that level. The biological immune system, an individual’s system of health behaviors, and the social system will be observed as systems that generate maintainable-ease of functioning in cells, selves, and societies respectively (Fig. 2 ).

Principle 3a: The biological immune system is directly responsible for maintainable-ease of functioning at the level of the cell

Throughout the course of human evolution, the complexity and biodiversity of the human body continued to increase (Rodríguez et al., 2012 ). What keeps the trillions of cells and microorganisms in cooperation in a human body? The biological immune system maintains functional cells (Rodríguez et al., 2012 ). Although it is documented that the functioning of the biological immune system has implications for behavioral functioning (Ader, 1974 , 2000 ; Johnston et al., 1992 ; CDC, 2016 ) and social functioning (CDC, 2016 ; Reidel, 2005 ; Cutler and Miller, 2005 ) the system’s primary purpose is supporting functioning in the cellular/biological system.

Principle 3b: Health behavior is directly responsible for maintainable-ease of functioning at the level of the self

Throughout the course of time, the complexity of human behavior, has continued to increase (Boulding and Khalil, 2002 ). What keeps an individual in a state of balance during times of rapid change? One’s system of health behaviors (e.g. one’s practices of breathing, drinking, eating, and moving) maintain a functional self. Although it is well documented that the behavior of the individual impacts biological functioning (Fadel, 2013 , 2015 ) and social functioning (Omer et al., 2009 ), one’s system of health behaviors directly impacts one’s experience of (or one’s ‘sense of’) their “self”.

Principle 3c: The social system is directly responsible for maintainable-ease of functioning at the level of the society

Throughout history, the social diversity of human societies continued to increase. During periods of rapid increases in social diversity and cultural integration, what supported cooperation in the society? Social systems (e.g. public governments, private social organizations, religious/spiritual organizations) emerge to maintain a functional society. Although it is well documented that a social system can impact biological functioning (CDC, 2016 ; Riedel, 2005 ; Cutler and Miller, 2005 ) and behavioral functioning (Buettner, 2012 ), the social system’s primary role is to maintain functions at the level of the society.

Principle 3d: By considering health as maintainable-ease of functioning generated by systems , we have the ability generalize health across levels

To observe health at the level of the cell, the self, and the society simultaneously, we consider systems that support maintainable-ease of biological, behavioral, and social functioning. The biological immune system, an individual’s system of health behaviors, and the social system make meaningful contributions to the functioning of cells, selves, and societies, respectively. While these systems are not the only systems that impact each level (e.g. one’s cardiovascular system impacts cells, one’s “personality” impacts the self, the environment impacts society), the biological immune system, health behavior, and the social system have great implications for population health from their respective levels; and they can be operationalized at these levels based upon their functions .

By considering health as maintainable-ease of functioning (rather than maintained biological structures) at multiple levels, we set a point of reference from which to integrate important determinants of population health. When taking the structuralist’s perspective, the biological immune system, health behavior, and social systems appear as distinctly separated. When taking a functionalist’s perspective, the biological immune system (i.e. the integration of host defense functions and microbiota functions), one’s (system of) health behaviors (i.e. the integration of decision-making/executive functions and habits/habitual life functions), and the social system (i.e. the integration of population values and population behaviors) appear together in A Philosophy of Health.

Principle 4: Each system employs two general functions— variation and precision —to generate maintainable-ease of functioning at a level

The functionalist perspective allows us to observe systems based upon their functions . The biological immune system will be observed as an integration of host defense functions and microbiota functions (Hooper and Littman Macpherson, 2012 ); (2) an individual’s system of health behaviors will be observed as an integration of decisions/executive functions and habits/habitual life functions (de Bruin et al., 2016 ; Verplankern, 2005 ; Norman et al., 1998 ; Prochaska et al., 1994 ; Prochaska et al., 1991 ); and the social system will be observed as an integration of actively functioning values and population-wide behaviors that function in relation to those values (Dowling and Pfeffer, 1975 ; Cotgrove and Duff, 1981 ).

By researching the role of these functions at each level, we distilled two general functions of each system: variation and precision. Variation appears in the functions of each system that generate a range of abilities, the “varied-abilities”, that sustain health in presently changing conditions. The microbiota, habits/habitual life functions and population behaviors will be observed (in Principle 4a) as the variation-functions of the biological immune system, health behavior, and the social system, respectively. Precision appears in those functions that prioritize and organize the patterns of variation that can sustain health at a level in future, changing conditions. The host-defense functions, decision-making/executive functions, and values systems will be observed (in Principle 4b) as the precision-functions in the biological immune system, health behavior, and the social system, respectively.

Consideration of a complementary relationship among precision and variation is not novel. Precision and variation have been discussed as central to the development of neural and biological systems (Hiesinger and Bassem, 2018 ). Discussions of precision and variation have also provided important insight into research on the biological immune system (Albert-Vega et al., 2018 ; Brodin et al., 2015 ). Through this philosophy, one can go beyond biological systems to observe how precision (in the form of host-defense functions, decision-making/executive functions, and values) and variation (in the form of microbiota functions, habits/habitual life functions, and population-wide behaviors) integrate to generate to maintainable-ease of functioning in cells, selves, and societies simultaneously (Fig. 3 ).

Principle 4a: Variation is responsible for generating the range of abilities, the “varied-abilities”, that can express ease-of-functioning in presently changing conditions

Without functional variation, life is fragile because the present environment is always changing (Taleb and Blyth, 2011 ). Fragile systems’ inability to experience changing conditions (in part) relates to limited variability. Conversely, adaptive system’s ability to experience changing conditions (in part) relates to functional variability (Taleb, 2012 ). When one microorganism in the microbiome takes over, biological fragility reflects a state of infection. When one habit takes over, behavioral fragility reflects a state of an addiction/dependence. When one population behavior takes over (e.g. when economic participation or access to food is restricted to a small percentage of the population) social fragility reflects a state of social/civil unrest.

The human microbiota is comprised of trillions of microorganisms, such as bacteria, fungi, and viruses. When variability in the human microbiota exists, an ease of functioning, or “homeostasis” in cells can be expressed in the present biological/ecological environment (Parfrey and Knight, 2012 ; Bogaert et al., 2011 ; Claesson et al., 2011 ). Research demonstrates that variation in the microbiota impacts the health of human cells by metabolizing complex carbohydrates, converting proteins to neural signals, and modulating diurnal rhythms that maintain biological homeostasis (Clemente et al., 2012 ; Rothe and Blaut, 2012 ; Blaut and Clavel, 2007 ; De Vadder et al., 2014 ). When variation in the microbiota is dramatically limited or changed (e.g. following antibiotic overuse), cellular tissue in the human body is fragile and vulnerable to infections, allergies, and inflammatory outbreaks (Francino, 2016 ).

When one’s habitual life functions (e.g. breathing, drinking, eating, and moving) and one’s healthy habits (e.g. one’s weekly exercise schedule, or weekly meal preparation) can be expressed freely, an ease of functioning is felt by one-self in the present environment. When life functions are no longer expressed with ease (e.g. breathing and movement are compromised due to prolonged sedentary lifestyle), or when a single habit takes over one’s lifestyle (e.g. smokes breaks “must” occur every 30 min), an individual is vulnerable to stressful outbreaks and chronic states (Al’Absi, 2011 ; Conrad et al., 2007 ; Suess et al., 1980 ; León and Sheen, 2003 ; Parrott, 1999 ; Koob, 2008 ).

When the basic human rights in a society are preserved in the present (e.g. right to life, freedom of speech; right to property), human populations have the ability to freely engage in the population - wide behaviors (e.g. health behaviors, social behaviors, economic behaviors) that support a functioning society. Health behaviors drive health and longevity. Social behaviors drive communication and cooperation. Economic behaviors drive goods and resources. When these population-wide behaviors are chronically restricted in a population (e.g. poor access to health care, oppression of free-speech, economic crash), societies become vulnerable to social/civil unrest [as commented historically by Victor Frankl ( 1985 ), Alexander Solzhenitsyn ( 2003 ), Franklin D. Roosevelt ( 1941 ), and Dr. Martin Luther King ( 1985 )].

Variation is essential so that a system has varied-abilities that can express ease-of-functioning in present environmental conditions . Dramatic and prolonged restrictions to variation in the microbiota, habits/habitual life functions, and population-wide behaviors characterize fragile and vulnerable states in cells, selves, and societies. Conversely, functional-variation supports resilience, robustness, and antifragility (Taleb, 2012 ). This does not mean that infinite variation is desirable; however, in this philosophy, precision is responsible for organizing expressions of variation so that the system does not degrade into unpredictably random variation or chaos (see Principle 4b).

Principle 4b: Precision is responsible for prioritizing and organizing the patterns of variation that maintain ease-of-functioning in future, changing conditions

Some environmental changes are too challenging for ease to be expressed in the present. However, following an exposure to challenging conditions, some systems adapt and become more functional (Taleb, 2012 ). Without the ability to functionally organize after stressors, a system degrades into disorder or chaos over time. Host-defense functions, decision-making/executive functions and values systems prioritize and organize variation in the microbiota, habits/habitual life functions, and population behaviors respectively.

When a pathogen invades the biological system, precise responses must occur to organize this potentially chaotic situation. At the level of the cell, a functional host-defense system (comprised of the innate, adaptive and complement immune system branches) organizes the biological system so that functional invaders (i.e. symbionts) and healthy cells are maintained and dysfunctional invaders (i.e. pathogens) and damaged cells are removed (Hoeb et al., 2004 ; Janeway, 1992 ; Janeway and Medzhitov, 2002 ; Janeway et al., 2014 ). When precision is dysfunctional, the host-defense system may (1) fail to prioritize responses to a costly invasion, leading to a state of infection; or (2) the host-defense system might prioritize dysfunctional responses to the cells of body that prolong a state of autoimmunity (Naor and Tarcic, 1982 ).

When a bad habit emerges, precise responses must occur to organize this potentially chaotic situation. At the level of the self, functional decision-making (or at smaller scales executive functioning) prioritizes and organizes behavior so that functional expressions of habit (or at smaller scales, habitual life functions) are prioritized regularly, and dysfunctional ones are replaced or minimized (de Bruin et al., 2016 ; Prochaska et al., 1994 ; Prochaska and Prochaska, 2016 ; Prochaska et al., 1988 ; Redding et al., 2011 ; Weissenborn and Duka, 2003 ; Bickel et al., 2012 ). When dysfunctional, decisions may (1) fail to prioritize responses that remove a costly expression of habit (e.g. a teen started smoking cigarettes to “be cool” and now has to smoke in the bathroom before each class to get through the day; by not deciding to move at work, one’s breathing becomes shallow and movement becomes rigid); or decisions may (2) prioritize habits that prolong dysfunction despite knowing the dangerous consequences (e.g. an adult continues smoking cigarettes despite knowing the family’s history of lung cancer; an adolescent continues binge on sugar despite a diabetes diagnosis).

When dangerous population-wide behaviors threaten life in a society, precise responses must occur to organize this potentially chaotic situation. At the level of society, the agreed upon values organize the social system so that functional population behaviors are prioritized and dysfunctional population behaviors are minimized. Functional values prioritize behaviors that support the society (e.g. as seen when societies mandate that students get certain vaccines before attending University), while also setting standards that remove/replace behaviors that threaten the society (e.g. new laws create legal repercussions for risk behaviors in society). Without values that functionally prioritize population-wide behavior, society may (1) fail to prioritize responses to a dysfunctional population behavior (e.g. as seen during AIDS epidemic of the 1980s due to insufficient public health values around safe sex); or society may (2) prioritize dangerous behaviors that can prolong societal dysfunction (e.g. the antibiotic resistance crisis (Ventola, 2015 ; Michael et al., 2014 ) has been attributed in part to the over-valuing or over-use of antibiotic medications in healthcare practices).

Precision is essential so that a system can maintain ease-of-functioning in future, changing conditions . When precision does not adequately detect the presence of costly conditions, a response may not be prioritized (e.g. as seen during acute infection, addiction/dependence following a surgery, the AIDs outbreak in the 1980s). When precision prioritizes responses that prevent ease longitudinally, dysfunction is prolonged (e.g. autoimmunity, continued smoking despite family history of cancer, misguided values that create an antibiotic-resistant bacteria). Through dysfunctional -precision, the conditions for life in cells, selves, and societies becomes disordered over time. Through functional -precision, a system prioritizes responses that maintain ease-of-functioning in future conditions. Prioritizing functional microorganisms (i.e. symbionts) supports the developing life of cells; prioritizing functional habits (e.g. weekly exercise) and habitual life functions (e.g. diaphragmatic breathing and relaxed movement) supports the developing life of the self; and prioritizing functional population behaviors (e.g. access to functional health care, economic resources; access to social support) supports the developing life of the society.

Principle 5: Health is valued by a system when precision-and-variation generate maintainable-ease of functioning. Health is de-valued by a system when precision or variation prevent maintainable-ease of functioning

By defining precision-and-variation, we can better understand maintainable-ease of functioning in population health:

Functional-Variation generates ease-of-functioning in the present (e.g. fluid and variable motion reflects an ease and variability of one’s movement); while Functional-Precision prioritizes expressions that can maintain ease-of-functioning in the future (e.g. prioritizing challenging exercise for 20 min each day may lead to an ease in bodily movement long term).

Dysfunctional-Variation prevents ease-of-functioning in the present (e.g. prolonged sitting might lead to rigid movement and shallow breathing); while Dysfunctional-Precision might prioritize expressions that prevent ease in the future (e.g. rather than focus on relaxing breathing and movement on work breaks, one decides to drink alcohol to relax).

Without functional-variation, life is fragile and vulnerable to changing conditions of the present. Without functional-precision, life becomes disorganized from the system’s exposure to changing conditions across time. When functional-and-integrated, precision-and-variation value maintainable-ease of functioning in cells, selves, and societies. When dysfunctional or fragmented, precision or variation can de-value maintainable-ease of functioning in cells, selves, or societies. If maintainable-ease of functioning can be valued in cells, selves, and societies, we will likely observe healthy publics.

Five principles of health are presented: (1) Health is the maintainable-ease of functioning; (2) Maintainable-ease of functioning emerges from multiple levels ; (3) At each level, maintainable-ease of functioning is generated by systems ; (4) Each system employs two functions, precision - and - variation , that generate maintainable-ease of functioning ; and (5) Health is valued by a system if precision-and-variation generate maintainable-ease of functioning. Through these five principles, both naturalistic and holistic perspectives can be considered simultaneously because maintainable-ease of functioning is relevant to biological functioning (e.g. as described in BST) and personal/social, goal-oriented functioning (e.g. as described in HTH). This philosophy can also be used to investigate how naturalistic and holistic phenomena have informed past healthcare interventions. What do vaccine interventions, behavior change interventions, and social change interventions have in common? When successful, these interventions enhance both precision and variation.

Vaccine interventions can enhance both the precision of the host-defense functions and variation in the microbiome. During a vaccine intervention, the microbiome is exposed to a new variation in the form of a new virus (Reidel, 2005 ). Through this exposure, the precision of host defense functions can adapt to prioritize maintainable-ease of functioning in the microbiome in the future. How? The host-defense system produces antibodies that allow the immune system to respond effectively and efficiently to this virus when exposed to it again in the future (Janeyway, 2014 ). Although the precision of the immune system has been enhanced to handle historical threats through vaccines (e.g. for small pox, chickenpox, measles), new viruses like the coronavirus can still emerge. With this philosophy, vaccine developers and public health officials might not only ask the question, “How do we combat the coronavirus?” Researchers, vaccine developers and public health officials may also ask the functional question: “How do we enhance the precision of the host-defense system and the variation of the human microbiome to adapt following an exposure to the coronavirus?”

Behavior change interventions can enhance both the precision in one’s decisions and the variation in one’s habits. During a behavior change intervention, a person’s existing habits are exposed to a new variation in habit. For example, the beginning of a new exercise intervention exposes the individual’s current habits/habitual functioning to changes in movement and breathing (i.e. exercise) that may also change their patterns of eating and hydration. Through this exposure, a person’s decision-making might adapt to prioritize maintainable-ease of functioning in the individual’s lifestyle. How? Some behavior change interventions train one’s decision-making to remove or “counter-condition” unhealthy habits, by replacing them with healthy habits (Prochaska et al., 1988 ). Although modern behavior change interventions have shaped the precision of decision-making during health behavior change (e.g. of smoking, diet, alcohol use, inactivity), new problems for health behavior still emerge when the individual is exposed to a new, potentially addictive technology. With this philosophy, behavior change interventionists and health officials might not only ask the question, “How do we support good decision-making of individuals?” Researchers, behavior change technology developers, and public health officials may also ask the functional question: “How do we enhance the precision of one’s decisions and the variation of one’s habits following the exposure to a new, potentially addictive technology?”

Public health campaigns disseminated by social organizations can enhance the precision of the population’s health values and variation in population-wide health behaviors. Leading up to first Surgeon General’s Advisory Committee on Smoking and Health (1964), the U.S. Department of Health had become increasingly aware of (i.e. exposed to) variations in a population health behavior. If populations smoked, then populations were more likely to develop lung cancer, laryngeal cancer, or chronic bronchitis (CDC, 2018 ). Following this exposure to (the consequences of) population smoking behavior, society’s values shifted to prioritize health. How? The Federal Cigarette Labeling and Advertising Act of 1965 was adopted, and the Public Health Cigarette Smoking Act of 1969 was adopted to create new health values. This shift in values prioritized new variations in population health behavior by: (1) requiring a health warning on cigarette packages; (2) banning cigarette advertising in the broadcasting media; and (3) calling for an annual report on the health consequences of smoking (CDC, 2018 ). Since these first initiatives adult smoking rates have fallen from about 43% (in 1965) to about 18% today; and mortality rates from lung cancer, the leading cause of cancer death, are declining (Department of Health and Human Services, 2014 ). Although the precision of the population’s values has been enhanced to impact population behaviors (e.g. the tobacco laws described above supported healthy change), new chronic states can still emerge following exposure to social changes (e.g. the invention of the Juul impacted high school and college aged populations). With this philosophy, public policy officials and public health researchers might not only ask the question, “How do we create new laws to protect population health from nicotine addiction?” They may also ask the functional question: “How do we enhance the precision of the population’s values and the variation of the population’s behavior following the invention of a new nicotine delivery system technology (e.g. flavored Juuls)?”

Previously we described that without functional variation, life is fragile when exposed to present changing conditions; and without functional precision, life becomes disorganized from exposure to changing conditions across time. When successful, the above interventions upon biological, behavioral, and social functioning have a common theme: each facilitates exposures to biological, behavioral or social conditions that support (1) increasingly complex/diverse variation; and (2) increasingly organizable precision. Exposure, not avoidance , has facilitated population health in these interventions. While healthcare systematically prioritizes biological exposures in the form of vaccine interventions, they do not systematically prioritize behavioral or social exposures. However, it is documented that exposure to healthy behaviors in youth prevents risk behaviors in adolescence (Velicer et al., 2000 ); and exposure to community-based health initiatives can support population health (Dulin et al., 2018 ; CDC, 2018 ). Given that systematic biological exposures in the form of vaccination have led to a global control of some acute infectious diseases (Tangermann et al., 2007 ); might systematic behavioral and social exposures (especially in youth) be needed to enhance global campaigns toward the control of chronic disease?

A functional language of health is central to the success of a Philosophy of Health. Why? The levels are not separate, but rather are continuously connecting with one another. A good philosophy of health should have the ability to discuss assessment, diagnosis, intervention, and prevention across levels, across systems, across cultural populations, and across time. Using the common language of precision and variation creates discussions that connect the levels and integrate research disciplines.

A case (to) study: mental health as between-level functioning in this philosophy

Historically, and still too often, health professionals have an expertise at one level, that limits their prescription of interventions to that level. This can actually create barriers to a complete solution when a health problem is multileveled. While a person’s mental health is typically assessed based upon their first-person experience of thoughts, feelings, and behaviors; symptoms can be triggered by biological, physiological, behavioral, psychological, and/or social dysfunction. Most clinicians typically do not have the ability to assess and address all forms functioning. So if one person, John, is meeting with a clinician who specializes in primary care medicine, he may only be prescribed a biological intervention like medication. If John is meeting with a clinician who specializes in behavioral medicine, he may only be prescribed a health behavior change intervention. If John is meeting with a clinician who specializes in a certain theory of psychotherapy, he may only be prescribed a psychotherapy intervention based on the clinician’s training. If John is meeting with a clinician who specializes in social work, he may only be prescribed a group, community or social intervention. While the above specializations have been helpful in establishing an empirical bases for mental health interventions, over-specialization can be problematic when a multi-leveled solution is needed. In addition, it can also be problematic when a level-specific solution is needed that the clinician cannot provide (e.g. when psychotherapy is needed but a clinician only has the ability to prescribe psychiatric medication).

Technology poses a multileveled issue for population mental health in 2020. Selves have more social connection then ever in history, yet societies are characterized by increasing rates of depression and loneliness (Sum et al., 2008 ; Hammond, 2020 ; Srivastava and Tiwari, 2013 ; Twenge, 2017 ). Researchers might use this Philosophy of Health to facilitate between-level conversations that address seemingly paradoxical outcomes that emerge during this new age of rapid technological growth. To do this, a researcher might first begin by asking questions about functioning at each level ; second , ask questions about processes between the levels ; and third , concurrently ask questions at and between levels .

First: Begin by asking questions at each level

Novel challenges face the iGeneration (and their parents) due to technology’s novel impacts on the development of individual and social functioning (Twenge, 2017 ). For example, if John’s decisions (self-precision) and habits (self-variation) remain consistent during school hours because his parents do not let him have a phone; but his class’ social behaviors around him (society-variation) change dramatically because everyone else at school uses the newest smartphone application to talk during class; will John’s mental health suffer? Although his parents’ intentions are to protect John, the contrast between his behavior (self’s precision-and-variation) and the population social behavior (society-variation) can impact John’s health. Notice here how we have not yet considered functions that connect the self to the society (e.g. John’s thoughts and feelings). Rather we first consider (or contrast) functioning at the level of the self (i.e. John’s decisions-and-habits) and the society (i.e. population social behavior) in accordance with Principles 1–5 (see Figs 1 – 3 ).

Second: Look for functional processes that connect the levels

One person’s thoughts and emotions/feelings are processes that help to integrate the functioning of one-self within the functioning of a society. How might John’s thoughts and feelings connect his (sense of) self to his society? Perhaps John’s parents teach him that it is important to feel separate from his classmates during class so he can think clearly in class; and that he can feel connected to his friends by inviting them over to communicate together after school. This parenting may impact John’s thoughts and feelings during school. If John’s parents do not talk with him about this topic, John may experience different thoughts and feelings during school hours. When kept to one-self, thoughts and emotions are foundational to an internal sense of self as one functions in the larger society; and, when acted upon, thoughts and feelings can become verbal communication (e.g. speech) and non-verbal communication (e.g. body language, facial expressions) that form an external sense of self that is visible to the society. The (internal) experience of and (external) communication of thoughts, feelings and actions form the foundation of all systems of psychotherapy (Prochaska and Norcross, 2018 ). This view can be particularly helpful as researchers begin to investigate how smart technology impacts developmental changes to the self within the society beginning in youth.

Third: Concurrently ask questions at and between levels

Perhaps, a clinical researcher is interested in investigating protective mental health factors in the iGeneration; and they hypothesize that lower rates of loneliness, anxiety, and depression will be seen in subjects that do not respond to text messages immediately. The researcher might investigate further by using the philosophy to develop questions for the research subjects: “(1) Do you use conscious decision-making (self-precision) to prevent yourself from habitually responding to your phone when a text appears (self-variation)? (2) How fast do other’s in your social group typically respond to texts (society-variation)? (3) What changes in thoughts and feelings are experienced (internal self-society connection) after you communicate via text (external self-society connection)?” Perhaps this researcher also wants to investigate how those who are addicted to the technology perceive non-responders. The clinical researcher might again apply the philosophy: “(1) How fast do other’s in your social group typically respond to your texts (society-variation)? (2) Do you experience changes in thought and feeling (internal self-society connection) when others do not respond to you within an hour (society-variation)? (3) How do you communicate those thoughts and feelings (external self-society connection) with others when they do not respond for a prolonged period of time (society-variation)?” Future research might use this method to gather and organize levels of information on mental health factors across different self- and societal-conditions.

The processes that form our mental health form a functional connection between self and society. If mental health is a reflection of the self–society connection, what might be a reflection of the self–cell connection? Physiological health evidences a functional connection between our sense of self and our cells. For example, aerobic exercise is a health behavior that stimulates changes to variations in breathing and movement. By engaging in this behavior, the biological cells of the body are also stimulated via various physiological processes. Breathing will stimulate cellular functioning via the cardiovascular and respiratory systems; and movement will stimulate cellular functioning via the cardiovascular, musculoskeletal, and central nervous systems. While all physiological systems are working in collaboration in the body, certain changes to behavioral and biological functioning will stimulate certain physiological systems. By viewing health through this lens, between-level observations join the philosophy: biological functions emerge at the level of the cell; physiological functioning emerges as the cell–self connection; behavioral functions emerge at the level of the self; psychological/mental functioning emerges as the self–society connection; and social functions emerge at the level of the society. Future papers will explore maintainable-ease of functioning at and between levels.

Future directions: new images of healthcare integration and new perspectives of healthcare innovation

By considering this integrative philosophy, one can define health based upon a tangible connectedness, rather than separateness, of cells, selves, and societies. We provide Image 4 as a way to visualize the common paths to the health of healthy publics. When researchers observe that a host defense system is changing cellular functions following an infection, they may also expect these changes to have an impact [along Path 1] on expressions of habitual or physiological functions (e.g. immune function can stimulate the sensation of “achiness” or “pain” altering one’s physical movement, breath rate, hydration, and hunger) (Kelley, 2003 ; Johnson et al., 1992 ; Danzer, 2009 ). When researchers observe an individual deciding to engage in health behavior change following an addiction, they may also expect these changes to have an impact [along Path 2] on the group-behavior of their family system or social systems. When researchers observe changes to society’s values following a newly detected problem (e.g. laws ban Cigarette Advertising in broadcasting media; public health standards mandate certain vaccines before attending school), they may also expect that these changes can have an impact on behavioral functions of individuals [along Path 2] and biological functions of cells/organs [along Path 3]. These levels are continually integrating along these common paths to the health of healthy publics (Fig. 4 ).

When attending to this connectedness new, important questions can have new answers. What function does modern technology serve in population health and healthcare? If technology algorithms prioritize variations in population behaviors, then they fulfill a role as society-level precision. When modern technologies like machine learning (ML) technology and Computer Tailored Interventions (CTI) prioritize patterns of population behavior, we can see profound impacts on social change in a society. Although one might argue that technologies can be used by individual-level functions, the algorithms that are currently deployed and updated on devices interface with big-data gathered on population behaviors (Manogaran and Lopez, 2017 ; Dinov, 2016 ; Mullainathan and Spiess, 2017 ; Cheng et al., 2017 ).

In this paper, we identified that precision can be functional or dysfunctional. Similarly, technologies can support or prevent healthy population behavior. Some technologies prioritize health behavior in populations by tracking physical activity and providing feedback on activity progress; while others prevent healthy behavior by prioritizing sedentary behavior through video-gaming. Some social media technologies facilitate social communication with distant friends and relatives that supports wellbeing; while others facilitate conflictual communication that diminishes wellbeing. Given that modern technology can support or hinder health, we believe it is important that healthcare can prioritize technological innovations that value health in cells, selves, and societies. To do this, technology innovators might seek to value a higher order construct (e.g. maintainable-ease of functioning) in their algorithms.

Medical technology is currently used to titrate the doses of vaccines so that maintainable-ease of biological functioning (i.e. inoculation) is made available to the general population. When biological exposures are not properly titrated, infections can become active in the population and health is no longer valued at the level of the cell. Similarly, when behavioral and social exposures are not tailored to the needs of individuals and groups, populations can become resistant to healthy change, and health is no longer valued at the level of the self and the society. Behavior change researchers Prochaska and Prochaska ( 2016 ) report that when individuals and populations are not ready for a change, interventions that force individuals or populations to take action can increase resistance and prolong dysfunction. By tailoring (or what they term “staging”) behavioral and social level interventions, Computer Tailored Interventions upon behavioral and social functioning are made possible (Prochaska et al., 2001 ; Velicer et al., 2000 , Prochaska and Prochaska, 2016 ). Despite these advances, there remains a need for technological advances that can make maintainable-ease of behavioral and social functioning available to the general population.

Future healthcare interventions could benefit from ML algorithms that tailor behavioral and social exposures to enhance precision-and-variation. Research already demonstrates that tailoring interventions for biological precision (Albert-Vega et al., 2018 ) and biological variation (Brodin et al., 2015 ) can impact long-term biological functioning. Future innovations might seek to use technology to tailor behavioral and social interventions to generate maintainable-ease of functioning. Through the functional language used in this paper we hope readers are inspired to present new questions, new comments, and new perspectives about needed healthcare innovations.

This philosophy of health investigates three levels of health: cell, self, and society. The level of the cell accounts for biological functioning within human beings. The level of the self accounts for first-person functioning of each human being. The level of the society accounts for group functioning of human beings.

Each system is responsible for generating maintainable-ease of functioning at a level. The biological immune system is responsible at the level of the cell. A human's system of health behaviors is responsible at the level of the self. The social system is responsible at the level of the society.

Maintainable-ease of functioning is generated by two functions in each system: precision and variation. The human microbiota, habits, and population-wide behaviors evidence variation in cells, selves and societies respectively. The host defense system, decisions, and values evidence precision in cells, selves and societies respectively.

Population health is generated along common paths that integrate the levels. The biological functioing of cells impacts fluctuations of habits/habitual functioning; and vice versa. The behavioral functioning of each self impacts fluctuations in population behavior; and vice versa. The biological functioning of cells also can impact fluctations in population behavior; and vice versa.

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This research was supported by funding from the National Institutes of Health’s (NIH) National Cancer Institute (NCI).

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Saad, J.M., Prochaska, J.O. A philosophy of health: life as reality, health as a universal value. Palgrave Commun 6 , 45 (2020). https://doi.org/10.1057/s41599-020-0420-9

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Home / Living Well / A holistic approach to integrative medicine

A holistic approach to integrative medicine

As studies continue to reveal the important role the mind plays in healing and in fighting disease, a transformation is taking place in hospitals and clinics across the country. Meta description: Discover principles and benefits of integrative medicine, a comprehensive approach combining conventional and complementary therapies.

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Interested in integrative medicine? Read the following excerpt from the Mayo Clinic Guide to Integrative Medicine .

People who take an active role in their health care experience better health and improved healing. It’s a commonsense concept that’s been gaining scientific support for several years now.

As studies continue to reveal the important role the mind plays in healing and in fighting disease, a transformation is taking place in hospitals and clinics across the country. Doctors, in partnership with their patients, are turning to practices once considered alternative as they attempt to treat the whole person — mind and spirit, as well as body. This type of approach is known today as integrative medicine.

Incorporate integrative medicine alongside your treatments

Integrative medicine describes an evolution taking place in many health care institutions. This evolution is due in part to a shift in the medical industry as health care professionals focus on wellness as well as on treating disease. This shift offers a new opportunity for integrative therapies.

Integrative medicine is the practice of using conventional medicine alongside evidence-based complementary treatments. The idea behind integrative medicine is not to replace conventional medicine, but to find ways to complement existing treatments.

For example, taking a prescribed medication may not be enough to bring your blood pressure level into a healthy range, but adding meditation to your daily wellness routine may give you the boost you need — and prevent you from needing to take a second medication.

Integrative medicine isn’t just about fixing things when they’re broken; it’s about keeping things from breaking in the first place. And in many cases, it means bringing new therapies and approaches to the table, such as meditation, mindfulness and tai chi. Sometimes, integrative approaches help lead people into a complete lifestyle of wellness.

What types of integrative medicines are available?

What are some of the most promising practices in integrative medicine? Here’s a list of 10 treatments that you might consider for your own health and wellness:

• Acupuncture is a Chinese practice that involves inserting very thin needles at strategic points on the body.
• Guided imagery involves bringing to mind a specific image or a series of memories to produce certain responses in the body.
• Hypnotherapy involves a trancelike state where the mind is more open to suggestion.
• Massage uses pressure to manipulate the soft tissues of the body. There are many different kinds of massage, and some have specific health goals in mind.
• Meditation involves clearing and calming the mind by focusing on your breathing or a word, phrase or sound.
• Music therapy can influence both your mental and physical health.
• Spinal manipulation, which is also called spinal adjustment, is practiced by chiropractors and physical therapists.
• Spirituality has many definitions, but its focus is on an individual’s connection to others and to the search for meaning in life.
• Tai chi is a graceful exercise in which you move from pose to pose.
• Yoga involves a series of postures that often include a focus on breathing. Yoga is commonly practiced to relieve stress, as well as treat heart disease and depression.

Who can integrative medicine help?

A number of surveys focused on the use of integrative medicine by adults in the United States suggest that more than a third of Americans are already using these practices as part of their health care.

These surveys demonstrate that although the United States has the most advanced medical technology in the world, Americans are turning to integrative treatments — and there are several reasons for this trend. Here are three of the top reasons why more and more people are exploring integrative medicine.

Integrative medicine for people engaged in their health

One reason integrative medicine is popular is that people in general are taking a greater, more active role in their own health care. People are more aware of health issues and are more open to trying different treatment approaches.

Internet access is also helping to fuel this trend by playing a significant role in improving patient education. Two decades ago, consumers had little access to research or reliable medical information. Today, clinical trials and pharmaceutical developments are more widely available for public knowledge.

For example, people who have arthritis can find a good deal of information about it online. They may find research showing that glucosamine, for example, helps with joint pain and doesn’t appear to have a lot of risks associated with it. With this information in hand, they feel empowered to ask their doctors if glucosamine might work with their current treatment plans.

Integrative medicine for an aging population

A second reason for the wider acceptance of integrative treatments is the influence of the baby boomer generation. This generation is open to a variety of treatments as it explores ways to age well. In addition, baby boomers are often dealing with several medical issues, from weight control to joint pain, high blood pressure and elevated cholesterol. Not everyone wants to start with medication; many prefer to try complementary methods first.

Integrative medicine for the chronically stressed

A third reason for the growth, interest and use of integrative therapies is the degree of chronic stress in the American lifestyle. Workplace stress, long commutes, relationship issues and financial worries are just some of the concerns that make up a long list of stressors.

Although medications can effectively treat short-term stress, they can become just as damaging — and even as life-threatening — as stress itself is when taken long term. Integrative medicine, on the other hand, offers several effective, evidence-based approaches to dealing with stress that don’t involve medication. Many otherwise healthy people are learning to manage the stress in their lives successfully by using complementary methods such as yoga, meditation, massage and guided imagery.

Considering that many healthy people are engaging in integrative practices, it isn’t surprising to find out that they’re turning to these treatments in times of illness, as well. Here are just a few ways integrative medicine is used to help people cope with medical conditions:

• Meditation can help manage the anxiety and discomfort of medical procedures.
• Massage has been shown to improve recovery rates after heart surgery.
• Gentle tai chi or yoga can assist the transition back to an active life after illness or surgery.

Conventional Western medicine doesn’t have cures for everything. Many people who have arthritis, back pain, neck pain, fibromyalgia and anxiety look to integrative treatments to help them manage these often-chronic conditions without the need for medications that may have serious side effects or that may be addictive.

The risks and benefits of integrative medicine

As interest in integrative medicine continues to grow, so does the research in this field. Researchers are studying these approaches in an effort to separate evidence-based, effective therapies from those that don’t show effectiveness or may be risky. In the process, this research is helping to identify many genuinely beneficial treatments. In essence, both consumer interest and scientific research have led to further review of these therapies within modern medicine.

As evidence showing the safety and efficacy of many of these therapies grows, physicians are starting to integrate aspects of complementary medicine into conventional medical care. Ultimately, this is what has led to the current term integrative medicine.

Ask your healthcare team about integrative medicine and wellness

If you’re interested in improving your health, many integrative medicine practices can help. Not only can they speed your recovery from illness or surgery, but they can also help you cope with a chronic condition. In addition, complementary practices such as meditation and yoga can work to keep you healthy and may actually prevent many diseases.

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Free Essay About 'holistic Health' And Its Application In Health Promotion

Type of paper: Essay

Topic: Health , Alternative Medicine , Medicine , Marketing , Holism , Disease , Promotion , Wellness

Words: 1400

Published: 02/20/2020

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Health promotion has received numerous definitions over time, with differences dependent on the emphasis and perspective one has, rather than any core substance disagreement (Irvin et.al 9). However, the most characteristic one is probably that of Perry and Jessor (1985), who define health promotion as “The implementation of efforts to foster improved health and well-being in all four domains of health [physical, social, psychological and personal]” (22). So, taking into account the aforementioned definition of health promotion, one can say that holistic health and medicine are indeed dedicated to health promotion, in more ways than one, that will be further analyzed throughout this paper.

Basic Principles of Holistic Health/Medicine

Holistic health or holistic medicine is a field of alternative medicine that focuses on the whole of a human existence, meaning the physical, emotional, mental and spiritual health of each individual (American Cancer Society). To holistic medicine, if the body, or mind suffers the whole person’s health is affected, which is why it is believed that all four pre mentioned elements of a human existence interconnect to bring health to an individual. For that reason, when a person is ill or unhealthy for some reason, holistic health will focus on the whole person, rather than trying to manage the disease and cure the specific illness or part of the body that suffers (American Cancer Society). In other words, holistic health targets maximum well-being, where all four elements that comprise humans, function the best possible way. So, it becomes obvious that holistic health is a direct example of health promotion, as already defined by Perry and Jessor. With respect to the law of nature, holistic health forwards the concept that everything around us is closely connected with one another. For example, the earth is made up of various, independent systems, like land, water, animals and air. Although independent, if one system faces a problem, the other systems are also affected, which is exactly what happens to individuals: if something goes wrong in physical, emotional, mental or spiritual level, overall health is negatively impacted (Walter). For instance, if one is stressed because they have missed the bus and will be late for work, all the nervousness might as well cause a physical reaction, like a stomach ache. Studies have shown that suppressed anger, or anger turned inward is a reason for migraines (Boyle, Church & Byrnes 47), which demonstrates the interconnection of emotional and physical health. The good thing about holistic health is that it is an ongoing process, where the current health status of an individual does not block cure; everyone can achieve overall wellbeing, despite potential mishaps that may occur on the way (Walter). It is widely accepted that lifestyle choices affect health and elevate the risk for developing a disease, if one choses to not take care of their overall health (Genetic Science Learning Center). The most prevailing dangers that jeopardize one’s health is smoking, drugs, alcohol, lack of exercise and unhealthy eating habits, while some of the equally dangerous, yet not as recognized, dangers to health, include sugar and of course, negative attitudes towards life and low self-esteem (Walter). But, if what is inside the human being is of low quality, due to the bad lifestyle choices one makes, illness might take hold. What holistic health does is to promote people towards eating healthy, exercising, taking care of their inner self and balance and allow a healthy mind and spirit live in a healthy body, exactly like the Latin quotation “Mens sana in corpore sano” (Juvenal, line 356), meaning “a sound mind in a healthy body”.

Applications of Holistic Medicine in Health Promotion

Some mainstream doctors and other health care professionals chose to add non-mainstream, or complementary treatments to the care they provide patients with, which is called holistic care, or most widely known as integrative care (American Cancer Association). Integrative medicine or integrative health is a completely patient-centered care that not only educate, but also empowers individuals to take a very active role in their own health care and wellness (Bravewell Collaborative). So, with integrative care, optimal health and healing is achieved with an integration of the best medicine used in the West and a greater understanding of the very nature of any disease, illness and suffering, as a means to promote healing and wellbeing. However, there are practically myriads of healing arts that are based in holistic health/medicine, who can get involved in integrative medicine, there is a wide array of different approaches and applications of holistic medicine to patients. For example, health care professionals can work with acupuncturists, massage therapists, practitioners using Ayuvedic medicine or nutritionists, among others. Holistic Health is considered part of alternative and complementary medicine (Passarelli) and according to the National Center for Complementary and Alternative Medicine, approximately 38 percent of adults in the US and about 12 percent of children prefer some form of a complementary and alternative medicine (nih.gov). The population of the UK also show a preference for contemporary and alternative medicine, given that about one third of them use the aforementioned medicine (Hill). Contemporary and Alternative Medicine, in general, appears to be experiencing an increase in recent years, especially within biomedical health care, although many are still skeptical on the use of holistic health (Hill). It is for sure that health promotion must partner with other professions, in light of the 21st century, in order to promote public health (Hill).

Holistic Health is considered by many part of Contemporary and Alternative medicine and is believed to promote health in various ways. If health promotion is indeed implementing ways to foster improved health on all major elements that comprise the human nature, that of the body, mind and soul, the holistic health has lots to demonstrate. It relies on basic principles that treat an individual as a whole and not every illness or body part that aches separately. By caring for the entire “human ecosystem”, holistic health promotes overall health and well-being, and educates people on how to achieve high levels of wellness. Truth is that for the last 20 years holistic health and complementary and alternative medicine have become the pole of serious criticism; however, it is vital that health promotion joints forces with holistic health, since they both have the same goad: public health. According to the latest statistics and figures, about a third of the population in the US and the UK have started using complementary and alternative medicine, which shows that people are in fact trying to enhance their wellbeing and life a healthier, happier life. And, when people want health, governments are obliged to take the necessary action to provide them with exactly that.

Works Cited:

American Cancer Society (2013). “Holistic Medicine”. Web. Nov. 9, 2013 <http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/mindbodyandspirit/holistic-medicine> Boyle, Scott, Church II, Wesley and Byrnes, Edward (2005). “Migraine Headaches and Anger”. Print. Best Practices in Mental Health, Vol. 1, No. 1, Winter 2005. Lyceum Books, Inc. The Bravewell Collaborative (n.d). “Elements of Integrative Care”. Web. Nov. 8, 2013 <http://www.bravewell.org/integrative_medicine/integrative_care/> Genetic Science Learning Center (n.d). “Lifestyle Choices and Risks”. The University of Utah. Web. Nov. 8, 2013. < http://learn.genetics.utah.edu/content/health/history/lifestyle/> Hill, Faith (2003). “Complementary and alternative medicine: the next generation of health promotion?”. Oxford Journals. Health Promotion International 18 (3): 265-272 Irvin, Rootman, et.al (2001). “Evaluation in Health Promotion: Principles and Perspectives”. WHO Regional Publications European Series, No 92 Juvenal, edited by Courtney & Rudd (1991). “Juvenal: Satires I, III, X”. Print. Bristol Classical Press; 2 edition. National Center for Complementary and Alternative Medicine (2008). “The Use of Complementary and Alternative Medicine in the United States”. US Department of Health and Human Services: National Institutes of Health. Web. Nov. 8, 2013 <http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm> Passarelli, Tonya (2008). “Complementary and Alternative Medicine in the United States». Print. <http://www.cwru.edu/med/epidbio/mphp439/complimentary_meds.pdf> Perry, C.L. and Jessor, R (1985). “The concept of health promotion and the prevention of adolescent drug abuse. Health Education Quarterly, 12 (2): 169-184 Walter, Susan (n.d). “Holistic Health”. American Holistic Health Association. Web. Nov. 9, 2013 < http://ahha.org/rosen.htm>

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Essay on Holistic Health and Holistic Medicine

What is holistic health and holistic medicine.

The notion of Holistic Medicine has been around for many years. But why now, has interest in this area skyrocketed? People are starting to prefer a more natural approach when it comes to healthcare. Holistic Health is actually an approach to life. Rather than focusing on illness or specific parts of the body, this ancient approach to health considers the whole person and how he or she interacts with his or her environment. It emphasizes the connection of mind, body, and spirit.

The goal is to achieve maximum well-being, where everything is functioning at its best. Holistic health is based on the law of nature, which is; a whole is made up of interdependent parts. The earth is made up of systems, such as air, land, water, plants and animals. If life is to be sustained the systems cannot be separated, for what is happening to one is also felt by all of the other systems.

In the same way, an individual is a whole made up of interdependent parts, which are the physical, mental, emotional, and spiritual.

When one part is not working at its best, it impacts all of the other parts of that person. Furthermore, this whole person, including all of the parts, is constantly interacting with everything in the surrounding environment. For example, when an individual is anxious about a school exam or a job interview, his or her nervousness may result in a physical reaction, such as a headache or a stomachache.

Proficient in: Alternative Medicine

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When people suppress anger over a long period of time, they often develop a serious illness, such as migraine headaches, emphysema, or even arthritis.

The U. S. Center for Disease Control and Prevention report that the key factors influencing an individual’s state of health have not changed significantly over the past 20 years. Quality of medical care is only 10%. Heredity accounts for 18% and environment 19%. Everyday lifestyle choices are 53%. The decisions people make about their life and habits are therefore, by far, the largest factor in determining their state of wellness. Holistic Health is an empowering approach to living life.

It starts with the holistic (whole person) philosophy that recognizes the interrelationship between all aspects of who we are and the world we live in. This is combined with an understanding that achieving health is an ongoing personal journey toward a goal of functioning at our very best level possible. The basis of holism is the concept that “ the whole is made up of interdependent parts. ” As human beings we may think of ourselves as made up of separate parts or aspects, such as physical, mental, emotional and spiritual.

Yet, our parts do not function alone, but are constantly interacting. What happens to one will impact all of the other aspects of who we are as individuals. In the same way, we are a part of the world around us, and constantly responding to our surrounding environment. Holistic health involves our everyday choices and actions as we strive to reach a higher level of personal wellness. Picture the various levels of wellness as a continuum. Where are you? Are you on the left half, dealing with an illness or a chronic condition? In the center, not sick, yet not feeling very peppy?

On the right half, in good shape, but striving for the highest possible level of vitality and well-being? A holistic approach to creating wellness includes taking charge of your own health by exploring a variety of life enhancing activities until you discover which ones work for you. While we think of holistic health in terms of our personal actions for self-improvement, the same holistic principles can be applied to dealing with any disease or chronic condition. When a healthcare practitioner applies these holistic principles, it is usually called holistic medicine.

In addition to the concepts already mentioned, other factors are added. The Healthcare professional and the patient work together as a team, rather than just eliminating or masking symptoms, the symptom is used as a guide to look below the surface for the root cause. Whenever possible, treatments are selected that support the body’s natural healing system. Consumers of health care services have been seeking out and switching their health care to holistic health care providers in greater numbers than ever before.

With the growing interest in holistic medicine, there has become a increasing number of practicing holistic physicians and healthcare providers who have increasingly put into practice some of these sought after ideals. They have preferred the safer, less costly, more effective and natural treatments, along with an emphasis on empowerment of the person, as a partner in there own health care and healing. Today, healthcare provides and patients understand the side effects connected with drugs, surgery, and synthetic materials.

While some holistic procedures are considered unorthodox by mainstream medicine, new research and patient testimonials are pointing to the fact that lacing any foreign substance in the body can have side effects. Interest in holistic medicine has increased tremendously in recent years, with more and more people becoming aware of the real benefits to be obtained from natural, intuitive and traditional healing methods. As we move into the future, perhaps more people will realize that a balanced approach with “all things considered” is more beneficial than techniques and synthetic materials.

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National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Transforming Health Care to Create Whole Health: Strategies to Assess, Scale, and Spread the Whole Person Approach to Health; Meisnere M, South-Paul J, Krist AH, editors. Achieving Whole Health: A New Approach for Veterans and the Nation. Washington (DC): National Academies Press (US); 2023 Feb 15.

Achieving Whole Health: A New Approach for Veterans and the Nation.

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2 Defining Whole Health

In 1948 the World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity” ( WHO, 2020 , p. 1). Some criticized this definition as being excessively broad, vague, and unmeasurable, and in subsequent years health care focused more on a biomedical reductionist model than on achieving that more holistic vision of health. In 1984 the WHO revisited and updated the definition of health, shifting it from a desirable state of being to a dynamic set of resources for living well—“the extent to which an individual or group is able to realize aspirations and satisfy needs to change or cope with the environment . . . health is a resource for everyday life, not the objective”—that emphasized the social and personal resources as well as physical capabilities that are a part of health ( WHO, 1984 , p. 34).

More recently, the term whole health has emerged. The concept of whole health is not novel, and it has been evolving for decades under a range of different names such as salutogenesis, patient-centered care, people-centered care, integrated care, and population health ( Anastas et al., 2018 ; Bhattacharya et al., 2020 ; Nash et al., 2016 ; National Committee for Quality Assurance, 2018 ; Stewart, 2014 ; Thomas et al., 2018 ). Two recent reviews considered the history and evolution of the term whole health and identified several common themes ( Jonas and Rosenbaum, 2021 ; Thomas et al., 2018 ). These common themes suggest that whole health systems require a multidimensional, integrated approach that recognizes the importance of the therapeutic relationship, acknowledges the clinician's humanity, recognizes the patient's individual personhood, and employs a range of treatment modalities using a holistic biopsychosocial approachthat involves additional health care practitioners. Frameworks such as the Chronic Care Model, Patient-Centered Medical Home, accountable care organizations, Accountable Health Community, and Optimal Healing Environment Health have also described community systems that deliver and support whole health components ( Alley et al., 2016 ; Jonas and Chez, 2004 ; Kuzel, 2009 ; Martin et al., 2004 ; McClellan et al., 2010 ; Primary Care Collaborative, 2022 ; Tipirneni et al., 2015 ; Wagner et al., 1996 , 2001 ; Wiley and Matthews, 2017 ).

Driven by the unique needs of veterans returning from combat and suffering from long-term symptomatic mind–body consequences and functional injuries, the Department of Veterans Affairs (VA) and Samueli Institute have been leaders in advancing the whole health concept. In 2003 the Samueli Institute developed the Optimal Healing Environment framework to include the psychological, spiritual, physical, and behavioral components of health care ( Jonas and Chez, 2004 ). It addressed people in relationships, their health-creating behaviors, and the surrounding physical environment as a pathway to well-being ( Sakallaris et al., 2015 ). Several health care systems that adopted this approach realized improved patient experiences and demonstrated business case benefits. From this emerged the Total Force Fitness model that went beyond a medical environment to include physical, psychological, spiritual, social, and even economic aspects of human flourishing, integrated into a single framework for active-duty service members ( Jonas and Rosenbaum, 2021 ). The VA implemented multiple offshoots of the program, including the Performance Triad, Operation LiveWell, and Holistic Health and Fitness Program ( Jonas and Rosenbaum, 2021 ).

Today, the VA presents patients with the following definition to describe its Whole Health System (WHS):

Whole Health is VA's cutting-edge approach to care that supports your health and well-being. Whole Health centers around what matters to you, not what is the matter with you. This means your health team will get to know you as a person, before working with you to develop a personalized health plan based on your values, needs, and goals. ( VA, 2022a )

Another definition the VA has used that is geared more toward clinicians describes whole health as “an approach to care that empowers and equips a person to take charge of their health and well-being and live their life to the fullest” ( Kligler, 2022 , p. 1).

The VA's definition of whole health purposefully shifts the focus from a “disease” care system to a “health” care system by emphasizing the idea that people need to be enabled, empowered, and equipped to take charge of their health and well-being and to live life to the fullest ( VA, 2021 ). As Figure 2-1 shows, the VA's WHS model is supported by three pillars:

The three pillars of the VA Whole Health System. SOURCE: VA, 2022b.

The pathway—engaging veterans with fellow veterans (who are themselves trained peer facilitators) to discover their mission, aspiration, and purpose through personal health plans.

Well-being programs—encouraging self-empowerment, self-healing, self-care, and improvements in the social and structural determinants of health.

Whole health clinical care—a cultural transformation in care delivery to include prevention and treatment and conventional and complementary approaches. Together these elements aim to create a “circle of health.” (See Figure 4-1 in Chapter 4 for a more detailed discussion of the circle of health.)

The circle includes four elements: the person, self-care, professional care, and the community. The person is at the center and where whole health starts. As each person is unique, what matters to the individual person is what ultimately determines what whole health means. Each person has the power to affect their well-being through self-care, and whole health offers the skills and support needed to make the changes a person wants. A health team delivers professional care, including prevention and treatment of disease and illness. The community encircles the person virtually and in the real world as these are the people and groups that a person connects with, including the professional and personal elements of health and self-care.

To operationalize its approach to whole health, the VA made systemic and cultural shifts in its approach to care. Chapters 4 and 5 of this report detail how the VA operationalized these changes and the evidence on the impact it had on health outcomes and the care delivery experience for veterans and clinicians.

• A UNIVERSAL DEFINITION OF WHOLE HEALTH

The statement of task for this study directed the committee to consider the following (see Chapter 1 for the complete statement of task): (1) Where is whole health currently being implemented, (2) what does whole health accomplish, (3) how can effective whole health strategies spread, and (4) what other factors affect the performance of whole health? To address this statement of task, the committee created a universal definition of whole health and the whole health approach. The committee needed this definition to identify and examine whole health implementations outside of the VA. To create the definition, the committee reviewed the existing definitions, foundational elements, best practices, and lessons learned from identified whole health and whole health–like approaches operating by different names. This included ideas about what it means for a person or community to achieve or have whole health as well as what is needed from health care systems to bring out, deliver, and support whole health.

From these fact-finding activities, the committee developed the following definition for whole health:

Whole health is physical, behavioral, spiritual, and socioeconomic wellbeing as defined by individuals, families, and communities. To achieve this, whole health care is an interprofessional, team-based approach anchored in trusted longitudinal relationships to promote resilience, prevent disease, and restore health. It aligns with a person's life mission, aspiration, and purpose.

While the committee's definition is different from the VA's definition—it is more inclusive of other systems' approaches to whole health—it is highly aligned with and derived from the VA's work. It is an aspirational definition, as the committee found no systems that have fully implemented this definition of a whole health approach for the entire community to whom they are accountable (see Chapters 4 and 5 ). Nevertheless, this aspirational definition is essential to set goals for what the VA and other health systems need to do to help people, families, and communities achieve whole health.

The state of whole health envisioned by the committee is fundamentally different from how health care currently views health and well-being in three ways. First, whole health is not just about the conventional “medical” well-being that health care currently addresses, nor is it merely the absence, prevention, or control of disease. Instead, it is about a whole state of well-being that spans physical, behavioral, spiritual, and socioeconomic well-being. Whole health is the extent to which an individual or group can realize goals and satisfy needs to change or cope with the environment ( IOM, 2009 ).

Second, the philosophy of person-, family-, and community-centered-ness is essential to define what the “whole state of well-being” means. Individual people, families, and communities get to say what physical, behavioral, spiritual, and socioeconomic well-being means to them. To understand the needs and desires of those they serve, whole health providers and systems need to build trustworthy relationships. Third, an ideal state of whole health is not just about being healthy, but is about being supported to enable a person, family, and community to achieve what they want from life. It is a resource for everyday life and not an objective.

The systems that deliver whole health are also fundamentally different from the current systems that deliver health care. Whole health systems are cross-sectoral, spanning health care, mental health, health behavior promotion, public health, community care, social services, the built environment, education, religion, and the financial and economic sectors. This means whole health systems cannot just be located in hospitals and clinician offices but need to span community settings that include where people live, work, and play.

In addition, whole health systems are not merely the sum of their parts. There is seamless coordination and provision of services across sectors and interprofessional 1 care teams with a shared goal of helping people and communities achieve whole health. Moreover, whole health systems start by identifying how people, families, and communities define what health and well-being means for them and what they need to achieve it. This can be done through a range of approaches such as creating care plans or doingneeds assessments, but at its core, the delivery of whole health starts by listening to what people say they want and need.

• FOUNDATIONAL ELEMENTS OF WHOLE HEALTH

From the review of whole health definitions and various program descriptions, the committee identified five interdependent and foundational elements of whole health systems: (1) people-centered, (2) comprehensive and holistic, (3) upstream-focused, (4) accountable and equitable, and grounded in (5) team well-being ( Table 2-1 and Figure 2-2 ).

Foundational Elements of Whole Health.

The foundational elements of whole health.

People-Centered

Whole health requires a partnership with people to ensure that the health system respects, informs, engages, supports, and treats people, their families, and their communities with dignity and compassion ( Epperly et al., 2015 ; Stewart, 2014 ). Whole health delivery occurs within the context of social and cultural environments and starts by understanding peoples' needs and goals and then directing tailored, effective care around those needs and goals ( Cloninger et al., 2014 ). Thus, whole health is more than the absence of disease, and it is also more than a state of wellness. Achieving person-centered whole health is a process grounded in longitudinal relationships with team members and organizations that build shared understanding and trust over time. This includes relationships among individual clinicians, care teams, and health systems and the people, families, and communities for whom they are accountable. It is in the context of these relationships that the whole health system supports people to articulate and achieve their missions, aspirations, and purposes and to continually learn from their work, such that aspirations and goals are redefined over time. Examples of processes to achieve purpose can include tasks such as goal setting, care planning, and group-level assessments ( Bolton et al., 2019 ; Fix et al., 2017 ; Kilbourne et al., 2014 ; Seidel et al., 2021 ; Vaughn and Lohmueller, 2014 ).

Comprehensive and Holistic

Critical to whole health is attention to the entirety of the person's state of being, and the design of whole health systems needs to address this entirety. It recognizes that “the whole” is more than the sum of its parts for the people, communities, and the health systems that care for them. This diverges from how medicine often uses the term “holistic care” today as a code for therapeutics outside of conventional medicine. Therapeutics outside of conventional medicine is a component of whole health care, but merely adding it to conventional care does not make whole health care. Fundamentally, designing and developing whole health delivery systems cannot be done simply by creating and adding in each individual component of whole health to current systems. It requires the components and the care team members delivering the components to be collaboratively interwoven, coordinated, and comprehensive in their approach to addressing the goals and needs of the people, families, and communities they serve. This includes conventional medical care—acute, chronic, preventive, reproductive, and mental health care, dental, hearing, and vision care—plus the components of complementary and integrative health, spiritual care, and upstream factors such as health behaviors, education, and social needs.

Upstream-Focused

It is well known that socioecological factors and life-course events are the key drivers of health ( McGinnis and Foege, 1993 ; Mokdad, 2004 ; IOM/NRC, 2013). Four unhealthy behaviors—tobacco use, unhealthy diet, physical inactivity, and risky alcohol use—account for nearly 40 percent of preventable deaths in the United States ( Mokdad, 2004 ). The growing pandemic of unhealthy drug use, including opioids, further undermines health and well-being. Empowering people with the tools, resources, and the environment to more easily adopt healthy behaviors is an essential component of whole health care. Whole health systems also need to address the social and structural determinants of health—poverty, housing, food, finances, education, environment, equity, and racism—which represent both the cause of poor health (social determinants) and the cause of the causes of poor health (structural determinants) ( Braveman and Gottlieb, 2014 ). Because factors and events vary from person to person and community to community, whole health systems need to seek to understand and address the specific root causes affecting the people, families, and communities they serve. A major challenge is that these socioecological and life-course events and structural determinants of health are often the most difficult things to change. They are engrained in our lives through our daily activities, the communities we live in, the places that we work, and family events reaching back generations. Root causes of poor health cannot be dealt with solely by health care but need to be addressed everywhere. In addition, a range of expertise is needed that extends beyond health care. Whole health systems require multisector collaborations, and whole health care teams should include interprofessional members.

Equitable and Accountable

Whole health systems should focus on providing high-quality, safe, and evidence-based care. This means providing the right care at the right time to the right people ( Campbell, 2016 ). Because health inequities are such a key driver of poor health ( AHRQ, 2019 ; Nelson et al., 2020 ), ensuring whole health means ensuring health equity. While whole health systems cannot solve all of society's ills, they need to address the root causes of inequity, including intrapersonal, interpersonal, institutional, and systemic mechanisms as well as the unequal distribution of power and resources ( Weinstein et al., 2017 ). A key step in this process is accepting accountability for people, families, and communities. This allows whole health systems to be proactive in their care, using population health approaches that reach out to people and communities and do not wait for people to access care when they think they need it. It also means that some systems should be accountable for every person, family, and community—everyone needs a home and a system that will make sure that they do not fall through the cracks. Empanelment, the process of individuals within a given population declaring a source of primary care (or being assigned to one) is one method of helping ensure accountability within a system or geographic area (see Chapter 3 for more detail).

Whole health care should also create accessibility. People, families, and communities who need care should be able to access care through many avenues with a “no wrong door” type approach. Because achieving whole health needs to occur where people live, work, learn, and play—and not just in health care settings—the supports, resources, and surrounding environment should all provide access to and support for achieving whole health.

Team Well-Being

Interprofessional teams deliver whole health. The team is organized around the person, family, or community and includes, based on needs, conventional health care clinicians, integrative medicine providers, and professionals from non–health care sectors, such as social services and education, spiritual, and financial areas. Team members also include community and peer providers. Clinician stress and burnout are common in health care and can hamper the ability to provide high-quality care ( Schwenk,2018 ). In addition to assembling the right team for the right care, members of the care team and the team itself need to be healthy. Clinician stress and burnout hurt not only clinicians but also patients, communities, health care organizations, and learners. Ensuring and enhancing the health of those who care for and support communities creates an engaged and effective workforce, high-functioning care teams, and healing person–clinician relationships. While many health systems have implemented employee well-being programs, they tend to focus on individual-level interventions, such as providing benefits to employees to improve health and well-being (e.g., complementary integrative health such as yoga, acupuncture, and meditation). While some of these efforts are valuable, these approaches are less effective at preventing burnout and improving well-being than more systemic approaches that improve workflow efficiency, reduce administrative burden, improve technology usability, and reduce unreasonable work demands ( NASEM, 2019b ) (see Chapter 3 for more detail). Whole health care team members need to have the necessary systems to effectively and efficiently deliver whole health care, a supportive and positive work environment, and to experience whole health themselves.

Overlap of Whole Health with Other Care Delivery Models

The whole health approach overlaps with other concepts and care delivery models. To accomplish its statement of task, the committee reviewed and included major reports summarizing critical thinking about these concepts and models. In this section the committee identifies and describes these concepts and models, highlights how they are related to the concept and delivery of whole health, and discusses how they informed the committee's work.

Primary Care

The committee's definition of whole health aligns well with high-quality primary care. In 2021 the National Academies of Sciences, Engineering, and Medicine (National Academies) published the report Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care ( NASEM, 2021 ). The report defined high-quality primary care as

the provision of whole-person, integrated, accessible and equitable health care by interprofessional teams who are accountable for addressing the majority of an individual's health and wellness needs across settings and through sustained relationships with patients, families, and communities. (p. 4)

Primary health care is a similar but broader concept than primary care. Primary health care includes primary care but also focuses on population health and health system strengthening and public health approaches ( WHO, 2022 ). Whole health is built upon both concepts.

High-quality primary care is the foundation of health care in any high-functioning health system and is rooted in a generalist approach. Primary care clinicians start with a focus on the whole person, which considers a person's family and community context. Primary care clinicians build relationships with a person, understanding their preferences and priorities and working with the person to address concerns while keeping the whole in view ( NASEM, 2021 ). In addition to the relationship between a person and his or her primary care clinician, there are a growing number of primary care practices in which clinicians work as part of an interprofessional team that may include behavioral health specialists, community health workers, health coaches, pharmacists, and others. These professionals work together to care for people in a manner that integrates physical, behavioral, and social and economic well-being. When a person requires specialist care, primary care clinicians and teams coordinate and connect the person to care. Primary care is a force for bringing the more fragmented parts of a person's health care together, which is also an essential element of whole health care.

Primary care in its ideal form—which is not what primary care is for most people in the United States today—is the foundation of effective whole health systems. Primary care clinicians are core members of the whole health interprofessional team, and primary care clinicians often have a trusted longitudinal relationship with patients. It is in the context of this relationship that primary care clinicians personalize and align a person's care with life mission, aspiration, and purpose. Primary care clinicians are also a conduit between the person and other professionals who help promote wellness in the fullest sense, and the primary care clinician and team add value by ensuring the parts of a person's health care are connected, not fragmented, and continue to align well with the view of the person as a whole. Whole health is an outcome of a high-quality comprehensive primary care system.

Given that a wide variety of environments and experiences influence an individual's well-being, the journey to achieving and maintaining whole health needs to involve professionals outside of primary care. The comprehensive and coordinated approach to the individual's well-being should be embedded in care provided by all medical and behavioral specialists as well as every professional on the health care team and the community.

The National Academies' recommendations for implementing high-quality primary care are also applicable to implementing whole health ( NASEM, 2021 ). The five overarching objectives of the Implementing High-Quality Primary Care implementation plan include

Paying for primary care teams to care for people, not doctors to deliver services.

Ensuring that high-quality primary care is available to every individual and family in every community.

Training primary care teams where people live and work.

Designing information technology that serves the patient, family, and interprofessional care team.

Ensuring that high-quality primary care is implemented in the United States.

For each of these recommendations, the words “whole health” could replace “primary care,” and this list would then identify the requirements for implementing whole health in the United States. While this committee's statement of task differed from that of the committee that authored Implementing High-Quality Primary Care , this committee recognizes that widespread implementation of those recommendations would align with and help facilitate the systematic scaling and spreading of a whole health system of care. However, the subsequent chapters and recommendations of this report will focus on the issues unique to whole health.

Health Centers

Health centers (also commonly known as community health centers) include federally qualified health centers (FQHCs), tribal health centers, urban Indian health centers, health care for people who are homeless, health centers for residents of public housing, school-based health clinics, and migrant health centers ( NASEM, 2021 ). A defining feature of health centers is that they provide locally tailored, comprehensive primary care and preventive health (including dental, cancer screening, family planning, and immunizations) to underserved populations, regardless of insurance status ( HRSA, 2021 ). Many health centers are certified patient-centered medical homes and also offer more holistic and comprehensive services, such as gynecologic, behavioral health, vision and eye care, and diagnostic and radiologic services. They may also provide various services that focus on upstream factors including case management, referrals to specialty care and social services (many of which address root causes of poor health), and transportation and translation services ( National Association of Community Health Centers, 2022 ).

Health centers have several features that align closely with the equitable and accountable foundational element of whole health. They are financially accessible. They will provide services to individuals regardless of their insurance status or ability to pay ( Schwartz, 2014 ). Overall, health centers are widely accessible geographically and are a regular source of care for people in underserved communities. As of 2021, they served 1 in 11 people in the United States (29 million people total), including 1 in 8 children and 1 in 7 racial and ethnic minorities. They served 376,000 veterans, 1.3 million people experiencing homelessness, over 5 million people living in public housing, 658,000 in school-based health centers, nearly 1 million agricultural workers, and almost 7 million best served in a language other than English ( National Association of Community Health Centers, 2022 ).

Over 90 percent of people who use health centers are near or in poverty. The proportion of people they serve who are on Medicaid is much higher than in the general population (48 percent compared to 15 percent), as is the proportion of people they serve who are uninsured (23 percent compared to 9 percent). Nationally, 63 percent of people who seek care at health centers are members of a racial or ethnic minority, compared with 42 percent of the general population. Health centers are 35 percent more likely to have patients with chronic conditions than private practices ( National Association of Community Health Centers, 2022 ).

FQHCs receive Health Resources and Services Administration Health Center Program federal grant funding to improve the health of underserved populations in the United States. ( HRSA, 2022 ). Nearly 1,400 FQHCs operate in the United States today, a number that has held steady since 2015, at about 14,000 delivery sites. Despite the lack of growth, FQHCs have expanded the number of services they offer and outperform the national averages for many health outcomes despite serving a higher-risk population. For example, 58 percent of people whom health centers serve have their hypertension under control versus only 26 percent in the nation overall, while 64 percent of people whom health centers serve have their diabetes under control versus 19 percent in the nation overall. People who go to health centers are also less likely to have delays in medical care or dental care than those who seek care elsewhere ( National Association of Community Health Centers, 2022 ). People who receive care at health centers also had 24 percent lower spending than those who received care from other medical facilities across all services provided ( HRSA, 2022 ).

A key feature of health centers is that they are accountable to the communities they serve. They must have at least 51 percent of their governing boards of directors composed of people in the community who seek care at the health center ( NASEM, 2021 ). Governing boards must also reflect the demographic characteristics of the overall populations that the health centers serve, although there is some evidence that this is not always the case ( Wright, 2013 , 2015 ). The purpose of this requirement is to ensure that the people served, who are often from underserved communities that are rarely included in organizational decision making, can have a voice in health center decisions regarding daily operations and how the health center delivers services.

Health centers are also required to annually assess the geographic catchment area of the people whom they serve ( HRSA, 2018 ). They also need to complete a community needs assessment every 3 years, including a review of barriers to care, unmet health needs, health indexes for the population served, poverty level, and other demographic factors that affect the demand for services (such as percentage of population over the age of 65) and then adjust their services to better address the assessed needs. They are also required to make and maintain a reasonable effort to build partnerships with clinicians and services, including other hospitals and specialists, within their catchment areas to help facilitate coordination of services that the health center does not offer. Health centers often complete their needs assessments in coordination with nonprofit hospitals (which also should complete their own needs assessments to maintain their nonprofit status) and public health departments with the goal of coordinating their collective response to identified needs ( NASEM, 2021 ).

Overall, the health center model shares many features of whole health and could be a logical platform to expand whole health throughout the U.S. health system. Some health centers, including Southcentral Foundation's Nuka System of Care and Mary's Center in Washington, D.C. (both of which are described in detail in Chapter 4 ), already align closely with the whole health approach.

Social and Structural Determinants of Health

Social and structural determinants of health (commonly referred to as “social determinants” or “social needs”) are the true reasons for health inequities and a whole health approach is key to addressing them at the population and community levels. They include things like poverty and economic systems in communities, structural racism and oppression, gender bias, and other social and economic factors—physical, social, cultural, community, economic, legal, and structural factors—that affect health, such as access to healthy food and having a place to live ( Benjamin, 2011 ; Lushniak et al., 2015 ). Everyone has social and economic factors that shape their health. Social determinants of health are “social risks” when they negatively affect a person's health. For example, not having access to reliable transportation might limit a person's ability to attend a medical visit ( Grembowski et al., 2014 ; Loeb et al., 2015 ; Safford et al., 2007 ). The structural determinants of health are the structures and systems that cause social and health needs; they span a wide range of socioeconomic systems, physical environment, education, social support networks, employment, and even health care equity ( Braveman and Gottlieb, 2014 ).

Public health leaders, including the National Academies, have recognized the potential negative effects of social risk on health and have recommended that health care organizations, including clinicians and teams in these organizations, systematically collect and document information about patients' social risks ( NASEM, 2019a ; Wyatt et al., 2016 ). The 2019 National Academies report Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health provides a comprehensive list of the social and structural determinants that affect peoples' health and summarizes the compelling and growing body of evidence that shows that these factors affect health directly ( NASEM, 2019a ). That report also recommended screening for these factors and identified five health system activities that strengthen social care integration:

• Awareness activities focus on individuals and identify the social risks and assets of individuals and communities.
• Adjustment activities focus on individuals and alter clinical care to accommodate identified social barriers.
• Assistance activities focus on the community and reduce social risk by providing assistance in connecting people with relevant social services.
• Alignment activities focus on community health systems, which undertake them to understand existing social care assets in the community, use them efficiently, and invest in and deploy them to improve health outcomes.
• Advocacy activities focus on both individuals and the community to promote policies that facilitate or strengthen efforts to improve social needs.

Achieving whole health depends in part on engaging in these five activities. In some cases, social risks will shape the extent to which patients are able to engage in whole health care. In other cases, social risks may be the root cause of poor health. In all cases systems that aim to deliver care that is holistic, optimally aligned with patients' preferences, and focused on the whole person will, at a minimum, need to collect information about patients' social and structural determinants of health and equip the interprofessional care team to help mitigate social risks and are necessarily relevant to whole health care at both a person and system level.

Addressing the social and structural determinants of health is not something that health care can or should do alone. Social services, community programs, educational systems, environmental planners, judicial systems, and employers are essential and, in many cases, primarily charged with addressing social and structural determinants of health.

Integrated Behavioral Health

The committee uses the term “integrated behavioral health” to describe when medical and behavioral health care is delivered together. The committee considered behavioral health to include both mental health and healthy behaviors, and adopted the following definition of the term:

[Integrated behavioral health] results from a practice team of primary care and behavioral health clinicians, working together with patients and families, using a systematic and cost-effective approach to provide patient-centered care for a defined population. This care may address mental health and substance abuse conditions, health behaviors (including their contribution to chronic medical illnesses), life stressors and crises, stress-related physical symptoms, and ineffective patterns of health care utilization. ( Peek and the National Integration Academy Council, 2013 , p. 2)

There is a growing body of research that suggests that patient experience becomes better, health outcomes improve, and costs are contained when conventional medical and behavioral health needs are addressed together ( Katon and Guico-Pabia, 2011 ; Reiss-Brennan et al., 2016 ; Unützer et al., 2013 ).

As with addressing social needs, integrated behavioral health is a critical part of the whole health care approach ( Hodgkinson et al., 2017 ; Miller et al., 2014 ; Reiss-Brennan et al., 2016 ). Whole health is intended to attend to and care for the whole person, and integrated behavioral health reflects that by recognizing that health and well-being include wellness for the mind and the body as well as a daily pattern of healthy behaviors. Whole health care aims to deliver care that is integrated and coordinated, not siloed. The integrated behavioral health movement has found that care is best “integrated” when delivered from a single location by co-located interprofessional team members who create a seamless experience for patients ( Asarnow et al., 2015 ; Bokhour et al., 2020 ; Reiss-Brennan et al., 2016 ). This concept will be important for whole health systems to consider, but it may be evolving with telehealth advancements that can create seamless experiences without co-location.

Community Health

The committee identified several key concepts concerning whole health and whole health systems when reviewing critical thinking on community health ( Peek et al., 2021 ; Sturmberg et al., 2019 ; Sweeney et al., 2012 ; Weinstein et al., 2017 ). When examining the field of community health, the committee broadly considered the domains of community health, population health, and public health. Communities can be defined by physicallocation, shared interests, common characteristics, or other unifying factors. Veterans are a clear example of a community joined by a shared experience.

As part of the definition process, the committee decided that whole health systems are responsible for the collective health of the communities they serve, not just for individual people. When applying the whole health definition to communities, it would have the same characteristics and essential elements as applied to individual people. For example, “community whole health” is not just the absence of disease in a community but ensuring that the community thrives.

In a 1983 report, Community-Oriented Primary Care: New Directions for Health Services Delivery ( IOM, 1983 ), the Institute of Medicine described how community context is critical when dealing with the complexities of delivering high-quality primary care. It described community-oriented primary care as

an approach to medical practice that undertakes responsibility for the health of a defined population, by combining epidemiological study and social intervention with the clinical care of individuals, so that the primary care practice itself becomes a community medicine program. Both the individual and the community or population are the focus of the diagnosis, treatment, and ongoing surveillance. (p. 70)

This description highlights the need for a population health approach to care, which is also needed to provide whole health care. Community-oriented care starts with assuming responsibility for the health of a community and proceeds to consider population-level interventions for care. This requires identifying those who need care and proactively reaching out to ensure that they get care rather than waiting to react to community members seeking care. This process ensures that people do not fall through the cracks. It is also concerned with preventing people from getting sick so that they do not need care in the first place. Proactive population health is an essential tool for health equity.

Despite the biomedical-centric language in the description above which is reflective of the time, community-oriented care also addresses the social and cultural context of individuals and families. The Implementing High-Quality Primary Care report describes this feature of community-oriented health in detail ( NASEM, 2021 ). Including the social and cultural context in care can improve outcomes across different populations and conditions ( Black et al., 2017 ; Derose et al., 2019 ; Epstein et al., 2002 ; Izquierdo et al., 2018 ; Jones et al., 2018 ). However, incorporating community-oriented approaches into traditional biomedical fee-for-service models does come with challenges. For example, a 2018 study found that primary care clinicians had trouble incorporating or even seeing how it could be possible to incorporate evidence-based community, proactive, population-based programs for disease management and prevention because of health system and financial pressures to focus on diagnosis and treatment ( Leppin et al., 2018 ).

The community is also a tool and source for the delivery of care. Being a member of a community can create a sense of belonging and purpose. It is a source of support and a resource to achieve one's aspirations, purposes, and mission, and connection to community can be a pathway to achieving whole health ( Kitchen et al., 2012 ). The community can be a source for understanding and changing factors that influence health, such as the social and structural determinants of health or environmental factors ( Woolf et al., 2016 ). In addition, many community health interventions require policy, environment, community organizational, and social/interpersonal actions that only community partners can achieve ( Ackermann, 2013 ). Achieving whole health for people and communities requires understanding the community in which people live and partnership with public health and community organizations ( Krist et al., 2013 ).

Learning Health Systems

In 2007 the Institute of Medicine held its first in a series of workshops on the learning health system that focused on issues related to improving the evidence being created and used to inform decision making in health care ( IOM, 2007 ). The Institute of Medicine defined a learning health system as a system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the health care delivery process and leads to continual improvement in care” ( IOM, 2007 , p. 6). Learning health systems should emphasize continuous learning and have learning and knowledge translation inform patient care ( Grumbach et al., 2014 ). Moreover, synergies should exist among the research, clinical, and educational missions of the learning health system.

Learning health systems need data they can access rapidly in order to make iterative changes. Multiple sources, such as a system's electronic health record or claims data sourced from an insurer or accountable care organization, can provide the necessary data ( Etheredge, 2007 ). In addition, a learning health system requires methods for analyzing big data combined with system sciences, such as translational and implementation sciences, to understand the impacts of changes on person and system outcomes ( Maddox et al., 2017 ; Mandl et al., 2014 ; Mullins et al., 2018 ). This learning health systems approach can guide the evidence for enabling a health system's transformation to delivering whole health.

• FINDINGS AND CONCLUSIONS

To support the committee in identifying and studying whole health systems within the VA and more broadly in the United States and internationally, this chapter provides an updated universal definition of whole health, identifies the essential elements of whole health systems, and highlights lessons from other domains of critical thinking that can inform whole health system design. This information provides the framework for the findings presented in the subsequent chapters of this report. More importantly, this chapter provides a concrete description of the aspirational goals for systems interested in providing whole health, and the subsequent chapters provide a detailed roadmap with examples including successes and failures, challenges, and lessons learned from the whole health field.

The universal definition defines what whole health is—“physical, behavioral, spiritual, and socioeconomic well-being as defined by individuals, families, and communities.” The definition also defines what a whole health approach is—“an interprofessional, team-based approach anchored in trusted longitudinal relationships to promote resilience, prevent disease, and restore health. It aligns with a person's life mission, aspiration, and purpose.” The five foundational elements of whole health are broadly identified as (1) people-centered, (2) comprehensive and holistic, (3) upstream-focused, (4) equitable and accountable, and grounded in (5) team well-being.

An important feature of whole health care is that it is tailored to the needs of the person, family, and community, which means that there will be considerable variation in how effective whole health systems look and function. For example, systems that care for communities with higher social needs will look different from those that care for communities with higher mental health needs. Another key feature is that whole health is grounded in equity. Inequity is a primary cause for poor health, and it is not possible for communities to achieve whole health without addressing inequity.

The VA has been a leader in creating a culture of whole health and is redesigning its system to deliver whole health care. It has successfully focused its design to address several pressing needs of veterans, specifically chronic pain, post-traumatic stress disorder, mental trauma, and disability. Expanding the whole health focus to address the full range of veteran needs across different communities and supporting veterans in different phases of their life will be necessary for all veterans to receive the benefits of whole health care. This will require the VA to expand is definition and support for whole health.

Many veterans receive care outside of the VA. Therefore, for all veterans to receive whole health benefits, they must be able to access whole health care in all settings, not just VA settings. Fortunately, the concept of whole health is gaining widespread acceptance as the aspirational goal of health care. Accordingly, many health systems beyond the VA have adopted a mission to promote whole health and are developing their approaches to whole health care delivery.

However, this field is very much in its infancy. Improving the understanding of what whole health means and the best way to help people, families, and communities achieve it is an enduring adaptive process. It is worth pursuing and should be a common health care goal. The committee's definition and the five foundational elements can help to inform the next phases of this national journey.

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An interprofessional care team includes a variety of clinical and nonclinical team members that collectively meet the whole health needs of a population or community. An interprofessional team will look different depending on available resources and local needs and should ideally reflect the diversity of its community.

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AIMEE LONG, CNHP

Certified natural health professional diplomate of holistic iridology  zyto technology specialist.

Aimee Long earned a Bachelor of Science degree from the University of Scranton in 1988. While originally scheduled to graduate the year prior, an unexpected leukemia diagnosis not only delayed graduation, but ultimately shifted her focus away from allopathic medicine and toward holistic/alternative studies.

 Aimee became a Certified Natural Health Professional (CNHP) through the Trinity School of Natural Health and then eventually earned the title of Diplomate of Holistic Iridology through the International College of Iridology; she has attended iridology conferences all throughout the US, as well as in Canada and in France. She is also a specialist in ZYTO technology, a software that uses galvanic skin response to analyze energy frequencies and provide valuable health insight. Aimee's primary interests/specialties include iridology, herbology, women’s hormone health, children’s developmental health, nutritional biochemistry, homeopathy, parasitology, Bach flower remedies, and Lifewave light therapy.  

  Outside the office, Aimee spends most of her time with her husband - together they enjoy hiking, foraging for herbs, gardening, cross-country skiing, repurposing antiques, creating art projects, and traveling. Aimee has three grown sons, all of whom were raised with the knowledge of natural/holistic health practices. 

[ORGANIZATION OF MEDICAL CARE FOR CHILDREN WITH A NEW CORONAVIRUS INFECTION IN PATIENT CONDITIONS ON THE EXAMPLE OF THE CHILDREN'S CITY CLINICAL HOSPITAL NAMED AFTER Z. A. BASHLYAEVA]

Affiliations.

• 1 Children's City Clinical Hospital named after Z. A. Bashlyaeva of the Moscow City Health Department, 125373, Moscow, Russian Federation.
• 2 Pirogov Russian National Research Medical University, 117997, Moscow, Russian Federation.
• 3 Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, 125993, Moscow, Russian Federation.
• 4 Pirogov Russian National Research Medical University, 117997, Moscow, Russian Federation, [email protected].
• 5 Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, 115088, Moscow, Russian Federation.
• PMID: 34792888
• DOI: 10.32687/0869-866X-2021-29-s2-1343-1349

The article presents an analysis of the work of the largest children's COVID-19 center in Moscow, organized on the basis of the Children's City Clinical Hospital named after Z. A. Bashlyaeva of the Moscow City Health Department. From March to November 2020 at the COVID-19 Center were hospitalized 2,837 patients with suspected/confirmed diagnosis of COVID-19, in total in 2020 1,876 children with a confirmed diagnosis of COVID-19 were treated, 58 (3%) children were in serious condition in the intensive care unit, of which children 11-18 years old were 25%. At the 2020 neonatal COVID-19 center, 215 newborns were observed with suspected COVID-19 diagnosis. The diagnosis of COVID-19 was confirmed in 18 children, while 8 newborns came from the home of COVID-19. In the Center for rehabilitation, where children aged 0 to 3 years old who were born with very low and extremely low body weight are observed, dispensary observation for children who have undergone COVID-19 is organized. 45 children who were observed fell ill with the new coronavirus infection. There were no deaths among children with COVID-19.

Keywords: COVID-19; COVID-center; children; new coronavirus infection; newborns; treatment.

• COVID-19 Testing*
• Child, Preschool
• Hospitals, Pediatric
• Infant, Newborn
• Retrospective Studies

Reimagining Design with Nature: ecological urbanism in Moscow

• Reflective Essay
• Published: 10 September 2019
• Volume 1 , pages 233–247, ( 2019 )

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The twenty-first century is the era when populations of cities will exceed rural communities for the first time in human history. The population growth of cities in many countries, including those in transition from planned to market economies, is putting considerable strain on ecological and natural resources. This paper examines four central issues: (a) the challenges and opportunities presented through working in jurisdictions where there are no official or established methods in place to guide regional, ecological and landscape planning and design; (b) the experience of the author’s practice—Gillespies LLP—in addressing these challenges using techniques and methods inspired by McHarg in Design with Nature in the Russian Federation in the first decade of the twenty-first century; (c) the augmentation of methods derived from Design with Nature in reference to innovations in technology since its publication and the contribution that the art of landscape painters can make to landscape analysis and interpretation; and (d) the application of this experience to the international competition and colloquium for the expansion of Moscow. The text concludes with a comment on how the application of this learning and methodological development to landscape and ecological planning and design was judged to be a central tenant of the winning design. Finally, a concluding section reflects on lessons learned and conclusions drawn.

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The landscape team from Gillespies Glasgow Studio (Steve Nelson, Graeme Pert, Joanne Walker, Rory Wilson and Chris Swan) led by the author and all our collaborators in the Capital Cities Planning Group.

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Evans, B.M. Reimagining Design with Nature: ecological urbanism in Moscow. Socio Ecol Pract Res 1 , 233–247 (2019). https://doi.org/10.1007/s42532-019-00031-5

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Received : 17 March 2019

Accepted : 13 August 2019

Published : 10 September 2019

Issue Date : October 2019

DOI : https://doi.org/10.1007/s42532-019-00031-5

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