The World Health Organization (WHO) defined health to be a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2018). This became one of nine guiding principles embedded into the Constitution of the World Health Organization and has come under scrutiny for being too narrow-minded. Huber (2011) cites that most of the concern regarding this statement arises from the term “complete”. Considering our ability to detect diseases and conditions is increasing and improved management of chronic diseases leads to a longer lifespan, it becomes challenging to suggest “complete” as the gold standard.
A new movement towards adopting the concept of “integrative health” has now started to emerge (Witt et al., 2017). This approach embraces “all health-related areas, such as the physical and social environment, education, agriculture and architecture” that go beyond the clinic to look at factors that influence health (HRH The Prince, 2012). It also empowers individuals to lead healthy lives, inclusive of chronic conditions or other constraints.
So how do we achieve homeostasis in health? If we embrace this integrative health model, we would consider the conditions but also the influence of a multitude of extrinsic factors that can promote or disrupt this balance. An example provided by Witt et al. (2017) includes the management of a patient with asthma who receives medical support that is then augmented with educations programs on proper use of inhaled beta agonists and housing interventions to control cockroach infestations in subsidized housing units.
But are we not already practicing some forms of integrative health? Healthcare facilities are improving the delivery of patient-centred care using multidisciplinary teams which include non-traditional pathways. We also have a public health system that delivers prevention and promotion programs that can be tailored to specific community needs. In Ontario we also have “Local Health Integration Networks” (LHINs) whose primary focus is to integrate and fund local health care to improve access and patient care (Local Health Integration Network, 2014). Perhaps we are in the infancy of developing this vision of integrated health, but I would argue that we are heading in the right direction.
I’ve met the “real” Patch Adams and heard him speak at two engagements. He conducts 3-4 hour interviews with new patients. During these interviews he explores every aspect of their lives and considers on how this impacts their health. His model believes in “holistic medical care based on the belief that the health of the individual cannot be separated from the health of the family, the community, the society and the world”(Patch Adams, 2018). Much like integrative health, it recognizes the important contributions factors outside of the body play when determining optimal health. But it means getting to know the patient on a much deeper level.
Health is not “one-size fits all” and certainly not static. Any definition would need to be broad in scope, adaptable and scalable to every culture, race and demographic.
References:
HRH The Prince, o. W. (2012). Integrated health and post modern medicine. Great Britain: ROYAL SOC OF MED. Retrieved from http://0-search.ebscohost.com.aupac.lib.athabascau.ca/login.aspx?direct=true&db=edsbl&AN=RN325406264&site=eds-live
Huber, M. (2011). Health: How should we define it? BMJ: British Medical Journal, (7817), 235. Retrieved from http://0-search.ebscohost.com.aupac.lib.athabascau.ca/login.aspx?direct=true&db=edsjsr&AN=edsjsr.23051314&site=eds-live
Local Health Integration Network. (2018). Retrieved from http://www.lhins.on.ca/
Patch Adams. (2018). Retrieved from http://www.patchadams.org/
Witt et al. (2017) Defining health in a comprehensive context: A new definition of integrative health. American Journal of Preventive Medicine, (1), 134. doi:10.1016/j.amepre.2016.11.029
World Health Organization. (2018). Retrieved from http://www.who.int/about/mission/en/