What is health?

This question was recently posed to a group of allopathic trained health care professionals who answered with responses such as, “absence of disease,” “body, mind, and emotional wellness,” and “continuum between disease and total well being.” Although the responses seem vague and generalized, the descriptions were generally in line with the World Health Organization (WHO) definition – “state of compete physical, mental, and social well being and not merely the absence of disease.” Andrew Weil takes a more philosophical approach in his definition. In the book, Health and Healing, the famed integrative physician states “health is wholeness – wholeness in its most profound sense, with nothing left out and everything in just the right order to manifest the mystery of balance….[it] is a dynamic and harmonious equilibrium of all the elements and forces making up and surrounding a human being.” There is an overlap between both definitions with a holistic focus encompassing multiple aspects of patient’s health.

However, if our goals are to improve health, how can we do so without having a more quantified definition? As quality expert H. James Harrington states, “if you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.” Therefore, lets use the above frameworks to quantify health. The inputs of health are physical, mental, and social well-being. The physical realm is the focus of allopathic medicine and is measured by laboratory values. We currently lack the granularity to measure mental health but this can be approximated via proxy measurements of well being. Social determinants include the houses and neighborhoods people live in, the food people eat, the air people breathe, the amount of exercise people get, and the jobs people have. These inputs interact with our genomes to generate a continuum or equilibrium of health. These pillars and relationships in sum serve as the pillars of our health dashboard.

As the bioinformatics and the “internet of things (IOT)” revolution gain momentum, we will increasingly be able to capture and record two key inputs of our health. The “–omics” (genomics, lipidomics, metabolomics, proteomics, nutrigenomics) will provide us with unprecedented insight into our genomic makeup, and even more importantly, how these genes interact with our environment. Sensors will facilitate the capture of environmental inputs and the relationships between the social, physical, and mental health of patient will be represented in a dynamic health dashboard. This health score could not only be a metric to quantify health, but could also serve as a benchmark that can be utilized for creating plans to improve and optimize health.

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