Derived from the Greek χόλος (holos), health refers to a salutary balance of internal and externally derived forces. Three overlapping dynamics are at play: social, environmental and innate. Social factors, at their core, represent the effects of attachment as represented by the fields of interpersonal neurobiology and social sciences. Environmental influences, including biological, toxicological and physical agents, represent non-human systems. Both social and environmental forces are external to the individual, or “allostatic.” Innate (or “autostatic”) factors include our capacity for maintaining homeostasis in the face of allostatic load. This ability is determined by the adaptability of our psychophsyiological networks. So, secure attachment, a trophic environment, and a practice of psychophysiological plasticity best support optimum health, or “wellness.”
Three corollaries from this conceptualization inform learning objectives for studying health and wellness. First, understanding health requires consideration of complex systems. Second, health is a dynamic equilibrium that evolves with the development of unique resources and experiences of each individual. Third, wellness can exist in the presence of disease.
1. Complex systems produce emergent phenomena that are more than the sum of their parts. All of the factors that affect health, including health itself, are emergent properties of complex and self-regulating systems. While the science of health and medical care have benefitted by the reductionist, categorical model of the last 400 years, this approach has become limiting and, ultimately, costly. The last 60 years has brought human cybernetics to the study of health. This evolution is most evident in the growing fields of psychoneuroimmunology, psychoneuroendocrinology, applied pscyhophysiology and more generally, the domain of “mind-body health.” These fields consider anatomy and physiology as media for information and energy flow, operating in networks that transcend biologically-limited categories and systems.
2. Health is a dynamic balance. Innate processes such as development and encoding experience in psychophysiological networks are constantly evolving within us and through interaction with ever-changing social and environmental systems. So health is determined by unique patterns of interaction. Understanding of health requires learning about an individual’s resources for change within a given culture.
3. Health is not the absence of disease. The traditional Western allopathic model of medical care holds that health occurs when there is no disease, or defect condition in the system. Interventions tend to focus on repairing or replacing defective components. The opposite of health is system failure or death. A multi-systemic model projects health as an evolving co-creation of balance and a shifting homeostasis that maximizes allo- and auto-static forces. With secure social attachment and a nurturing environment, a person can die healthy by utilizing a wealth of accumulated experience.
In order to demonstrate proficiency in the Health and Wellness component of the Biomedical Sciences Curriculum, students should be able to:
Compare and contrast the medical care model and its interventions from the health model and its pursuit of wellness in terms of epistemology, economics, ethics, and goals.