June 2023
Karen Ensle EdD, RDN, FAND, CFCS
Rutgers Cooperative Extension of Union County
Having whole health is fundamentally different from being healthy in a typical medical model. Whole health is a resource for everyday life to enable people and communities to achieve their life aspirations and cope with change.
Achieving whole health starts with understanding what matters to people and then builds the environment, resources, and support to help people and communities achieve their life goals. All people and all communities have a right to whole health. It is a common good and should be the desired goal of any effective health care system. Whole health is defined by this definition:
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.
The five foundational elements of whole health that are necessary to have an effective whole health care system: (1) people-centered, (2) comprehensive and holistic, (3) upstream-focused, (4) accountable and equitable, and (5) grounded in team well-being.
Whole health is people-centered and is based on the idea that people, families, and communities should direct their goals of care. It fosters self-empowerment of all people through longitudinal, relationship-based care. Decades of research demonstrates that people-centered care most strongly influences patients' health as documented in the publication Achieving Whole Health: A New Approach for Veterans and the Nation published by the National Academy of Sciences.
Being comprehensive and holistic means that our health care systems address all the domains of care that affect our health and consider the entire person, their family, and their community. Each component of comprehensive care (acute and chronic care, mental health care, oral care, vision care, hearing care, complementary and integrative health, spiritual care, social care, health behaviors, and additional upstream factors) improves peoples' well-being. Evidence also shows that providing all components of comprehensive care in one setting (e.g., high quality primary care) further improves a persons' well-being.
Being upstream focused requires an integrated and coordinated approach to identifying and addressing the root causes of poor health. It addresses the conditions of daily life with the goal of making individuals more able to achieve whole health. These root causes of poor health (health behaviors, social needs, environment), often referred to as the social determinants of health, have more impact and influence on a person's health then conventional medical care. Addressing these needs through cross-sector community collaborations can have a tremendous impact on health.
At their core, whole health systems must be equitable and accountable in providing care. The people not seeking care are often in greatest need of care. By being held responsible for people, families, and communities, whole health systems can transform care from being reactive to proactive and help meet a persons' health needs before they develop into serious chronic diseases.
Changing our current health care system that emphasizes a medical model that "fixes health care problems" to one of prevention will not be easy and can only succeed if medical professionals are trained to deliver prevention services. The well-being of the public is dependent on how the entire professional health care team is trained and how they will provide healthcare to the public. Caring for others requires a stable, healthy, resilient, and innovative medical team that can support the cultural transformations needed for a whole health care system in the US.