What is Health? Expanding the Paradigm
What is Health? Expanding the Paradigm
If someone were to ask what part of the photograph above is the healthy part, what might you say? The baby? The mother? What about the health of the practitioner bringing the baby to mom? The question of the nature of health as a construct purposes the following article, and sheds light on how I approach my new position as the Associate University Research Chair for the Center for Health Engineering Research (CHER). Before I describe and explain the CHER mission, vision, and purpose designed to address this question and align with Boyer’s (1990) Model of Scholarship, I want to acknowledge the scholarship and successes of CHER under the leadership of Dr. Ellen Darosweski. Having spent the first month of my tenure studying the Center, I am impressed scholarly achievements resulting from the 2015-2016 health promotion agenda, and the leadership responsible for these accomplishments. It is my hope to build upon the strengths of CHER through facilitating scholarship regarding health and wellness across the lifespan.
What is '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 or infirmity." Despite the fact that this statement is nearly 50 years old, we have yet to embrace a paradigm of health beyond a paradigm of disease. As a culture, we collectively shake our heads at the inefficiency of healthcare system design, the cost of effective healthcare delivery, and the gaps in access to healthcare for underserved populations. The traditional silos of healthcare systemically separate research, clinical practitioners, educators, administrators, students, and patients. The disease-based paradigm remains problematic. Maintaining constructs of people as patients, healthcare as medical treatment, and wellness as disease prevention, dysfunctional systems walled off from one another will remain. If, however, we approach the paradigm of health as the WHO suggested, as a state of well-being across physical, mental and social domains, we may create the causes for dismantling the silos of healthcare and designing sustainable systems of health and wellness.
From this expanded worldview, the mission, vision, and purpose of CHER are as follows:
The Center for Health Engineering Research (CHER) purposes scholarly initiatives that explore and promote the design, delivery, and access to the full spectrum of physical, mental and social well-being.
The mission of CHER includes three core components:
1. CHER seeks to promote scholarship regarding the design, delivery, and access to healthcare systems.
The mission expands the definition of healthcare through innovative system design and delivery. Potential areas of exploration include:
Electronic health record management
Digital systems technology
Transdisciplinary collaboration between leaders in healthcare, government, business, technology, and military to promote health in private, corporate, and public sectors.
Access to health and wellness for communities of color; LGBTQ2A communities, immigrant communities, homeless population, the elderly
2. CHER seeks to expand health research beyond the traditional silos within the healthcare system to support research projects that further the understanding of environmental, public, community, workplace, first responder, military, family, and individual health and wellness.
CHER will foster the growth of health awareness and education through interdisciplinary engagement. Considerations may include:
Environmental health: teratogenicity of environment and racial justice, food safety and sustainability, air quality, water safety, and non-organic chemical waste production
Public health: Epidemiology, disease prevention, public safety and disaster preparedness, wellness promotion
Community health: Community-based health promotion, education, and localized service provider education, faith-based leaders as health and wellness advocates, local and small business health and wellness partnerships (greening space, farm to table, organic food production, clean-energy transportation, community leader disaster management)
Workplace health: Environmental hazards, risk management, toxic stress, work and wellness, thriving, substance use and abuse
First responder health: Increasing health awareness in first responder communities, de-stigmatizing mental illness, expanded research regarding trauma, traumatic stress, and post-traumatic stress disorder for first responders and their partners (first responder could be operationalized as law enforcement, fire, search, and rescue, emergency medical providers)
Military health: Increasing healthcare systems innovations, military healthcare delivery innovations, wellness training integration, veteran health
Family health: Reproductive life course model application, perinatal health care, intergenerational health, family as health advocates
Individual health: Health and wellness for the individual, patient advocacy, life course model, individual and wellness
3. CHER seeks scholarship that promotes mental health and psychological well-being as integral components of health in the public and private sectors.
Advancing the research of the intersection of missions 1 and 2 and psychological science, mental health, and psychological well-being.
In order to promote an agenda that supports the mission, the CHER vision is as follows:
To expand the current paradigm of health, wellness, and healthcare through scholarship, leadership, and education.
To contextualize the need for an expanded health paradigm in CHER, consider that healthcare employment is predicted to increase more than any other field by the year 2024, with a growth rate of as much as 19 percent, and an addition of a projected 2.3 million new jobs (US Bureau of Labor Statistics; 2011). Accordingly, the CHER mission, vision, and purpose align to meet the increasing needs of our students, faculty, and alumni engaged scholarship, practice, and education in the healthcare fields. However, we cannot remain within our silos of study. Moreover, other fields of scholarship have equally vested interest the pursuit of better healthcare systems and practices that include mental health and psychological well-being. Breaking down the silos of healthcare involves bringing all stakeholders to the table to define health and participate in the pragmatic purpose of putting health wisdom to work in the world.
So my one question is this: What does health mean to you?
Boyer, E. L. (1990). Scholarship reconsidered: Priorities of the professoriate. New York, NY: Carnegie Foundation for the Advancement of Teaching with Jossey-Bass.
Index, C. P. (2011). US Bureau of labor statistics. Washington, DC.