Options in Health

Most people live as if they are “fully alive”, functioning at 100% or as if they are on the verge of death, figuratively if not literally. We, also, acknowledge that there is a lot of ground, or shades of grey, between the two states of being. However, this acknowledgment does not alter the manner of living as if our health is “perfect” and separate from the rest of our existence. Government entities, individuals, business entities, our entire society treats health and health care as if they were a product that can be isolated, patented, packaged and sold to the highest bidder or is totally ignored as if it isn’t relevant to the issue at hand. We attempt to negotiate with, make compromises with, try to bend to our own political or economic agendas, or totally ignore, our health. We fail to recognize and deal with, face to face, that our health is our life.

Over the years it has become harder and harder to avoid the obvious fact that health care and health are not about the provider, disciplines of health, diseases or conditions, it is about the health of an individual (society, company or community). Although this seems like it should be obvious, if we look at how health care is provided and how health is depicted in the media, health is treated as a commodity that is comprised of diseases and symptoms or youthful individuals exercising, eating certain cereals and taking certain drugs and leaping around a mountain meadow with a Labrador Retriever. The message seems to be that if we give enough money to find the “CURE” that what we will be left with will be “health” and we won’t have to be responsible for our health. When discussing health with most people the first words out of their mouth usually relates to exercising more and eating better or taking some form of supplements, as if health is only eating good foods and exercising, neither of which are done by most of us. Our observation is that most practitioners and health professions, not necessarily intentionally, practice as if they are “the way and the light”, “the answer”, to better health. What we have come to recognize is, again the obvious, that health care providers are “a light along the way” and the entity being served has “the way and the light” inside of them. Using this metaphor a bit further, if we look at how people in our society obtain health information and assistance we would have to visualize the road to health as a super highway with flashy billboards and street lamps only at service stations on exit ramps. Each discipline at it’s own isolated station with only a dirt road connecting the different exits and with very little light being cast upon the super highway of the persons health. Bringing the stations next to the freeway with the ability to easily travel between each station and with a good communications network, would enable that person to move easily on the freeway through a full life with an integrated support system. In other words, fully integrate health care as a support team and remove the focus on doctors and treatments and back onto personal responsibility.

Out of this gradual realization a group of practitioners and an on-line group of people with diverse backgrounds, to include; allopathic physicians, naturopathic physicians, a chiropractic college president, chiropractic physicians, a dentist, health consultants, business consultants, and interested lay people began a dialogue. The topic of the dialogue was “what is health?”, what is it comprised of, what drives it, how does it relate to the individual, to business entities, or government entities? How do we take this huge and complex subject and put it in a form that not only we, but also anyone can understand? How does health function inside the World Health Organizations definition of health as, “Health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or injury”? The outcome of these dialogs was very similar to, if not identical to, the components of health as listed in Evans and Stoddart’s 1990 paper, in “Social Science Medicine”, “Producing Health, Consuming Health Care”. An example of these similar conclusions was, as stated by Stoddard and Evans, “The WHO broad definition of ‘health’ is, as noted above, so broad as to become the objective, not only of health policy, but of all human activity.” Or as we stated it, “our health is our life.”

An outcome of our two-year dialogue is the concept depicted in illustration one. This chart represents a flow chart of health and can be used in multiple settings. It can be used to depict an individual’s or a corporation’s relationship to health or as a representation of health. The chart represents, on the A to B axis (or “life line”), the two extremes as lived by most people, these are “Fully Alive” and “Dead”. Most people live as if they were in one or the other of these extremes as the state of their health. Of course, the distinction of the vast area separating the two extremes is brought forth in the stating of the extremes. Dividing the axis into quarters creates the areas of “Mostly Alive”, “Alive” and “Mostly Dead” and allows for each division to be assigned an arbitrary value as a percentage of “aliveness” with “Dead”, of course, being zero. From zero to 50% is the area of symptoms and disease and 25% to 75% is where most people exist. Actually most appear to live somewhere between 25% and 50% of their potential, as depicted by this chart, with all efforts seemingly directed towards getting to and maintaining 51%, or symptom free. Our system of health is directed at and intended to eliminate all symptoms and to prevent or eliminate all diseases. This is not an inappropriate effort especially if people or societies are living in the zero to 25% range of health or, perhaps, in a third world country. The dominant system of health care in this country, allopathic medicine, is at it’s very best when heroically preventing death. When, however, we attempt to modify and apply these same lifesaving, yet life-threatening procedures, in the non-eminently lethal situations, in the area from 25% and above, the risk-reward ratio begins to tilt away from benefit to risk of harm (i.e. 16500 deaths/year from NASID’s, 2000 deaths/week from prescription drugs, 1.5 million hospitalizations/year due to prescriptions drugs).

So what is the alternative to the traditional allopathic model of health delivery or of “preventing death”? Historically, the “opposing” or, as we would prefer “complementary”, alternative is “vitalism” or “Promoting health”! “Promoting health” in this manner implies supporting the innate healing ability of the body and working with the body not to the body. If we acknowledge and respect the efforts of reductionism and the mechanistic approach to health and look at what else can be done, or what is the “alternative”, it is apparent that “promoting health” and the vitalistic approach gives us an access to 100% health that is not available to the mechanistic procedures that are dependent upon symptoms and diseases for their application. In the alternative, vitalistic approach, the efforts are aimed at improving, or optimizing, function so that a “rear view mirror’, so to speak, is necessary to realize the degree of success, or, as patients who are in care of an alternative provider have stated, “I didn’t realize how bad I felt when I thought I felt good.” “Promoting health” versus “preventing death” gives us, also, the distinction between “quality of life” and “maintenance of existence”.

Using this model acknowledges the areas of strength and weakness of both approaches and more importantly allows the person, system, company, the opportunity to have a “say” in the approach THEY determine is appropriate at the given moment. It also allows that neither point of view is “right” or “wrong”, only “appropriate” or “inappropriate” as determined by the person or owners of the company.

The question then must be asked, “What are the factors that impact and determine the level of health that is expressed?” What are the spheres of our life that move the marker up and down the AB axis? Our dialogs led us to seven, obvious, major areas that are also subsets of each other.

1. Physical
2. Nutritional
3. Mental/emotional
4. Environmental
5. Occupational
6. Family/community
7. Spiritual (faith)
(8). Financial

The eighth, financial, is placed in parenthesis, as it is not truly a factor of human health, except as society, or we as individuals, allow it to be a factor. However, as people and companies make health decisions based on money it becomes a “real” factor of health.


Hypothetically each of these areas intersect with the “life line” to create the percentage of health or quality of life being expressed. If we rotate the AB axis ninety degrees (illustration 2) we have the ability to apply values to each of the seven areas of health and begin to estimate what is “missing” and needs to be addressed for movement up the life line. Using this depiction and acknowledging the intersecting point that each area has in common helps to maintain focus on the interrelatedness of each area of life and, therefore, the need for communication between disciplines and the fact that it is about the “life line” of the individual, not the disciplines area of interest. It also helps to understand how each area of life or discipline specialty is a subset of all other areas of life depending upon the circumstances.

The question this representation raises is, “What are the values for each of the intersecting axis and how do we determine these values?” Obviously, some of the outcome measures used in the mechanistic model of measuring symptoms and function can be applied, however, new ways of measuring all areas in conjunction with each other must be identified to give the individual the opportunity to make informed decisions about his or her health. The metrics of “quality of life” need to be developed and to be as sophisticated as the outcomes measures for the “maintenance of life” or the dis-eases and symptoms of life.