The latest term hitting the health care benefit, insurance company, and point solution ecosystem is “whole person care.” This term is beginning to be used as a marketing buzzword and is losing its meaning.
What is the definition of whole person care? The DHHS/NIH National Center for Complementary and Integrative Health defines it as “looking at the whole person—not just separate organs or body systems—and considering multiple factors that promote either health or disease. It means helping and empowering individuals, families, communities, and populations to improve their health in multiple interconnected biological, behavioral, social, and environmental areas. Instead of just treating a specific disease, whole person health focuses on restoring health, promoting resilience, and preventing diseases across a lifespan.”
Whole person care is the foundation of population and public health. It moves from reactive to proactive care, from an illness approach to a wellness and well-being approach, and from the increasingly expensive and reductive U.S. allopathic approach to improving the health of more people further upstream in the disease process in a more expansive, health care-cost-reducing, disease-preventing, reversing, and mitigating approach.
Whole person care must encompass the following essential components: physical, emotional, social (including community), financial, and spiritual well-being.
Oddly, we have no word in English to describe these aspects in the context of a person. After scouring the world’s languages, the closest I found was a word in Eritrean—a throaty, clucking-like sound after a “t” consonant. It has a musical scale-like movement from low to high notes while expressing an “ah” sound (I apologize for the less-than-articulate definition). The best Western spelling we could come up with was “tiena,” to which we added the word “health,” resulting in “tienahealth.” According to the Eritreans who shared this word and concept, it means “whole and complete—physically, emotionally, socially, financially, and spiritually.” As they described it, when a person has reached a high level of functioning in all five areas of life, they have achieved tienahealth.
A few highlights from LinkedIn on what the concept of whole person health care is being reduced to:
Whole-person care: The integration of mental health and physical health: While combining mental and emotional support with primary care is crucial, this definition overlooks 60% of the concept and dilutes the true meaning of whole-person care.
My favorite: A panoramic view of whole person care – making drugs less expensive, integrating with specialists more effectively for eye and dental care, integrating behavioral health benefits, reducing out-of-pocket expenses for healthcare services, and providing wrap-around wellness programs. Making access to traditional health benefits less expensive is not whole person health. Physical, emotional, social, financial, and spiritual health are not better access to drugs, counseling, and wrap-around wellness programs. Note to file: making access to traditional healthcare easier is not whole person care.
Perhaps the issue is that we are interpreting whole person health from within an allopathic, fee-for-service, Western medicine tradition. With a more holistic mindset, the limitations of this approach become evident. The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Important social determinants include: “education, early childhood development, income and social protection, unemployment, and job security, working life conditions, food insecurity, housing, basic amenities, environment, social inclusion and non-discrimination, structural conflicts (political factors), and access to affordable health services of decent quality.”
Let’s agree that whole person health is much more than a marketing term to sound hip, cool, or up-to-date. It requires moving beyond a limited allopathic view of health and actually considering the whole person. Let’s make achieving tienahealth meaningful and set the stage for the next generation to move beyond our limitations to a model of well-being that actually works.
Scott Conard is a family physician.
