The Health Continuum

As a family physician that has practiced integrative medicine for more than 40 years, I interview and guide thousands of people in their goals for improved health. I have noticed that many of my patients not only tend to take their health for granted until they lose it, but often they haven't asked themselves exactly how they define health for themselves except as the absence of whatever unpleasant or painful symptoms may have brought them into my office.

Of course, medically speaking, treating disease is a primary goal and responsibility for any doctor; but for me, preventing disease is as important. Ideally I don't want to create chronic patients—people I see year in and year out with the same ongoing problems that are often treated primarily with pharmaceutical drugs. That is why I emphasize Lifestyle Medicine. I want to teach and support people to go beyond recovering from whatever problem they came to see me about, as well as learn something relevant about not repeating their illness. I want them to move beyond mere functional health and become healthier than they were; I want them to progress along what I call the Health Continuum towards their own Optimal Health.

How Do We Define Health?
As part of this process, I often ask my patients to consider more deeply what they mean by being healthy, so let's explore some definitions of health and then ask, "What is true healing?”

—Hippocrates, one of the founders of medicine, wrote: "Health is the expression of the harmonious balance of various aspects of a human's nature, environment, and ways of living.” That certainly sounds as though he considered lifestyle important and that was almost 2,500 years ago!

—The World Health Organization defines health as "a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.” This is interesting to me because it includes the aspect of our social interactions and relationships.

—One of my own definitions would be: "Health is a sense of wellbeing that incorporates function and environment, awareness and vitality, productivity and peace. Ultimately, it is the outcome of the alignment of body, mind, heart and spirit, and the connection with the path that lives at the core of our being.”

We could bring together a hundred great medical minds, even thousands, and it is unlikely that we could come up with an exact definition of health, or healing, that all would embrace. I encourage you to consider your own definition so you can begin to look at this question in a new and expanded way.

True healing often means going far deeper than merely treating the physical symptoms of disease or poor health. It involves looking at the underlying causes, and sensing the nature of the changes that a person needs to make to eliminate a health problem, to prevent disease and to optimize wellbeing.

There are also many sources for healing. These can be in our personal life path choices plus what we inherit from our genetics and family upbringing. On a lifestyle level they include our diet, the way we use or abuse certain substances, our level of physical activity, our stress level, our sleep patterns and our general attitude to life—these areas I call the 5 Keys to Staying Healthy, which I wrote about last month here in TotalHealth magazine. We can also find healing in our relationships to other people and to Nature, in our emotional resilience and in our spiritual connections.

The Health Continuum
From my experience, rather than looking at healing as merely a reduction or elimination of symptoms and disease, there is actually a Continuum that ranges from illness, to not being sick, to being actively healthy and vital. It includes ideas like service to others and a sense of purpose in life.

The truth is that most of us settle at some wellness set point—an acceptable balance between feeling fine and feeling unwell—our habitual state of health, if you like. We wait there until we get sick and then we work to heal and return to our former condition. Maybe that includes a visit to the doctor. But what about optimizing our health and actually enhancing our energy, fitness and vitality— moving our set point in the direction of better health? I encourage everyone to aspire to this goal.

Of course, if we experience a serious illness, or perhaps as we age, we may find our level of functional health being re-set lower than before and we come to accept a "new normal," perhaps with less mobility or endurance. In such situations, the advice of an experienced physician or integrative practitioner, particularly one who is familiar with our health history, can be invaluable.

So, clearly this isn't linear or black and white; the various stages of the continuum are not mutually exclusive— you can be sick and in pain and still be creative and serving others; alternatively you can be healthy and vital and not productive or caring about others or our planet. However, as we move towards greater health and vitality, we are usually more able to activate these higher qualities of life.

Finally, while the path of increasing debilitation and disease eventually ends in death, so does the path towards optimal health. This leads us to consider how our attitudes about health and our approach to healing relate to our understanding of the death experience itself—a big question for another time.

Stay Healthy,
Dr. Elson