Health at the center of health systems reform: how philosophy can inform policy

Perspectives in Biology and Medicine
Joachim P SturmbergMark M Moes

Abstract

Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to imple...Continue Reading

Citations

Jun 7, 2014·Journal of Evaluation in Clinical Practice·Stefan Topolski, Joachim Sturmberg
Jan 10, 2012·Journal of Evaluation in Clinical Practice·Joachim P SturmbergCarmel M Martin
May 17, 2011·Journal of Evaluation in Clinical Practice·Anup K KanodiaJoachim P Sturmberg
Aug 1, 2012·Journal of Evaluation in Clinical Practice·Joachim P Sturmberg
Apr 19, 2011·Journal of Evaluation in Clinical Practice·Joachim P Sturmberg
Jul 8, 2010·Journal of Evaluation in Clinical Practice·Joachim P SturmbergDi O'Halloran
Nov 5, 2014·Journal of Evaluation in Clinical Practice·D Justin LarkinDenis A Cortese
Mar 31, 2015·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Judith Joy
Sep 8, 2015·The Cochrane Database of Systematic Reviews·Gerd FlodgrenSasha Shepperd
Nov 2, 2017·Journal of Comorbidity·Joachim P SturmbergBruno Kissling
Oct 20, 2010·The Medical Journal of Australia·Joachim P SturmbergCarmel M Martin

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