A new model to better understand the nature of health

The health of each individual is defined through ongoing interactions between the demands of life, the biological and personally acquired potentials, and social and environmental determinants. This new definition of health has been provided by Dr. Johannes Bircher, former Dean of the Medical Faculty at the University Witten/Herdecke in Germany, with his co-author Dr. Shyama Kuruvilla. Their model, the Meikirch Model of Health, was published in the Journal of Public Health Policy (JPHP), accompanied by an editorial and eight other expert commentaries. This series discusses the implications of the new model and the importance of developing a better understanding of the nature of health with new opportunities to improve health care and population health.

The Meikirch Model defines health in this way: "Health is a state of well-being emergent from conducive interactions between individuals' potentials, life's demands, and social and environmental determinants." This definition goes beyond, and helps operationalize, the thus far best known definition of health used by the WHO in its constitution of 1946: "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

Health results throughout the course of life when individuals' potentials – supported by social and environmental determinants – suffice to respond satisfactorily to the demands of life. Life's demands can be physiological, psychosocial, or environmental, and they will vary across contexts, but in every case unsatisfactory responses will lead to disease.

The decisive advantage of the Meikirch Model is its considerations of and the environment. This includes income, access to medical care, education, professional training, working and leisure. Environmental aspects are also considered, including the physical, chemical and biological factors that affect a person. What is more, the model highlights how individuals can supplement their biological potential with personally acquired potential to improve health. A person in a high-income country can get information and medication required to treat insulin-dependent diabetes mellitus type-1; for people in low-income countries acquiring the necessary external resources might be more of a challenge.

Bircher and Kuruvilla underline the importance of interactive processes between the different health-determining components – demand of life, biological and personally acquired potentials, and social and environmental determinants. Those intervening with these components at different levels may all see how they can collectively act to improve health.

A shared understanding of health can support the cooperation between actors and sectors for the improvement of individual and . In this way it will ensure greater for all.

More information: Bircher, Johannes & Shyama Kuruvilla (2014): "Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health." Journal of Public Health Policy, 2014 Aug; 35 (3): 363-386 http://www.ncbi.nlm.nih.gov/pubmed/24943659. DOI: 10.1057/jphp.2014.19

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