Less disease = more health
More health = less disease
Which of those two statements do you agree with?
Of course, neither equation is that simple. Sometimes bringing a disease under control, or removing a pathological lesion, results in a person’s health increasing. It’s true in most acute diseases. But it’s a bit more complex in chronic illness. Better managed diabetes allows the patient a better health experience, and controlled asthma does too, but those chronic diseases don’t go away and a person with any chronic disease isn’t likely to experience health as fully as someone who doesn’t have any such disease. Sometimes increasing health, resilience and wellbeing not only reduces limiting symptoms, but allows the innate self-healing capacity of human beings to work so well that the disease is removed completely. Other times, again in chronic situations, it results in greater wellbeing but not erradication of the disease.
The lack of simplicity reflects the fact we can’t put parts of life into unconnected boxes. There aren’t two, separate, complete states – disease and health. But they influence each other. They influence each other in unpredictable ways because human beings are complex adaptive systems, and such systems have distinct types of relationships between their parts – non-linear links. Non-linear links are typical of human feedback loops. And that’s a good description of the relationship between health and disease – they are bound together in non-linear negative feedback loops.
Most health care focuses on the first statement. We have a disease-focused, disease-management service, not a health service. Health, if it increases, does so as a kind of side-effect of the treatment. Yet, health is still the goal. Taking a health-making focus creates or enhances the conditions for reduction, or control, of disease. But that too may not be enough. The human ability to self-heal is not perfect, and not omnipotent. Management of a disease really can contribute to better health.
Why don’t we do that more?
Are we doing our best to help people to experience as much health as possible?
Not if we only focus on disease. Not if we only focus on health.
We need an integrated health service – where disease management AND health making are available to all patients.
