Many things affect your health. These include your biological makeup as well as your behavior. Eating a healthy diet, getting enough physical activity and sleep, and managing your stress can all help you stay healthy. But your environment matters, too. Where you’re born and grow up, and where you live and work influence your risk for many diseases.

Whole person health looks at all the factors that affect your well-being. Health and disease are not separate things. Instead, you can think of them as a path that’s connected, with health in one direction and disease in the other. Some things move you toward health, and some things lead you away from it. Whole person health emphasizes restoring health, promoting resilience, and preventing diseases.

Understanding how the places you’ve lived impact your health can help you prevent some diseases. Addressing issues as early as possible can help restore your health.

Self-care, a healthy lifestyle, and learning new ways of managing stress can help you stay healthier. Chronic stress can make many diseases worse. These include diabetes, heart disease, obesity, chronic pain, and depression.

NIH researchers continue to study the connections between lifestyle, diet, biology, health, and disease. Learn more about NIH research on whole person health.

Whole person health involves 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 treating a specific disease, whole person health focuses on restoring health, promoting resilience, and preventing diseases across a lifespan.

Health and disease are not separate, disconnected states but instead occur on a path that can move in two different directions, either toward health or toward disease.

On this path, many factors, including one’s biological makeup; some unhealthy behaviors, such as poor diet, sedentary lifestyle, chronic stress, and poor sleep; as well as social aspects of life—the conditions in which people are born, grow, live, work, and age—can lead to chronic diseases of more than one organ system. On the other hand, self-care, lifestyle, and behavioral interventions may help with the return to health.

Chronic diseases, such as diabetes, cardiovascular disease, obesity, and degenerative joint disease, can also occur with chronic pain, depression, and opioid misuse—all conditions exacerbated by chronic stress. Some chronic diseases increase the immediate and long-term risks with COVID-19 infection. Understanding the condition in which a person has lived, addressing behaviors at an early stage, and managing stress can not only prevent multiple diseases but also help restore health and stop the progression to disease across a person’s lifespan.

Some health care systems and programs are now focusing more on whole person health.

U.S. Department of Veterans Affairs (VA) Whole Health Approach

The VA’s Whole Health System of Care and Whole Health approach aims to improve the health and well-being of veterans and to address lifestyle and environmental root causes of chronic disease. The approach shifts from a disease-centered focus to a more personalized approach that engages and empowers veterans early in and throughout their lives to prioritize healthy lifestyle changes in areas like nutrition, activity, sleep, relationships, and surroundings. Conventional testing and treatment are combined with complementary and integrative health approaches that may include acupuncture, biofeedback, massage therapy, yoga, and meditation.

U.S. Department of Defense Total Force Fitness Program

The Total Force Fitness program arose within the U.S. Department of Defense Military Health System in response to the need for a more holistic approach—a focus on the whole person instead of separate parts or only symptoms—to the demands of multiple deployments and the strains on the U.S. Armed Forces and their family members. The focus extends the idea of total fitness to include the health, well-being, and resilience of the whole person, family, community, and U.S. military.

Whole Health Institute

Established in 2020, the Whole Health Institute’s Whole Health model helps people identify what matters most to them and build a plan for their journey to whole health. The model provides tools to help people take good care of their body, mind, and spirit, and involves working with a health care team as well as tapping into the support of family, friends, and communities.

North Carolina Department of Health and Human Services

The North Carolina Department of Health and Human Services has incorporated a whole person health approach into its health care system by focusing on integrating physical, behavioral, and social health. The state has taken steps to encourage collaborative behavioral health care and help resolve widespread inequities in social conditions, such as housing and nutritious food access.

Ornish Program for Reversing Heart Disease

The Ornish Program for Reversing Heart Disease is an intensive cardiac rehabilitation program that has been shown to reverse the progression of coronary heart disease through lifestyle changes, without drugs or surgery. The program is covered by Medicare and some health insurance companies. The program’s lifestyle changes include exercise, smoking cessation, stress management, social support, and a whole-foods, plant-based diet low in total fat. The program is offered by a team of health care professionals who provide the support that individuals need to make and maintain lasting changes in lifestyle.

A growing body of research suggests the benefits of healthy behaviors, environments, and policies to maintain health and prevent, treat, and reverse chronic diseases. This research includes several large, long-term epidemiological studies—such as the Framingham Heart Study, Nurses’ Health Study, and Adventist Health Studies—that have evaluated the connections between lifestyle, diet, genetics, health, and disease.

There is a lack, however, of randomized controlled trials and other types of research on multicomponent interventions and whole person health. Challenges come with conducting this type of research and with finding appropriate ways to assess the evidence. But opportunities are emerging to explore new paths toward reliable and rigorous research on whole person health.

Whole person health is not altogether a new goal. A whole person health perspective has been central to NCCIH’s mission dating back to its origins. The Center’s current definition of “integrative health” refers to treatment of the whole person as opposed to separate organ systems. Integrative health also aims for well-coordinated care among different providers and institutions by bringing conventional and complementary approaches together to care for the whole person. Further, one of the Center’s longstanding strategic objectives is to foster health promotion and disease prevention, central tenets of whole person health.

This strategic plan has been informed and shaped by an effort to better define and map a path to whole person health by expanding and building on current activities while advancing new research strategies and ideas to promote its realization. The concept of whole person health will continue to evolve, just as the concept of complementary medicine has changed over time as the line between conventional and complementary medicine has increasingly become blurred.

What Is Whole Person Health?

Whole person health is a concept and a vision as well as an organizing principle. There are many ways to promote and achieve it, and methods and strategies will evolve as understanding and refinement of this concept mature over time.

Any kind of knowledge base includes both analysis and synthesis: analysis breaks things down into individual components, and synthesis puts them back together to understand the whole. For more than a century, biomedicine has been strongly pulled toward analysis, from its early organization into organ systems in the late nineteenth century to cellular and molecular biology with its increasingly detailed understanding of cells, molecules, genetics, and signaling pathways. In the last few decades, systems biology, derived from ecology, has begun to influence biomedical research, with a greater awareness of how body systems relate to one another and how networks of genes influence physiological processes. Nevertheless, our predominantly biochemical approach to treatment remains overwhelmingly pharmacologic. And because we tend to think about a specific disease or specific organ system, even when co-occurring conditions are present, we typically treat them separately, sometimes with medications that interfere with one another.

Now is the time for biomedical science to work toward restoring its balance between analysis and synthesis. We can do this by strengthening our efforts toward integration of knowledge across disciplines, focusing on the whole person, and taking a transdisciplinary approach that integrates the natural, social, and health sciences and transcends traditional boundaries.

We also need to recognize that health and disease are not separate disconnected states but rather a bidirectional continuum. We know that on the path between health and disease, some unhealthy behaviors, such as poor diet, sedentary lifestyle, chronic stress, and poor sleep, as well as social determinants of health (the conditions in which people are born, grow, live, work, and age) can lead to chronic diseases of multiple organ systems, such as diabetes, cardiovascular disease, degenerative joint disease, and depression. Addressing these issues at an early stage can not only prevent multiple diseases but also restore health and stop progression to disease across the lifespan. We witnessed this in real time in 2020 and 2021. Although COVID-19 is a respiratory infection, chronic conditions in other body systems (e.g., diabetes, hypertension) as well as social determinants of health are important factors in its severity and mortality.

By looking at the entire health/disease spectrum in a bidirectional way, we can expand our understanding of integrative health to include the return to an improved state of health, in addition to disease prevention. By looking at connections across biological, behavioral, social, and environmental domains, we can better understand how co-occurring conditions can arise from common, interrelated factors. As a result, we can also examine the potential role of multicomponent behavioral and/or systems-level interventions in addressing these problems and restoring health. It is possible that one intervention developed with the whole person in mind could cross several systems, restoring health in all.

Integrated Approach to Multisystem Health Restoration

How To Study Whole Person Health?

Research on whole person health aims to identify the gaps in our knowledge of the progression from health to disease and from disease back to health. It also may identify gaps in integration of care to develop multicomponent interventions that not only prevent progression to disease but also restore an improved state of health, as well as systems-level interventions to improve access to and/or reimbursement for these interventions. In addition, complementary health approaches such as yoga, mindfulness meditation, and tai chi impact multiple systems of the body (e.g., respiratory, neural, and musculoskeletal). This makes thinking about health in terms of the whole person important to understanding the role of complementary approaches in promoting health and preventing disease.

Strategic plans in the early history of the Center expressed an interest in exploring many paths, including research on systems of care such as traditional Chinese medicine, Ayurveda, and naturopathy. This type of research is challenging to conduct, and there were many stumbling blocks along the way. Figuring out the right methods for studying complex interventions was perplexing. As a result, many of the studies did not bear fruit.

In subsequent years, there was a concerted effort to address this problem by focusing on specific strategically chosen areas, such as natural products and mind and body therapies. There was also a decision to focus on symptom management, especially for pain, anxiety, and depression, which are some of the main reasons driving the use of complementary therapies. NCCIH also supported methods development for both basic science and clinical trials. The development of methodologies for conducting rigorous pragmatic trials was particularly important and will be invaluable for conducting research on whole person health.

First Steps

As part of the strategic planning process, NCCIH has been examining the meaning of the terms complementary, integrative, and health in the Center’s name and has transitioned to more inclusive definitions to reflect a whole person approach, considering:

• The growing understanding of the overlap of complementary approaches with the conventional nutritional, psychological, and physical categories.
• The increased interest in various types of synthesis or integration in biomedical science, such as systems biology and integrative physiology.
• The recognition of common risk factors for a broad range of co-occurring conditions.

A whole person health framework also provides critical insights and opportunities to expand and build on NCCIH’s current research portfolio on natural products and mind and body approaches. By deepening our scientific understanding of the connections that exist across domains of human health, we can better understand how conditions interrelate, define multicomponent interventions that address these problems, and expand how we support patients through the full continuum of their health experience, including the return to health.