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One health summit kopie One health summit kopie Presentation Transcript

  • GRF Davos GRF Davos One Health Summit 2013 One Health Summit 2013 A New Definition of Health Based on Biological and Anthropological Principles Johannes Bircher MD Johannes Professor MD Emeritus Bircher Emeritus Professor University of Bern Switzerland University of Bern Switzerland 20.11.2013 Jbi, www.psim.ch www.psim.ch 1
  • Confucius and Zi Lu Why do we need to define health? About 2,600 years ago Zi Lu asked Confucius: “If the King of Wei invites you to administer his government, what needs to be done first?” Confucius answered: “What is necessary is to rectify the terms.“ (Lunyu 13.3) 20.11.2013 Jbi, www.psim.ch 2
  • Purpose of the Presentation 1. To propose a new definition of health entirely based on biological and anthropological principles. 2. To investigate the consequences of this definition for One Health. 20.11.2013 Jbi, www.psim.ch 3 View slide
  • Methods 1. An intuitive, empirical, interactive and iterative process aligned with the multigrounded theory approach (Goldkuhl et al. 2010) 2. The results were extensively tested in personal interactions and in lectures at scientific meetings. 3. The resulting definition of health was then called “Meikirch Model”. 20.11.2013 Jbi, www.psim.ch 4 View slide
  • Meikirch Model 1. Physiological demands: nutrition, homeokinesis, procreation, etc. 2. Psychosocial demands: self-realization, flourishing, integration, participation 3. Environmental demands: physical, chemical and microbiological threats, sustainable development Demands of life 20.11.2013 Jbi, www.psim.ch 5
  • Meikirch Model In order to respond to these demands of life each person has two types of resources. . Biologically given resources Personally acquired resources Demands of life 20.11.2013 Jbi, www.psim.ch 6
  • Meikirch Model These resources must be available also in the future. Biologically given potential Personally acquired potential Demands of life 20.11.2013 Jbi, www.psim.ch 7
  • Time Course of the Two Potentials The two curves are idealized. potential biologically given personally acquired* birth death time * The personally acquired potential may compensate in part for defects of the biologically given potential, but not vice versa. 20.11.2013 Jbi, www.psim.ch 8
  • Meikirch Model Individual Individual determinants of health Biologically given potential Personally acquired potential Demands of life 20.11.2013 Jbi, www.psim.ch 9
  • Meikirch Model Society Social determinants of health Individual Individual determinants of health Biologically given potential Personally acquired potential Demands of life 20.11.2013 Jbi, www.psim.ch 10
  • Meikirch Environment Model Environmental determinants of health Society Social determinants of health Individual Individual determinants of health Biologically given potential Personally acquired potential Demands of life 20.11.2013 Jbi, www.psim.ch 11
  • Meikirch Environment Model Environmental determinants of health Society Social determinants of health Individual Individual determinants of health Biologically given potential One 20.11.2013 Personally acquired potential Demands of life Jbi, www.psim.ch Health 12
  • Wording of the Meikirch Model “Health is an emergent state of wellbeing resulting from successful transactions between individuals’ biologically-given and personally acquired potentials and the physiological , psychosocial and environmental demands of life.” 20.11.2013 Jbi, www.psim.ch 13
  • Meikirch Environment Model Environmental determinants of health Society The multiple nonlinear Social determinants of health relationships among the different components specify health as a Individual Individual determinants complex adaptive system. of health Biologically given potential One 20.11.2013 Personally acquired potential Demands of life Jbi, www.psim.ch Health 14
  • Environment Environmental determinants of health Society Social determinants of health Individual Individual determinants of health Biologically given potential One 20.11.2013 Personally acquired potential Demands of life Jbi, Important relationships for health Health www.psim.ch 15
  • Environment Environmental determinants of health Society Improvement of these relationships will substantially contribute to health. Social determinants of health Individual Individual determinants of health Biologically given potential One 20.11.2013 Personally acquired potential Demands of life Jbi, Important relationships for health Health www.psim.ch 16
  • Two Theories to Look at Health: A first Approximation Newton-based Science Complex Adaptive System Thinking is reductionistic Thinking is empirical, “holistic” A human being functions A human being functions as a like a complicated machine. whole. Insight results from analysis of function of smaller and smaller parts of the body. Effective treatment, or replacement of diseased parts results in healing. Cure is feasible, it depends on successful treatment. 20.11.2013 Jbi, Insight results from the study of the relationships among the different components of health. Healing emerges from a sense of purpose and a positive evolution of the system as a whole. Prognosis is always uncertain. Systems evolve autonomously. www.psim.ch 17
  • Modern Medicine Individual Individual determinants of health Hard science Biologically given potential Personally acquired potential Soft science Demands of life 20.11.2013 Jbi, www.psim.ch 18
  • The Meikirch Model in India 1.Currently the Meikirch Model is applied in a rural health program for indigenous people in Orissa, India. 2.As a result people built more latrines, increased vaccination rates, used more mosquito nets, took mother-child care more seriously and ate healthier foods. 3.In summary, the Meikirch Model proved to be a strong motivator for health. 20.11.2013 Jbi, www.psim.ch 19
  • Conclusions 1 1. The Meikirch Model is a definition of health worked out with the multi-grounded theory. 2. It postulates that health is determined by five components which interact nonlinearly with each other. Therefore health must also be regarded as a complex adaptive system. 3. The Meikirch Model postulates that optimal health prevention and health care must take all components of health into account. 20.11.2013 Jbi, www.psim.ch 20
  • Conclusions 2 4. For the Meikirch Model the systems theory should complement Newton-based science. 5. Today’s medicine focusses more on the biologically given than on the personally acquired potential. This leads to suboptimal results. 6. The Meikirch Model, applied to rural villages in Orissa, India revealed that it has strong motivating effects for health. 20.11.2013 Jbi, www.psim.ch 21
  • Conclusions 3 7. If 2’600 years ago Confucius was right, rectification of the term “health” might lead to a new era of improved health worldwide. 8. Once the One Health paradigm will be based on the Meikirch Model, it may become more conclusive and more forceful. 20.11.2013 Jbi, www.psim.ch 22
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