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The Multiple Dimensions of Wellness with Dr. Marc Cohen


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The Multiple Dimensions of Wellness with Dr. Marc Cohen 01086

Start Date: April 14, 2011

End Date: April 14, 2011

Wellness is a multidimensional concept that is still evolving. The multiple dimensions of wellness are evident in the convergence of existing industries and disciplines. The wellness industry has emerged as a trillion dollar melting pot for a whole host of products and services that encourage enhanced health and wellbeing. Rather than merely selling products, wellness industries ultimately involve raising consciousness and thus must address issues of environmental sustainability, ecological design, social responsibility, corporate ethics, health and spirituality.

As an academic discipline, wellness represents an intersection of many disciplines including; the biological, health and physical sciences, engineering, business and design. This presentation will provide the background behind the development of Wellness as a new academic discipline and discuss future directions. See recorded live webinar archive at:

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The Multiple Dimensions of Wellness with Dr. Marc Cohen

  1. 1. Wellness at RMITPioneering a New Academic Discipline Prof Marc Cohen MBBS(Hons), PhD(TCM), PhD(Elec Eng), B.MedSc(Hons), FAMAS, FICAE, Dip Ac Program Leader, Master of Wellness Foundation Professor of Complementary Medicine, RMIT University
  2. 2. $ Intensive care $ Acute care $ General care$ Wellness Activities A stable health system
  3. 3. $ Intensive care Acute care $ $ General care Wellness $ Current health system
  4. 4. It’s going to fall over $ Intensive care Acute care $ $ General care Wellness $ Current health system
  5. 5. All is not wellwith the world
  6. 6. All is not wellwith the worldPan Books, London (1972).
  7. 7. •
  8. 8. Climate Change “Climate change represents the greatest and widest-ranging market failure ever seen” “Business as usual is not an option” A 1% pa investment will prevent a 20% decline in global GDP
  9. 9. Toxic Pollution • 70,000 toxic chemicals are now in commercial use and around 1,000 new chemicals enter the market every year • POPs are found everywhere on the planet -in our food, soil, air and water. • Combinations of toxins may combine to have greater effects than single toxins • Wildlife and humans around the world carry POPs in their bodies at or near levels that can cause injury.
  10. 10. Radioactive waste • High level waste may be radioactive for many millions of years and increases by about 12,000 tons/yr •A number of incidents have already occurred where radioactive material was disposed of improperly, shielding during transport was defective, or when it was simply abandoned or even stolen from a waste
  11. 11. Toxic bodies A 1995 study found breastfed infants in Victoria were regularly exposed to DDT and other pesticides at levels greater than the Acceptable Daily Intake (ADI) set for adults[1] Quinsey PM, et al. Food Chem Toxic 1995;33(1):49-56 © Prof Marc Cohen
  12. 12. Wealth Inequality • The richest 2% own more than 50% of global wealth. • The poorest 50% of adults own barely 1% • Wealth inequality for the world is estimated to be as if one person in a group of ten takes 99% of the total pie and the other nine share the remaining 1%. World Distribution of Household WealthWorld Institute for Development Economics Research of theUnited Nations University Kevin Carter 1994 Pulitzer Prize for photography
  13. 13. Obesity Epidemic • Globally, there are more than 1 billion overweight adults • In the US the number of overweight children has doubled and overweight adolescents has trebled since 1980. • Obesity and overweight pose a major risk for chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain cancers.www.stuffedandstarved.org
  14. 14. World hunger • The WHO estimates that 1/3 of the world is well-fed, 1/3 is under-fed 1/3 is starving. • 3 billion people in the world today struggle to survive on US$2/day. • Every 3.6 seconds someone dies of hungerKevin Carter 1994 Pulitzer Prize for photography
  15. 15. Rampant Consumerism Consumers have access to a seemingly unlimited choice yet are disconnected from the products and services they purchase. Depression and insomnia are at epidemic proportions Unchecked and unconscious consumption is at the root of many world problems
  16. 16. Chronic Disease Of the 58 million deaths in the world in 2005, 35 million (60%) will be caused by chronic diseases such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes. The main modifiable risk factors for these diseases are lifestyle related and include unhealthy diet, physical inactivity and tobacco use.
  17. 17. What is wellness?• The constant, conscious pursuit of living life to its fullest potential• A state of high consciousness where you can be fully present in the moment and where actions flow naturally and authentically from the ‘deep inner well of your being’• The state where you look, feel, perform and stay ‘well’ .• Wellness enable you to experience the greatest fulfillment and enjoyment from life and achieve the greatest longevity.
  18. 18. What is wellness?Wellness is a holistic and therefore has multiple dimensions including: - Physical - Psychological - Sexual - Emotional - Social - Cultural - Spiritual - Educational - Occupational - Financial - Environmental - Ethical - Political - Existential
  19. 19. The Global Wellness Industry Cluster
  20. 20. Ill health Average health Enhanced health
  21. 21. PERFECT HEALTH Blissors BLISS WELLNESSENHANCED HEALTH Complementary Flexibility of response MedicineAVERAGE HEALTH Western ILL Medicine HEALTH Stressors ILLNESS © Prof Marc Cohen
  22. 22. Basic Philosophical Concepts of TCMTao ∞ Experience FlowChi Transformation5 elements BalanceYin Yang Evolution/EntropyBu/Xie © Prof Marc Cohen
  23. 23. Experience Bliss ∞ Entropy bandwidthFlow Transformation Balance Negentropy Entropy gradient ΔS > 0 gradient © Prof Marc Cohen ΔS = 0
  24. 24. Wellness and entropyWellness is a state of minimal entropy productionAnabolism CatabolismConsumption CreationChallenges CapacityBeing Doing
  25. 25. Wellness Activities (Blissors) • Stress management • Exercise • Nutrition • Social / Spiritual interaction • Education
  26. 26. The future of healthcare “There is growing evidence that the current health systems of nations around the world will be unsustainable if unchanged over the next 15 years.” “Consumers will be play a much larger role in healthcare” “Preventive care and disease management programs have untapped potential to enhance health status and reduce costs.”
  27. 27. Most people in the west die of a broken heart © Prof Marc Cohen
  28. 28. Coronary Artery DiseaseNormal Thickened Almost open scarred and completeartery narrowed blockage
  29. 29. Which therapy would you choose?(Treatment 1) (Treatment 2)• 8% ↓ blockage • 28% ↑ blockage• 91% ↓ pain • 186% ↑ pain• 50% ↓ in hospitalisations & deaths• Safer & reduces other diseases• cost $400 • cost $40 000
  30. 30. Intensive lifestyle change • Low fat vegetarian diet • Moderate exercise • Stress management training • Group supportOrnish, D. et al. (1998) JAMA, 280(23): 2001-7
  31. 31. In the current health systemit is considered CONSERVATIVE to; • strip a vein from the leg • open the chest • place the vein across a blocked artery • repeat the procedure every 10 yearsit is considered RADICAL to; • relax • exercise • eat good food • share your feelings
  32. 32. LOHAS LOHAS Lifestyles Of Health And Sustainability In 2006 LOHAS consumers spent $300 billion, representing approximately 30% of the USA consumer market
  33. 33. Public are increasingly aware of: • Prevention of disease/ageing • Optimising health/performance • Deficiencies in conventional medicine • The need to invest in wellness
  34. 34. General dietary recommendations • Seasonal • Locally produced • Organic • Whole foods
  35. 35. ‘Conshumanism’ “Conscious and humane consumption” “Consumption with maximal awareness, efficiency andenjoyment and minimal pain, energy, waste and pollution”
  36. 36. ‘Conshumanism’ “Conscious and humane consumption” ?When consuming ask :• What is in it?• Who made it?• Where is it from?• How did it get here?• Who benefits from the sale?• What use is it - is it worth it?• What is its lifecycle and embodied energy?• What is its environmental & social impact?• What are the alternatives – do I really need it?
  37. 37. sandand heaven in a wild flowerHold infinity in the palm of yourhandand eternity in an hour -WilliamBlake © Prof Marc Cohen
  38. 38. Flow"a joyous, self-forgetful involvement through concentration, which in turn is made possible by a discipline of the body". -Mihalyi Csikszentmihalyi © Prof Marc Cohen
  39. 39. Arousal Flow AnxietyCHALLENGES Worry Control Apathy Boredom Relaxation SKILLS © Prof Marc Cohen
  40. 40. New Vocations• Wellness coach• Workplace wellness director• Positive psychologist• Spa practitioner• Permaculturalist © Prof Marc Cohen
  41. 41. Professional Issues• Confidentiality • Education• Ethical conduct • Continuing Education• Adverse event reporting • Evidence base• Complaints handling • Research strategy• Continuity of care • Professional indemnity• Contact management • Scope of practice• Privacy and e-Records • Conflict of interest• Billing and 3rd party payers • Code of practice• Referral base • Renumeration levels © Prof Marc Cohen
  42. 42. Presenteeism vs Being present
  43. 43. Towards a global health service No-one wants to go to a hospital but everyone wants to go to a good hotel © Prof Marc Cohen
  44. 44. Wellness Research ?
  45. 45. Sustainable ‘barefoot’ luxury Six senses resort Hua Hin
  46. 46. Natural swimming pools
  47. 47. Wellness DesignEarthship biotecturePermacultureLiving water flowforms
  48. 48. Connection with nature “ access to nature plays a vital role in human health, wellbeing, and development that has not been fully recognised .” “ . . . the positive effects on human health, particularly in urban environments, cannot be over-stated.”Healthy Parks Healthy People; A review of relevant literature. Maller & Townsend et al 2008
  49. 49. Connection with animals Contact with companion animals has multiple positive physiological and psychological effects on human health including: – decreasing blood pressure, heart rate, and cholesterol; – reducing anxiety and stress and providing protection against stress-related diseases; – provision of companionship and kinship; – and the opportunity to nurture. All of these factors improve quality of life and enhance health and wellbeing.Healthy Parks Healthy People; A review of relevant literature. Maller & Townsend et al 2008
  50. 50. If you don’t measure . . . you can’t manageIf you don’t state . . . you can’t © Prof Marc Cohen
  51. 51. Australian Unity Wellbeing index • Subjective measure of wellbeing • 19 national surveys since 2001 • Concept of wellbeing homeostatic set-point
  52. 52. SWB across the lifespan 80 77.9 78 78.3 77.1 76 76.3 74.7 74.2 74.4 74.3 74.0 75.7 73.8 74 Adult normative range Strength 73.3 of 72satisfaction 70 69.4 68 66 64 12&13 14&15 16 17&18 19-25 26-35 36-45 46-55 56-65 66-75 76+ Age group Dr Adrian Tomyn RMIT University
  53. 53. Quality-Adjusted Life Years (QALYs)• Quality of life is both objective and subjective.• Objective domains are measured through culturally relevant indices of objective well-being• Subjective domains are measured through questions of satisfaction• QALY equal 1 for each year of full-health life, less than 1 for various degrees of illness or disability• Cost-effectiveness of treatments can be assessed by the cost per QALY © Prof Marc Cohen
  54. 54. Disability-adjusted life years (DALYs) Measures of burden of disease DALY = Years of Life Lost + Years Lived with Disability 1990 WHO report indicated that 5 of the 10 leading causes of disability were psychiatric conditions which account for 28% of all years lived with disability, but only 1.4% of all deaths and 1.1% of years lost. Thus, psychiatric disorders, while generally not seen as a major epidemiological problem, are shown by consideration of disability years to have a huge impact on populations. © Prof Marc Cohen
  55. 55. BankWest Quality of Life Assessment based on: • Home ownership • Detached housing • Employment • Income Levels • Broadband Internet Access • Proportion of Empty Homes in an area • Volunteering Rates • School enrolments for sixteen year olds • Proportion of the Population in Good Health • Property related crime rates
  56. 56. Triple Bottom Line Reporting• John Elkington, who coined the phrase in 1994, has defined the TBL approach as: “At its broadest, the term is used to capture the whole set of values, issues and processes that companies must address in order to minimise any harm resulting from their activities and to create economic, social and environmental value. This involves being clear about the company’s purpose and taking into consideration the needs of all the company’s stakeholders.” © Prof Marc Cohen
  57. 57. Happy Planet Index
  58. 58. Wellness MeasuresWellness includes• Subjective wellbeing/happiness• Physiological status - HRA• Social capital /connectedness• Ecological footprint• Security and socioeconomic status
  59. 59. Wellness Footprint “Develop a Wellness Footprint to evaluate measure and resource services . . . and drive a prevention agenda.”
  60. 60. Research Questions• How do we measure wellness? What is a “Wellness Footprint”• How can different measures be used to assess levels of disease, disability and performance?• What interventions or policies are most likely to maximise wellness for individuals, businesses and communities?
  61. 61. Want to learn more?
  62. 62. Includes courses on:Want to learn more? •Leadership & Management •Global Business Context •Corporate Wellness •Wellness Coaching •Lifestyle Management •Positive Psychology •Mindbody Wellness •Aromatherapy •Herbs & Supplements •Food as Medicine •Energy Cross credits available for UC Irvine Spa Management Course
  63. 63. Pessimism and Optimism• Pessimists - – GOOD EVENT - external, temporary, specific, (Them, Then, That) – BAD EVENT - personal, permanent, pervasive, (Me, Always, Everything)• Optimists - – BAD EVENT - Then, That, Them – GOOD EVENT - Always, Me, Everything