A short interview between James Maskell and Dr. Jeffrey Bland exploring what "health" means. Bland contrasts the traditional disease-centric model (health as absence of disease) with the WHO 1946 framing of health as full functional capacity and the ability to adapt to change. He argues for a 21st-century model of precision, personal health based on each person’s unique "book of life" (genes) interacting with lifestyle and environment, and for a participatory practitioner–patient relationship focused on the individual's purpose for being healthy.
I am here with my co host, Dr. Jeffrey Bland. He is a nutritional biochemist known to some as the godfather of functional medicine. What's the point in all of this? What are we doing here?
What I would say about this question of what is health? Is that we have to go back and look at the history of how our healthcare system has really evolved, which is really as a disease care system. The way that we're taught about health is that it's the absence of disease. Now what does that really mean? It means that health is subordinate to or secondary to that of disease. Disease is the primary thing. That's the attractor. And then I said, why is that? The reason it is is that we haven't kind of deduct health from the disease discussion. We're going to say now hold up just a minute, let's go back to 1946, the World Health Organization, which they try to define health as being more than the absence of disease, but the presence of full function of your physical, emotional, mental and metabolic or physiological capabilities. Really health is defined as the capacity that people have to adapt to change so that it allows them to maintain through the course of living their full function. Now that is a really interesting definition of health. It's very different than the absence of disease and it's that definition that we really want to explore. But if we look at the kind of the granularity of how a person actually advocates for their own health, it's not directly tied to community health. It's tied to their own individual state of function, which is tied to what the genes that they were born with. Their book of life, which is unique, never been formed, ever and ever will again. Our unique book of life and how our book of life interacts with our unique lifestyle and environment, that's a new model of 21st century healthcare that's well, different than public health or community health. It's precision, personal health. And that's what we're going to be talking about.
I see that one of the things that has to happen at the beginning of these conversations is the practitioner has to kind of get from the person going through the process, what's your purpose for being healthy? Why are we here? What are you doing? And there's a shift from sort of like an external focus where the, the doctor had the solutions and he was bestowing those solutions on to the patient. Whereas now it's a much more participatory story. And ultimately, you know, if you're going to bring out a participatory story, let's Go directly to the participants.
Oh boy, you've just said right there, the golden pot at the end of the rainbow. When I first started in my training, which would been the 60s, hard to even say that now, but it's true. In the middle to late 60s, victims came on bended knees asking for the divination from a practitioner who was the provider of omniscience about disease care that would then write an illegible bit of writing on a piece of paper called a script and send them to the pharmacy to get it filled. And the patient would genuflect and feel very pleased that they got this universal knowledge as they backed out of the examining room thinking the solution to their problem and has now been given to them, bequeathed by the knowledge holder of all good, only to find out later, in many cases, not all cases, that this is a disillusioned sense of confidence. They didn't get better. The disease care system is really good at what it does and that is to treat in hospital based terminal illness or a very serious illness. It's good at that. It is really not rooted in an understanding of how to manage chronic problems that are related to dysfunction and, and chronic health problems. And so I think this process by which we're going to be giving back control to the patient, to the individual for their health and redefining what health means is an extraordinarily important step forward. And that's why people say, well, why is this big and bold? It just seems so obvious. It's big and bold because we have kind of known this silently for some years, but never had a system upon which it can be operated or delivered. And secondly, we've always felt kind of apologetic bringing it up, saying, oh please think about health. When you're thinking about disease, won't you be so kind to really consider health? And we're saying no, we're not going to go silently in the night in hope that we get someone to pick this up. We're going to say it is time, the technology is there, we can quantify health as well as we can quantify disease. And we're going to put the control of this in the hands of individuals to manage their own personalized health sat.
