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LUCERNE, Switzerland — The COVID-19 pandemic redefined what well-being means for many people. Add on the growing importance of mental well-being and “health” now means more than diet, exercise, and not being sick. Researchers say people are realizing that socializing, getting sunshine, and having a reliable routine are all really important parts of their overall health as well. The World Health Organization has understood this for some time and have created a new concept and assessment framework for capturing someone’s true well-being — “human functioning.”

Study authors in Switzerland define this concept as rethinking health beyond just disease and disability, considering multiple factors in their equation. Beyond the existing “biological health” dimension, they’ve added a “lived health” dimension to include things like eating independently, socializing, and working. Since biological health is so closely linked, adding this component provides a deeper understanding of the whole picture of a person’s life.

“We believe this approach can profoundly change health practice, education, research, and policy,” says Professor Jerome Bickenbach from the University of Lucerne in a media release.

“Functioning also clarifies how our health is linked to our well-being,” adds Prof. Sara Rubinelli. “It isn’t just about the absence of disease, injury, or other physical issues, but also the ability to take part in daily life and achieve personal goals. Nurturing individual well-being on a large scale could truly transform our society, ultimately enhancing societal welfare.”

Human functioning chart
‘Human functioning’ complements morbidity and mortality to provide a holistic understanding of human health that goes beyond disease. CREDIT: Frontiers/Swiss Paraplegic Research and the University of Lucerne

You’d think that integrating these concepts into healthcare would be a pretty simple addition, but it’s actually quite complex and requires a meaningful effort from healthcare providers, policymakers, and the public.

“Despite its great promise, this new tool has not been implemented widely in healthcare and policy. Our team’s goal is to make it happen,” explains Prof. Gerold Stucki, a senior member of a research team at Swiss Paraplegic Research and the University of Lucerne.

The authors point out that part of this has to do with lack of awareness in general about the possible benefits of a holistic approach like this one, which can be resolved with effective communication campaigns. They also mention the need for a new generation of policy, research, and healthcare workers that are dedicated to forming a workforce focused on human functioning.

“We can facilitate this step by establishing a new scientific field called ‘human functioning sciences’. This field will integrate distinct disciplines to deepen our understanding of health and guide research, healthcare, and policy,” explains Stucki.

While taking these steps may seem intimidating, the scientists don’t find it to be a task too large. For example, they mention that rehabilitation is an instance where functioning has already been put into practice successfully.

Rehabilitation is an evolving success story that can help guide us through the functioning revolution,” says Bickenbach. “While we’re well on our way to resolving methodological challenges, large-scale implementation is still in its infancy. Societal economic investment is essential for realizing the promise of human functioning.”

The findings are published in the journal Frontiers in Science.

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About Shyla Cadogan, RD

Shyla Cadogan is a DMV-Based acute care Registered Dietitian. She holds specialized interests in integrative nutrition and communicating nutrition concepts in a nuanced, approachable way.

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