Why Do We Care More About Disease than Health?

Abstract

Modern Western biomedical research and clinical practice are primarily focused on disease. This disease-centric approach has yielded an impressive amount of knowledge around what goes wrong in illness. However, in comparison, researchers and physicians know little about health. What is health? How do we quantify it? And how do we improve it? We currently do not have good answers to these questions. Our lack of fundamental knowledge about health is partly driven by three main factors: (i) a lack of understanding of the dynamic processes that cause variations in health/disease states over time, (ii) an excessive focus on genes, and (iii) a pervasive psychological bias towards additive solutions. Here I briefly discuss potential reasons why scientists and funders have generally adopted a gene- and disease-centric framework, how medicine has ended up practicing "diseasecare" rather than healthcare, and present cursory evidence that points towards an alternative energetic view of health. Understanding the basis of human health with a similar degree of precision that has been deployed towards mapping disease processes could bring us to a point where we can actively support and promote human health across the lifespan, before disease shows up on a scan or in bloodwork.

Keywords: Energetics; Genomics; Health; Medical care; Personalized medicine; Preventative medicine.

Fig. 1

Three structural factors that contribute to the prevailing disease-centric biomedical model. (Left) The scarcity of dynamic information about important molecular, cellular, physiological, and behavioral factors over short and long time scales occlude our ability to perceive and understand health as a dynamic phenomenon. (Center) The discovery of disease-causing genes for rare disorders provided compelling demonstrations that genetic defects can cause diseases. Generalizing this principle to all common chronic diseases provided the rationale for the hypothesis that genetic differences are at the origin of disparities in disease risk and longevity in the general population. The hypothesis that genomics will explain the source of individual variation in disease risk, longevity, and other health-related outcomes is only partially or not well-supported. In contrast, the alternative hypothesis that risk of disease and longevity are mainly determined by non-genetic, modifiable factors is strongly supported (see text for discussion). (Right) Illustration of the human implicit bias towards additive solutions (Adams et al. 2021). This psychological bias explains why individuals tend to approach and solve problems—including health problems—with additive strategies, rather than with equally effective subtractive strategies

Fig. 2

Summary of the disease-centric and health-centric models of care. The pillars of health are energy and communication, two fundamental principles of living organisms that interact with genes to produce dynamic health states that vary across the lifespan. (Left) The focus on genomics sustains a disease-centered framework that influences how resources are allocated and how research is conducted. This scientific landscape in turn influences how medicine is taught and practiced, and shapes the public discourse around the malleability of health and individual empowerment about one’s ability to effect change in one’s health through behaviors. In modern Western cultures, these and other factors discussed in the text contribute to sustain diseasecare, a system of care delivery that relies on the diagnosis of disease states, deploys disease-specific pharmacological and surgical treatments, and determines therapeutic success based on disease indicators. (Right) An idealized health-centered model of care calls for research investment focused on understanding the basis of human health and its dynamic variation over time (e.g., (Yurkovich et al. 2020)). Realizing this model will require the development of new methods to monitor health states before the onset of symptoms, and has the potential to empower individuals to effect positive change in their health through behavioral changes