The document proposes a new definition of health called the Meikirch Model. The model defines health as an emergent state resulting from successful transactions between an individual's biologically-given and personally acquired potentials and the physiological, psychosocial, and environmental demands of life. It views health as determined by the interaction of five components - the individual, society, environment, and their relationships - making health a complex adaptive system. The model was tested in rural India where it motivated improved health behaviors. The document concludes the model provides a more holistic definition of health and could improve health outcomes if adopted in medicine and public health.

1. 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
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www.psim.ch
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2. 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)
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3. 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.
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4. 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”.
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5. 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
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6. 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
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7. Meikirch
Model
These resources must be available also in the future.
Biologically
given
potential
Personally
acquired
potential
Demands of life
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8. 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.
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9. Meikirch
Model
Individual
Individual determinants
of health
Biologically
given
potential
Personally
acquired
potential
Demands of life
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10. Meikirch
Model
Society
Social determinants of health
Individual
Individual determinants
of health
Biologically
given
potential
Personally
acquired
potential
Demands of life
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11. 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
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12. Meikirch
Environment
Model
Environmental determinants of health
Society
Social determinants of health
Individual
Individual determinants
of health
Biologically
given
potential
One
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Personally
acquired
potential
Demands of life
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Health
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13. 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.”
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14. 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
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Health
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15. Environment
Environmental determinants of health
Society
Social determinants of health
Individual
Individual determinants
of health
Biologically
given
potential
One
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Personally
acquired
potential
Demands of life
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Important
relationships
for health
Health
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16. 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
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Personally
acquired
potential
Demands of life
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Important
relationships
for health
Health
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17. 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.
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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.
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18. Modern
Medicine
Individual
Individual
determinants of health
Hard science
Biologically
given
potential
Personally
acquired
potential
Soft science
Demands of life
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19. 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.
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20. 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.
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21. 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.
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22. 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.
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