From Health Care to Health, People to Planet

To celebrate National Public Health Week (April 4-10), Global Public Health Week (April 4-8), and World Health Day (April 7), we highlight 2021 inVIVO conference presenters who discuss moving from health “care” to better health for individuals, communities, and the planet. 

In “Shifting the Health Paradigm for Flourishing,” UK General Practitioner Gillian Orrow describes how her focus on disease shifted as she learned about the microbiome and adopted an “ecological approach to health.” 

Seeing the ties between the industrial health care system to industrial agriculture inspired her to collaborate with local individuals, nonprofits, and government officials to build a community health care program, Growing Health Together. Today, she has a very different vision of health — “not as doing things to people, to fix them” but using ecological approaches to allow for equitable flourishing.

Helping to “humanize and calm the environment of care” is key to Nova Scholar Sara Warber’s latest project. In “Nudging Hospital Audiences to Link Planetary Health and Human Health Through a Participatory Art Exhibition,” Warber’s vision is to use the hospital setting to provide an immersive respite in nature, including soundscapes as well as visuals, and to reach broad audiences who may never visit an art museum or go a nature center. 

She believes engaging people when health is at the forefront of their minds, connecting them to the natural world, and giving them ways to act can improve their own health as well as the health of the planet.

What is Health for?” is the question nutrition expert and president of True Health Initiative David Katz urges us to ask. He observes that for too long, health “admonition” has come in the form of telling people what they should or should not be doing, which can easily backfire — as witnessed during the COVID-19 pandemic. 

Diet is the single leading indicator of premature death in the United States, for example, but the solution may not be telling people what they should be doing or how they can lose weight, but how we can protect our loved ones and find the “sweet spot” between a diet that is healthy for people and for the environment. When we talk about health, we’ve got to talk about “healthy vital people on a healthy vital planet” and find common ground to give us all hope.

With “Our planet, our health,” the theme of this year’s World Health Day, it’s a great time to learn from Sione Tu’itahi, Richard Egan, and Huti Watson of the Global Working Group on Waiora Planetary Health of the International Union for Health Promotion and Education.

In “Promoting Planetary Health and Human Wellbeing for our Survival,” they ask the health community to ponder how science, ethics, spirituality, and indigenous knowledge can address planetary health and human well-being. Indigenous perspectives, long connected to natural landscapes, see humans as stewards of the Earth — a perspective exemplified in the encouraging practice of giving legal rights and personhood to natural systems such as rivers and forests. While “Planet Earth is broken,” our presenters insist there is hope if we have collective courage, will, and action.  

If you enjoyed these presentations, we encourage you to check out our previous blog posts featuring additional inVIVO conference highlights:  

With a theme of “From Healing to Flourishing,” the inVIVO Planetary Health’s 10th annual conference treated participants to more than 160 inspiring talks from scholars, artists, activists, scientists, researchers, health professionals, children, and more (see the program and bios here). Become a member of inVIVO to view all recordings from the 2021 and 2020 conferences. 

Developing safety, persistence, trust

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Acquiring Resources

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
    • “I think I kept trying to convince him I was crazy. And he kept saying, ‘No, you’re not crazy.’ […] You wouldn’t necessarily say a Vietnam Vet was crazy. You’d say they are responding like you’d expect to extraordinary circumstances.”
    • “I’m not the only one who have [sic] this problem. A lots, millions of people, you know. […] They don’t have nothing to do with that. I guess I have to live.”
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
    “You need a lot of energy and a lot of work … it takes a lot of work. It doesn’t just happen. It’s not like a magic wand.” This patient understood that they had to actively participate in the healing process.
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

Helping Relationships

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) “When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. Healing, in this sense, does not mean cured—none of the study participants were cured of their ailments—”but all developed a sense of integrity and wholeness despite ongoing pain or other symptoms.” In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” When we begin to heal, we find increased capacity for hope, renewed motivation to help others, and are more able to accept ourselves as we are.

Suffering

Suffering is the ongoing pain from wounding. There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. “The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”