Achieving Whole Health for Veterans and the Nation

Abstract

This Viewpoint discusses the Whole Health System of care led by the US Department of Veterans Affairs.

The Profound Implications of the Meaning of Health for Health Care and Health Equity

“…(1) be people-centered-understand peoples' needs, goals, and priorities in the context of their family, community, and cultural environment, (2) be comprehensive and holistic-collaboratively and comprehensively address the entirety of a person's well-being, spanning conventional medical care, complementary and integrative health, spiritual care, and social needs, (3) be upstream-focused-address health behaviors and the social and structural determinants of health, the root causes of poor health, (4) be equitable and accountable-ensure accountability for people, families, and communities and proactively engage with them to equitably address their prioritized needs, and ( 5) ensure team well-being-ensure the wellbeing of the entire care team by supporting them to do their jobs within a positive work environment and helping them achieve whole health themselves. 101 The central NASEM goals and recommendations are shown in Table 2. 33 Each of these initiatives offers the potential for health care change and the adoption of a whole health approach to health care.…”

“…Notably, the NASEM report Achieving Whole Health: A New Approach for Veterans and the Nation offers a potential roadmap for enabling capability for health based on five foundational characteristics:

(1) be people‐centered—understand peoples’ needs, goals, and priorities in the context of their family, community, and cultural environment, (2) be comprehensive and holistic—collaboratively and comprehensively address the entirety of a person's well‐being, spanning conventional medical care, complementary and integrative health, spiritual care, and social needs, (3) be upstream‐focused—address health behaviors and the social and structural determinants of health, the root causes of poor health, (4) be equitable and accountable—ensure accountability for people, families, and communities and proactively engage with them to equitably address their prioritized needs, and (5) ensure team well‐being—ensure the well‐being of the entire care team by supporting them to do their jobs within a positive work environment and helping them achieve whole health themselves 101

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“…Lessons include continuous learning and adaptation during the process, outcome evaluation based on a range of implementation strategies tailored for multiple perspectives, team-based care, leadership, and synergy involving high-level drivers of system change. 101 National leadership is critical. An obvious convener, if not a leader, is HHS based on its responsibility for administering federal health and human services agencies.…”

“…The VA's Whole Health approach in addition to Southcentral Foundation/the Nuka System of Care and Mary's Center cited by NASEM 33 offer potential templates for scaling nationally. Lessons include continuous learning and adaptation during the process, outcome evaluation based on a range of implementation strategies tailored for multiple perspectives, team‐based care, leadership, and synergy involving high‐level drivers of system change 101 …”