Wellbeing, Whole Health and Societal Transformation: Theoretical Insights and Practical Applications

Abstract

Society faces several major interrelated challenges which have an increasingly profound impact on global health including inequalities, inequities, chronic disease and the climate catastrophe. We argue here that a focus on the determinants of wellbeing across multiple domains offers under-realised potential for promoting the ‘whole health’ of individuals, communities and nature. Here, we review recent theoretical innovations that have laid the foundations for our own theoretical model of wellbeing – the GENIAL framework – which explicitly links health to wellbeing, broadly defined. We emphasise key determinants across multiple levels of scale spanning the individual, community and environmental levels, providing opportunities for positive change that is either constrained or facilitated by a host of sociostructural factors lying beyond the immediate control of the individual (e.g. social cohesion and health-related inequities can either promote or adversely impact on wellbeing, respectively). Following this, we show how the GENIAL theoretical framework has been applied to various populations including university students and people living with neurological disorders, with a focus on acquired brain injury. The wider implication of our work is discussed in terms of its contribution to the understanding of ‘whole health’ as well as laying the foundations for a ‘whole systems’ approach to improving health and wellbeing in a just and sustainable way.

Riding the wave into wellbeing: A qualitative evaluation of surf therapy for individuals living with acquired brain injury

“…Accordingly, our work draws from a much more expansive theoretical basis than the field of positive psychology and we argue that models of neurorehabilitation can be enhanced further by drawing on broader theories of wellbeing and advances in wellbeing science [ 22 , 23 ]. We recently defined wellbeing [ 38 ] from a biopsychosocial ecological perspective, emphasising connectedness to the self, others and nature, which may reflect a basic psychological need, supported by vagal function, a psychophysiological resource for connection. We also emphasise that wellbeing is impacted by socio-contextual factors that lie beyond the control of the individual.…”

The Complex Construct of Wellbeing and the Role of Vagal Function

“…We have captured a role for the vagus in wellbeing in the development of our “GENIAL” model ( G enomics– E nvironment–vagus N erve–social I nteraction– A llostatic regulation– L ongevity), an evidence-based framework that integrates multi- and interdisciplinary findings from wellbeing science (Kemp et al, 2017 ; Fisher et al, 2020 ; Mead et al, 2021 ; Kemp and Fisher, 2022 ). The vagus nerve is the tenth cranial nerve that connects many different organs including heart, gut, liver and lungs and the primary nerve supporting the parasympathetic nervous system.…”

Editorial: Improving Wellbeing in Patients With Chronic Conditions: Theory, Evidence, and Opportunities

“…Despite being designed to treat acute illness and disease, “the acute medical model” has become the dominant model of healthcare. We have argued that this model of healthcare constrains opportunities to develop evidenced based holistic approaches for supporting people living with chronic conditions (Fisher et al, 2022 ; Kemp and Fisher, 2022 ). There is a pressing need for approaches that consider all domains of functioning (biological, cognitive, emotional, social) and their interactions as well as considering the influence of wider systemic factors such as our relationships, community, environment and socio-contextual factors (Wilson et al, 2009 ; Gracey et al, 2015 ; Mead et al, 2019 , 2021 ; Wilkie et al, 2021 ; Fisher et al, 2022 ).…”

“…A variety of interventions have been shown to improve vagal function including meditation, relaxation, nutrition, exercise, social connection, and spending time in nature (Kok et al, 2013 ; Richardson et al, 2016 ; Laborde et al, 2018 ; Young and Benton, 2018 ). We have sought to synthesize these findings in our GENIAL model of wellbeing, in which we define wellbeing as connection to self, others and nature, supported by functioning of the vagus nerve, which appears to provide a psychophysiological resource for connection and the subsequent experience of wellbeing (Kemp et al, 2017a ; Mead et al, 2021 ; Kemp and Fisher, 2022 ).…”