ISPOR, WHO, and CDC Perspectives Examine Expanded Definition of Value to Include Outcomes Beyond the Healthcare Sector

Lawrenceville, NJ, USA—May 19, 2025—Value in Health, the official journal of ISPOR—The Professional Society for Health Economics and Outcomes Research, announced today the publication of a series of articles exploring the concept of "whole health"—a holistic approach to healthcare that extends beyond the traditional biomedical model to incorporate physical, mental, social, environmental, and spiritual dimensions of wellbeing. The series features perspectives from leading global health organizations including ISPOR, the World Health Organization (WHO), and the US Centers for Disease Control and Prevention (CDC), providing a comprehensive examination of what whole health means for health systems worldwide and its relevance to healthcare decisions. The series was published in the May 2025 issue of Value in Health.

In their opening editorial, “What Does ‘Whole Health’ Really Mean for Health Economics and Outcomes Research?,” Nancy J. Devlin, PhD, C. Daniel Mullins, PhD, and Pieter van Baal, PhD provide important background on whole health and examine how this approach "implies that decision making should expand both what are considered as relevant inputs/costs and what are considered as relevant outputs/benefits." They explain that a whole health approach reflects a view that "healthcare produces more than “health” (narrowly defined), implying a need to extend conventional measures of outcomes" and that "'health' and wider outcomes can be produced by many inputs other than healthcare."

The editorial emphasizes that whole health is not an entirely new concept, noting that "the consideration of wider influences on health has a long tradition in public health and discussions about broad outcome measures and what costs to consider when evaluating investments in health have been central to the development of health economics as a discipline." However, they argue that "a genuine commitment to whole health would suggest a very different approach to health technology assessment than that which is currently the norm around the world."

The series includes commentaries from 3 leading global health organizations:

1. “Taking Health Economics and Outcomes Research Forward: Expanding the Definition of Value to Include Whole Health,” by Laura T. Pizzi, PharmD, MPH, Robert M. Abbott, and Eberechukwu Onukwugha, MS, PhD (ISPOR)

   Synopsis: ISPOR's new strategic plan embraces whole health as a central concept. Using examples, the authors suggest that whole health will guide future research directions to expand the science and practice of healthcare value assessments and will help address tensions between innovative but costly medical treatments and broader investments in population health.

2. “Whole Health: A Global Perspective,” by Juliet Nabyonga-Orem, PhD, Kizito Aidam, JD, and Richard Banda, MPH (WHO)

   Synopsis: Whole health overcomes limitations of the biomedical model by addressing the health needs of individuals holistically. The authors highlight successful implementations of whole health approaches in countries like Rwanda, Ethiopia, and Costa Rica, demonstrating that while challenges exist, the approach is feasible across diverse contexts.

3. "Public Health Supports Whole Health," by Alison Fountain, MD, Gayane A. Baziyants, BA, Aisha Mahmood, MPH, Abigail Viall, ScD, MA, Debra Houry, MD, MPH, and Charlene Wong, MD, MSHP (CDC)
   Synopsis: The integration of public health with healthcare delivery encompasses 3 tactical areas: payment policies, quality measurement, and workforce development. This approach recognizes that factors outside traditional healthcare settings have the greatest influence on health outcomes.

Together, these papers highlight a growing consensus among global health leaders that achieving better health outcomes requires looking beyond traditional healthcare boundaries to address social, environmental, and economic factors that influence wellbeing. The series provides a roadmap for policy makers, researchers, and healthcare professionals seeking to implement whole health approaches in their work.

Further Reading:

• Social Decision-Making Analysis: A General Approach to Inform Decisions on Resources in the Public Sector
• Values Beyond “Health” in Budget-Constrained Healthcare Systems
• Health Technology Assessment With Diminishing Returns to Health: The Generalized Risk-Adjusted Cost-Effectiveness (GRACE) Approach
• Methods to Include Environmental Impacts in Health Economic Evaluations and Health Technology Assessments: A Scoping Review
• Distributional Cost-Effectiveness Analysis of Health Technologies: Data Requirements and Challenges
• The EQ-HWB: Overview of the Development of a Measure of Health and Wellbeing and Key Results
  

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ABOUT ISPOR

ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE^®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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ABOUT VALUE IN HEALTH
Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s current impact factor score is 4.9 and its 5-year impact factor score is 5.6. Value in Health is ranked 5th of 118 journals in Health Policy and Services, 15th of 174 journals in Health Care Sciences and Services, and 56th of 597 journals in Economics. Value in Health is a monthly publication that circulates to more than 55,000 readers around the world.
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