ISPOR’s Strategic Plan 2030 includes a new vision for healthcare decision making. The new vision conceptualizes health as a multifaceted construct that transcends the physical dimension of health to include economic, social, and spiritual dimensions. A multifaceted view of health is not new. For several decades, notions of a holistic approach to health have been proposed including salutogenesis,1 patient-centered care, person-centered care, integrated care, and population health. Notably, in 1984, the World Health Organization revisited and updated its definition of health, shifting it from a desirable state of being to a dynamic set of resources for living well—”the extent to which an individual or group is able to realize aspirations and satisfy needs to change or cope with the environment… health is a resource for everyday life, not the objective”—that emphasized the social and personal resources, as well as physical capabilities that are a part of health.2
This article discusses ISPOR's Strategic Plan 2030, which aims to expand how health value is assessed to include the concept of "whole health." Traditionally, health economics and outcomes research (HEOR) focused mainly on physical health, mental health, and cost-effectiveness. However, ISPOR now advocates for a broader approach, acknowledging health as a multifaceted construct that includes physical, economic, social, environmental, and spiritual dimensions. This shift is crucial for improving healthcare decision making and ensuring that health services are accessible, efficient, and affordable for everyone.
Whole health is defined as an approach to health that considers all aspects of a person’s life—including physical, mental, social, financial, environmental, and spiritual factors—as contributors to their overall well-being. A whole health approach helps people live healthier, more meaningful lives while also promoting well-being across communities and society. This approach is people-centered, comprehensive, upstream-focused, equitable, accountable, and grounded in overall well-being. By adopting this holistic view, the aim is to better capture what truly matters to patients and to enhance their quality of life. The article emphasizes that achieving whole health also means achieving well-being, which goes beyond the absence of illness to include a person's overall life satisfaction.
For researchers and healthcare decision makers, incorporating whole health requires significant changes because relevant outcomes go beyond physical and mental health, and relevant interventions may lie outside of the healthcare system or focus on prevention. This presents an opportunity for methodological advancements in HEOR.
A whole health approach also challenges traditional perspectives in health assessments. While the patient perspective is important, it is often too narrow to capture the broader impacts of healthcare interventions. Hence, a societal perspective, though less commonly used due to data constraints, is recommended to understand trade-offs between health investments and other societal programs. This approach requires collaboration with professionals from various sectors to enrich understanding and data integration.
Engaging a wider range of stakeholders, such as community groups and employers, alongside traditional healthcare stakeholders, is also necessary to support a whole health strategy. Linking healthcare data with information from other fields, HEOR can produce more relevant and comprehensive evidence.
In summary, ISPOR's initiative to include whole health in HEOR promises more meaningful insights for healthcare systems and policy makers, enhancing the impact of HEOR on health policies and promoting better health and well-being for all individuals. The article underscores the need for continuous development in whole health methods to better serve societal goals.