Is the Whole Greater Than the Sum of Its Parts? Self-Rated Health and Transdisciplinarity

Abstract

How individuals rate their general health – self-rated health, SRH – predicts future morbidity and mortality. Evidence shows that this prospective association hold true across age groups, patient populations and ethnicities, and is independent of existing illness or biomedical conditions. The reason why such subjective self-perception of one’s health (the whole) is a valid and powerful predictor of health outcomes, beyond traditional disease biomarkers and risk factors (the parts), has remained unclear. One possibility is that the experience of Health transcends the biological domain, and that psychological, social, behavioral and spiritual factors are integrated in unique ways among each individual/patient to shape “true” health. Each domain bears different relative importance for different individuals. Thus, self-rated health, by virtue that it arises from a completely non-leading and non-directed question, may capture an emergent holistic experience that best represents health, and which translates more directly than other focused assessments into healthspan and lifespan. By reviewing epidemiological, clinical and qualitative research findings about self-rated health, this presentation will adopt a transdisciplinary stance to explore new knowledge that can be derived from the study of self-rated health, as well as its limitations. We will also discuss a practical approach to “profile” self-rated health as a means to identify therapeutic windows and orient person-centered care. Integrating individuals’ self perceptions of health into healthcare practice should enhance patient satisfaction with care, strengthen the therapeutic alliance, and promote empowerment and sustainable care.