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Why Do We Care More About Disease than Health?

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Abstract

Modern Western biomedical research and clinical practice are primarily focused on disease. This disease-centric approach has yielded an impressive amount of knowledge around what goes wrong in illness. However, in comparison, researchers and physicians know little about health. What is health? How do we quantify it? And how do we improve it? We currently do not have good answers to these questions. Our lack of fundamental knowledge about health is partly driven by three main factors: (i) a lack of understanding of the dynamic processes that cause variations in health/disease states over time, (ii) an excessive focus on genes, and (iii) a pervasive psychological bias towards additive solutions. Here I briefly discuss potential reasons why scientists and funders have generally adopted a gene- and disease-centric framework, how medicine has ended up practicing “diseasecare” rather than healthcare, and present cursory evidence that points towards an alternative energetic view of health. Understanding the basis of human health with a similar degree of precision that has been deployed towards mapping disease processes could bring us to a point where we can actively support and promote human health across the lifespan, before disease shows up on a scan or in bloodwork.

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Fig. 1

source of individual variation in disease risk, longevity, and other health-related outcomes is only partially or not well-supported. In contrast, the alternative hypothesis that risk of disease and longevity are mainly determined by non-genetic, modifiable factors is strongly supported (see text for discussion). (Right) Illustration of the human implicit bias towards additive solutions (Adams et al. 2021). This psychological bias explains why individuals tend to approach and solve problems—including health problems—with additive strategies, rather than with equally effective subtractive strategies

Fig. 2

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Acknowledgements

I am grateful to Mary Elizabeth Sutherland for editorial assistance, to Judyann McNamara for discussions, and to Matthew Harms and Dan Belsky for pointing me to useful literatures.

Funding

M.P. is supported by NIH grants R01MH119336, R01MH122706, R01AG066828, R21MH123927 and the Wharton Fund.

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  1. Department of Psychiatry, Division of Behavioral Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA

    Martin Picard

  2. Department of Neurology, Merritt Center, Columbia Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, NY, 10032, USA

    Martin Picard

  3. New York State Psychiatric Institute, New York, NY, 10032, USA

    Martin Picard

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Picard, M. Why Do We Care More About Disease than Health?. Phenomics 2, 145–155 (2022). https://doi.org/10.1007/s43657-021-00037-8

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