Bortz's Next Medicine: Defining 'health' and h2cm

On page 137 of Next Medicine, Walter Bortz assembles the Health Equation:

Genes (A) + Extrinsic Agency (B) + Intrinsic Agency (C) + Aging (D) = Health

After providing values for the other elements Bortz notes that:

Intrinsic Agency = Health - 0.45

In other words, such reckoning, though admittedly coarse, means that internal agency accounts for around 55% of the values we need for health, which is similar to the figure obtained by Mike McGinnis of the Institute of Medicine and Bill Foege of the Gates Foundation. (p.137)

'Conceptual frameworks' are referred to frequently in the literature and in a way quite distinct from h2cm. I've just posted about h2cm as a conceptual framework - a potential conceptual space. Bortz stresses the value of having several conceptual frameworks that, for example: enable pursuit of preventive strategies; and the conceptual framework provided by thermodynamics that informs our understanding of life, health and not surprisingly - ageing.

Bortz's conclusion above however also serves to highlight:

1. The need for a global, generic, universal (data-, information-, knowledge-centric) conceptual framework to pull the elements of this equation together (and much more besides).
2. This IS essential as those elements include the various disciplines. agents (stakeholders)  involved.
3. Bortz's conclusion that internal agency accounts for around 55% also acts as a definition of person-centered health care.

From 1 - 3 perhaps h2cm can also serve as an indicator of a (the) prerequisite literacy level that an individual needs to achieve self-efficacy in health terms?

Chapter 10 next and posts on last week's Cardi conference - which was excellent.

Acknowledgement: I am very grateful to Oxford University Press for the review copy.