Exploring a Fundamental Question: What Is Health?

According to the World Health Organization, health is more than the absence of disease. But to better define it, Daniel Belsky, PhD, associate professor of Epidemiology in the Robert N. Butler Columbia Aging Center, is working with an interdisciplinary team which received a Centennial Grand Challenges grant.

HOW DOES YOUR PROJECT DEFINE HEALTH?

BELSKY: Realized health is the ability of people to do things they want and that society expects of them. We’re trying to understand the biology that underpins that—this is intrinsic health. We’re not focused just on the cellular or tissue level; we want to broadly describe what is required for organisms to experience health.

YOU PROPOSE HEALTH IS GOVERNED BY THREE MAIN FACTORS. CAN YOU ELABORATE?

BELSKY: Energy is crucial to all bodily functions, from movement to healing. Structure is fundamental to the function of DNA, proteins, cells, tissues, and organs. Communication is key to the coordination of biological processes. Intrinsic health is a function of these three factors. It’s not dependent on physical attributes. Someone who doesn’t have the use of all their limbs can still have exceptional intrinsic health. Think of a sprinter who runs on blades.

WHERE ARE YOU WITH THIS PROJECT NOW?

BELSKY: We’re mapping our theory of intrinsic health onto some exciting new statistical modeling techniques. The goal is to test proof of concept for the network of energy, communication, and structure as a fundamental building block of what people experience as health. Ultimately, we want to develop a simpler way to measure intrinsic health, ideally a blood or saliva test.

HOW COULD THIS TEST BE USED?

BELSKY: It could provide a metric for health surveillance or an endpoint for a clinical trial. This is useful when we’re testing complex interventions that affect multiple health states, such as access to primary care, better water quality, or policies that address social determinants of health. It could become a standard test. I think we’d all like to know our own intrinsic health.