From 2020 to 2021, life expectancy at birth in the United States dropped from 77.0 to 76.1 years, the lowest level in more than 2 decades. This decrease was largely driven by the toll of the COVID-19 pandemic and unintentional injuries, including opioid overdose deaths. The most dramatic drop was among non-Hispanic American Indian/Alaska Native (AI/AN) people at 1.9 years; in 2021, AI/AN people had a life expectancy at birth of 65.2 years, the same life expectancy as the total US population in 1944. The lower life expectancy overall and widening health disparities by race and geography made clear what many public health officials and researchers have reckoned with for quite some time: that the focus on treating disease once it is already apparent, which largely characterizes the US approach, cannot effectively address the major public health challenges of our time. It is becoming increasingly clear that a poor diet, sedentary lifestyle, chronic stress, and poor sleep can lead to multiple and often co-occurring diseases, such as diabetes, cardiovascular disease, degenerative joint disease, and depression, and that when addressed early, progression to disease can be prevented and health can be restored. Furthermore, understanding connections across biological, behavioral, social, and environmental domains can inform the development of multicomponent behavioral and/or systems-level interventions to prevent disease and restore health. We need a shift in perspective to an upstream “whole-person health” approach (also referred to as whole health or whole person) aimed at providing the tools and resources that individuals and communities need to face today’s challenges before they develop downstream consequences.
Whole-person health can be defined as “an approach that considers multiple dimensions of the patient and their context, including biological, psychological, social, and possibly spiritual and ecological factors, and addresses these in an integrated fashion that keeps sight of the whole.” This whole-person approach must address the impact of structural and social determinants of health within existing public health and community-based health efforts to ultimately succeed. It must also become a cornerstone of how we improve the public health of communities and our country. Fortunately, there are many innovative programs based on this principle that we can look to as we shift our approach to long-standing public health challenges. (author introduction) #P4HEwebinarQ12025