dimensions of wellness

I recently read an article about business’s revolutionary transition from employee wellness to wellbeing. “Historically speaking,” the author wrote, “wellness has been thought of as strictly pertaining to physical health, usually measured by biometrics.”

But, accurately speaking, this is not so.

Of course, there’s no single arbiter who can proclaim what exactly health, wellness, or wellbeing mean, but it’s worth understanding some of the ways these words have been interpreted in order to fully appreciate the implications, or lack thereof, of the “transition” from wellness to wellbeing

“Health” was defined by the World Health Organization (WHO) in 1946 as

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

WHO’s definition, incorporated into its constitution, remains unchanged to this day. But in 1986 the organization held an International Conference on Health Promotion in Ottawa, which resulted in the famous Ottawa Charter for Health Promotion that elaborated on the definition, stating,

An individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.

The Charter went on to list the conditions for health: peace, shelter, education, food, income, a stable eco-system, sustainable resources, and social justice. A far cry from biometrics.

In the late 1950s, the chief of the US Office of Vital Statistics — Halbert Dunn, MD — described a dynamic state-of-being he called “high-level wellness.” This is generally considered the founding of wellness, and Dr. Dunn’s sermon-like lectures reveal his concept to be anything but a simple embodiment of physical health. Dr. Dunn said…

The state of being well is…a fascinating and ever-changing panorama of life itself, inviting exploration of its every dimension.
I believe Dr. Dunn was amplifying — not refuting — WHO’s original definition, and the Ottawa Charter later adopted much of his take on wellness as a never-ending interaction with the environment.

But Dr. Dunn’s framework may have proven too cosmic for the mainstream. And many thought leaders have since distilled wellness into the sum of its various dimensions.

The National Wellness Institute adopted a model that incorporates six dimensions of wellness — occupational, physical, emotional, spiritual, intellectual, and social. Others have divvied wellness up into five, six, seven, or eight dimensions, sometimes tossing in a “relationship” dimension, sometimes “environmental,” “financial,” or “community.” A quick image search reveals a galaxy of multidimensional wellness models in the shape of pies, hexagons, prisms, Venn diagrams, concentric circles, and geodesic domes.

I don’t know exactly how “wellbeing,” in the last few years, worked its way into the hearts of employers and the wellness industry. But one catalyst probably was the bestselling book, The Five Elements of Wellbeing, by Tom Rath and Jim Harter. Both authors are workplace consultants with Gallup (a partner of wellness vendor Healthways) and entrepreneurial marketers with a track record of successfully persuading employers to their way of thinking.

Rath and Harter argue, based on Gallup findings, that wellbeing is more profound than health and wellness, incorporating career, social, financial, physical, and community wellbeing. Sound familiar?

In practice, employers are rallying around mindfulness programs and financial planning, and repackaging stress management as resilience, and using these incremental expansions of the status quo as markers to distinguish wellbeing from wellness. Ultimately, the transition amounts to little more than a name change.

That’s fine.

I’m more than happy to dispose of the word “wellness.” I never cared for it — not because of its definition, but because it has failed to resonate with employees or the public at large. And I see no harm in calling it wellbeing instead of wellness. Certainly, while the employee wellness industry has been celebrating this “transition,” I doubt many employees have noticed a difference.

Besides, I’m open to the evolution of language, as long as it isn’t contrived to cover up a deception (like calling participation “engagement,” which I’m sure no self-respecting wellness professional would ever do).

Here’s my bottom line based on this incomplete and superficial exploration of the terms health, wellness, and wellbeing: Some people are inclined to see connections, whereas others are more drawn to compartmentalize. Maybe surgeons and benefits directors are more likely to see what’s tangible and quantifiable, while artists and farmers see the whole and the dynamics it contains. Both points of view probably deliver value.

Either way, I’m guessing that anyone who views health and wellness as only physical phenomena is likely to see wellbeing the same way. Others who view these concepts holistically are likely to do so regardless of the labels we attach to them.

Health, wellness, wellbeing: In the end, what we call it won’t matter as much as how we think of it…and how we act on it.

(Originally published on LinkedIn May 3, 2016)