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A positive approach to health

Machteld Huber researched a new concept of health for many years and founded the ‘Institute for Positive Health’.
Photo: Machteld Huber

What makes the ‘Positive Health’ concept special is that it puts people’s autonomy front and centre and focuses not only on physical dimensions but also on additional ones that broaden our understanding and experience of health. ‘We now know that around 50% of chronic illnesses can be prevented. Despite that, here in the Netherlands, most money is directed towards the treatment of patients in residential institutions such as hospitals rather than prevention,’ Huber says. She argues that a paradigm shift is long overdue in the health sector.

A definition issue

The WHO constitution gave the following definition of health in 1948: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ Huber believes that this definition is outdated. ‘What does “complete” mean, for instance? That is a state that hardly anyone can achieve.’ For that reason, she organised a two-day international conference together with the Health Council and developed a new proposal in 2009. This defines ‘health as the ability to adapt and self-manage in the face of social, physical, and emotional challenges.’ As she is a woman of action and not just words, she developed the practical spider web model based on further research.

From theory to practice

Drawing on her experiences as a patient, but also as a general practitioner, Huber extensively researched a new approach that complements medical therapy. The result: a spider web diagram as a dialogue tool. This tool facilitates a broad understanding of health that takes us towards a holistic, salutogenic perspective. ‘That is a huge shift – not just in a cultural sense but also in a scientific one,’ the doctor explains. After all, many therapies are still geared towards physical well-being and symptom control.

Based on her research, Machteld Huber developed six ‘dimensions’ with relevant sub-points. Her conversation model works like this: the user fills out the spider web by marking a number on a scale of 0 to 10 (10 is the best value). This gives them an initial insight into their current health status. The model can be used as a basis for further medical care. Image: Positive Health international (PHi).
Photo: Positive Health international (PHi)

Taking responsibility

The dialogue tool Huber developed is a useful resource for doctors that helps them hold open-ended conversations with patients on an equal footing, ascertain patients’ condition and needs, and encourage them to take responsibility. ‘In the Netherlands, we know that people find it much harder to keep up with things that they should do if you dictate to them what they need to do. That is why inspiring them in the course of a conversation to decide themselves where they want to go is so important,’ the doctor says.

The secret to a healthy life

In her lectures, Huber references research already carried out in relation to the likes of ‘Blue Zones’. This research determined which regions most centenarians are from. The intriguing answer is many different parts of the world – the Ikaria island (Greece), Loma Linda (California), Sardinia (Italy), Okinawa (Japan) and Nicoya (Costa Rica). Their secret to a long and healthy life? A healthy, low-meat and moderate diet, physical activity in their surroundings (at least 30 minutes per day), a meaningful life, and a feeling of being socially connected, among other things. In many parts of the world, ‘positive’ health is therefore already being practised in a natural way – without any superfoods or fitness fads. Maybe we will also manage to make this transition.