A blog covering the health/care ecosystem and people.

“Yes,” we concurred on our session convened by the American Telemedicine Association (ATA) EDGE session today. “We” was a trio including Antoinette Thomas (@NurseTechExec1), Chief Patient Experience Officer with Microsoft, David Ryan (@DavidPRyan), former long-time Global Head of Intel’s Health/Life Science business; and, me. Antoinette posed three questions for all of us to brainstorm, addressing various aspects of health equity. We covered, The theory that telemedicine should increase health equity — where are we and what are the barriers to getting there? The role of social determinants of health in creating equitable opportunities for health citizens; and, Entering a post-pandemic world,

On U.S. Election Night, November 3, 2020, CNN’s John King stood in front of the “Key Race Alert” screen, announcing state-by-state polling results with the oft-used headline, “Too Early To Call.” That persistent media-moment was stressful for the millions of voters watching the multiple hairline-close battles from state to state. Then there was that company logo strategically placed at the lower left corner of the screen, as in “Brought to you by Calm.” Calm is but one of a growing portfolio of tools that health citizens can use to manage anxiety and stress, get to sleep (and stay sleeping), and

The pandemic has digitally transformed those people who could work from home, school at home, and undertake daily life-flows as health citizens tried to keep the coronavirus (and other people) at-a-distance. “Emerging hand-in-hand with place displacement, activity displacement is simply about the change in how people do things. Almost overnight, school lessons and doctors’ appointments were online. Yoga classes, concerts and weddings were streamed via Zoom,” Fjord Trends 2021 from Accenture Interactive observes. “Historically, people have often been quick to adopt new digital technology and slower to adapt to what it can help them achieve,” Fjord noted. But COVID-19 has

In 2020, the COVID-19 pandemic drove U.S. consumers to increase spending on electronics, notably laptops, smartphones, and desktop computers. But the coronavirus era also saw broadband households spending more on connecting health devices, with 42% of U.S. consumers owning digital health tech compared with 33% in 2015, according to research discussed in Supporting Today’s Connected Consumer from Parks Associates. developed for Sutherland, the digital transformation company. Consumer electronics purchase growth was, “likely driven by new social distancing guidelines brought on by COVID-19, which requires many individuals to work and attend school from home. Among the 26% of US broadband households

In the U.S., the latest read on supply-and-demand for COVID-19 vaccines illustrates a gap between what had been promised for the first phase of vaccine rollout versus the reality of supply chain challenges, cold storage, and 50-state and local fragmentation at the last mile for U.S. health citizens. An op-ed published in yesterday’s Washington Post by Dr. Robert Wachter of UCSF and Dr. Ashish Jha of Brown University found these two wise physicians feeling “punched in the face” with the state of coronavirus vaccination in America. As a result, they soberly, pragmatically recommended administering just the first jab of vaccine

In numerology, the symbolic meaning behind the number “21” is death and re-birth. In tarot cards, 21 is a promise of fulfillment, triumph, and victory. How apropos that feels right now as we say goodbye and good riddance to 2020 and turn the page for a kinder, gentler, healthier New Year. It would be sinful to enter a New Year as challenging as 2021 promises to be without taking the many lessons of our 2020 pandemic life and pain into account. For health care in America, it is a time to re-build and re-imagine a better, more equitable landscape for

Since the spike in hospitalizations and deaths topping 300,000 in the U.S., one day and week at a time, it appears that more Americans are moving on a continuum from being vaccine-hesitant toward vaccine-enthusiasm. The latest Kaiser Family Foundation COVID-19 Vaccine Monitor for December 2020 quantifies this moving sentiment across several perspectives: Most Americans across political party believe the COVID-19 vaccine development process is moving at the right speed The number of Americans who would get a coronavirus vaccine if it were free and seen as safe grew since September, from 34% of people who would “definitely get it” to

Two in three U.S. consumers skipped or delayed getting in-person medical care in 2020. One in 2 people had a telehealth visit int he last year. Most would use virtual care again. The coronavirus pandemic has mind-shifted how patients envision a health care visit. Today, most consumers prefer the idea of getting health care at home compared with going to a doctor’s office. Most Americans also like the idea of recovering at home instead of at a medical facility after a major medical event, according to the report, Health-at-Home 2020: The New Standard of Care Delivery from CareCentrix. COVID-19 has

While 85% of people are open to receiving a COVID-19 vaccine, over one-half of them would want to wait some time to observe if after-effects developed in people who took the jab, according to a new study from Acxiom, the data analytics-marketing company. Not all people are as enthused about getting a coronavirus vaccine at all, Acxiom discovered: in fact, those hardest hit by the virus — Black people — would be the least-likely to want to get a COVID-19 vaccine, discussed in in Vaccine Hesitancy in the U.S., a survey the company conducted among 10,000 people in the U.S.

Most psychologists in the U.S. treated more patients in the first six months of the coronavirus pandemic, shifting their practices to telehealth platforms. These therapists got more referrals and saw fewer cancellations, and one-third treated patients who lived in a different state from their practice site, according to Patients with Depression and Anxiety Surge as Psychologists Respond to the Coronavirus Pandemic from the American Psychological Association (APA). For this study, APA polled 1,787 licensed psychologists (both members and non-members in the Association) in the U.S. between late August and early October 2020. This year, APA has published four reports on

The coronavirus pandemic has been a shock to people across all aspects of everyday living, for older and younger people, for work and school, for entertainment and travel — all impacting our hearts, minds, and wallets. “As the bedrock of daily life was shaken, uncertainty predictably emerged as the prevailing emotion of our time but this universal problem was eliciting a highly differentiated reaction in different people,” Kern Schireson, CEO of Known, observed. His company has conducted a large quantitative and qualitative research program culminating in a first report, The Human Condition 2020: A Shock To The System. Known’s team of

Over one-half of Americans would likely use virtual care for their healthcare services, and one in four people would actually prefer a virtual relationship with a primary care physician, according to the fifth annual 2020 Consumer Sentiment Survey from UnitedHealthcare. What a difference a pandemic can make in accelerating patients’ adoption of digital health tools. This survey was conducted in mid-September 2020, and so the results demonstrate U.S. health consumers’ growing digital health “muscles” in the form of demand and confidence in using virtual care. One in four people would consider online options as their first-line to evaluating personal health

Yesterday, the 4th of November 2020, the cable network CNN published a story titled, “Survive election uncertainty with these expert tips on how to cope.” That morning-after-the-Election-night-before followed CNN’s allying on #2020Elections night with the Calm app — a marketing alliance meant to address the real phenomenon of political stress that has been ramping up in the U.S. for several years. I liked Teen Vogue‘s coverage of the story best, and linked it here, but you can also view lenses on the event in: Adweek, Meditation App Calm Was the Most 2020 Brand Partner for CNN’s Election Coverage, whose key

2020 marked the centennial anniversary of the 19th Amendment to the U.S. Constitution, giving women the right to vote. In this auspicious year for women’s voting rights, as COVID-19 emerged in the U.S. in February, women’s labor force participation rate was 58%. Ironic timing indeed: the coronavirus pandemic has been especially harmful to working women’s lives, the Brookings Institution asserted last week in their report in 19A: The Brookings Gender Equality Series. A new study from Tia, the women’s health services platform, looks deeply into COVID-19’s negative impacts on working-age women and how they would advise the next occupant of

2020 will be remembered for disruption and dislocation on many fronts; among the major blips in the year will be it remembered as the largest funding year for digital health recorded, according to Rock Health’s report on the 3Q2020 digital health funding. This funding record (“already” before year-end, tallied by the third quarter as Rock Health notes) was driven by “mega”-deals accelerated during the public health crisis of COVID-19. In the third quarter of 2020, some $4 billion was invested in U.S. based digital health start-ups adding up $9.4 billion in 2020….so far. This is $1.2 billion more than two

In the pandemic, I’ve been weaving together data to better understand how people as consumers are being re-shaped in daily life across their Maslow Hierarchies of Needs. One of those basic needs has been digital connectivity. People of color have faced many disparities in the wake of the pandemic: the virus itself, exacting greater rates of mortality and morbidity being the most obvious, dramatic inequity. Another has been digital inequity. Black people have had a more difficult time paying for phone and Internet connections during the COVID-19 crisis, we learned in a Morning Consult poll fielded in June 2020. In

The coronavirus pandemic has revealed the importance of connectivity, WiFi, broadband, as a social determinant of health and living. Connecting from our homes — now our health hubs, workplaces, schools, entertainment centers, and gyms — is necessary like air and water for survival across daily life flows. Digital connectivity can ameliorate social isolation and anxiety, bolster mental health, and access needed medical care via telehealth channels. As a result of the pandemic, staying connected is more important than ever for older people, Best Buy Health learned in a survey of U.S. adults. Insights from this study have informed the launch

On February 4th, 2020, in a hospital in northern California, the first known inpatient diagnosed with COVID-19 died. On March 11th, the World Health Organization called the growing prevalence of the coronavirus a “pandemic.” On May 25th, George Floyd, a 46-year-old Black man, died at the hands of police in Minneapolis. This summer, the Dixie Chicks dropped the “Dixie” from their name, and NASCAR cancelled the confederate flag from their tracks. Today, nearly 200,000 Americans have died due to the novel coronavirus. My new book, Health Citizenship: How a virus opened hearts and minds, launched this week. In it, I

In the U.S., symptoms of depression were three-times greater in April 2020 in the COVID-19 pandemic than in 2017-2018. And rates for depression were even higher among women versus men, along with people earning lower incomes, losing jobs, and having fewer “social resources” — that is, at greater risk of isolation and loneliness. America’s health system should be prepared to deal with a “probable increase” in mental illness after the pandemic, researchers recommend in Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic in JAMA Network Open. A multidisciplinary team knowledgeable in medicine, epidemiology, public health,

COVID-19 is re-shaping all industries, especially health care. And the pharma industry is challenged along with other health care sectors. In fact, the coronavirus crisis impacts on pharma are especially accelerated based on how the pandemic has affected health care providers, as seen through research from Accenture published in Reinventing Relevance: New Models for Pharma Engagement with Healthcare Providers in a COVID-19 World. For the study, Accenture surveyed 720 health care providers in general practice, oncology, immunology, and cardiology working in China, France, Japan, the United Kingdom, and the U.S., in May and June 2020. Top-line, Accenture points to four

The pandemic has become a sort of forcing function on all aspects of daily living, include health care. Deloitte’s latest wave of health care consumer market research updates the COVID-19 impacts on the U.S. health care landscape and asks the question in the study report’s title: “Are consumers already living the future of health?” For the general survey of U.S. Health Consumers, Deloitte polled 4,522 U.S. adults 18 and older online in February and March 2020. Deloitte conducted an additional 1,510 interviews with consumers in April to gauge peoples’ perspectives on the pandemic, health and well-being. In the Great Lockdown

The CDC calculated that some 200,000 American lives would be lost to the coronavirus pandemic by Labor Day weekend 2020. Beyond the tragic mortality in the U.S. come morbidity impacts hitting mental health in America, hard. And some people are being hit-harder than others, a report from the Centers for Disease Control details. Overall, 4 in 10 people in the U.S. reported at least one adverse mental or behavioral health symptom in the last week of June 2020. These symptoms included anxiety disorder, depressive disorder, COVID-19 related trauma- or stress-related disorder (TSRD), substance use (either starting or increasing), and serious

While I’m on holiday this week, restoring and re-setting, I’ve been sharing pages from my ABCovid-19 Journal with readers of Health Populi. I created this journal during the early phase of the pandemic in the U.S., as a form of art therapy, creative outlet, and learning. Today is Day 4 of sharing: we consider the letters “P” through “T,” and what I saw in the early coronavirus era. P is for pandemic This “P” was self-evidence in our collective early COVID-19 lexicon. The “P” word was uttered by the Secretary General of the World Health Organization on March 11, confirming

The coronavirus pandemic accelerated many trends and new workflows for patients and consumers, and health care providers, too. The convergence of basic needs like hygiene and safety, financial and health security, and living-working-learning-and-cooking-at-home has turbocharged a migration of more acute care delivered at home. I explore this growing concept in my latest essay on Medecision’s Liberation blog, How the Pandemic Is Accelerating the Hospital-At-Home Concept. The key points are that: Hospital-at-home services (H-a-H) combine home visits with virtual care and remote monitoring Think: advanced home care, enabled through virtual health technologies and wrap-around services both clinical and scaled social determinants

Pass me the Clorox…tip the UPS driver…love thy grocer. These are our daily life-flows in the Age of COVID-19. Our basic needs are reflected in the new 2020 Axios-Harris Poll, released today. For the past several years, I’ve covered the Harris Poll of companies’ reputation rankings here in Health Populi. Last year, Wegmans, the grocer, ranked #1; Amazon, #2. In the wake of the COVID-19 pandemic, U.S. consumers’ basic needs are emerging as health and hygiene, food, and technology, based on the new Axios-Harris Poll on the top 100 companies. This year’s study was conducted in four waves, with the

Patients embraced virtual care and communications at very high rates in the first months of the pandemic, and want to continue to use telehealth platforms after the pandemic ends. The new era of virtual care has begun and is here to stay, Accenture expects in its latest look at How COVID-19 will permanently alter patient behavior, a patient survey conducted in May 2020. Accenture polled 2,700 patients around the world, 450 participants each from China, France, Germany, Japan, the U.K., and the U.S. Patients represented one of three conditions, with one-third each managing cardiovascular, immunology/rheumatology, and oncology. Topline, consumers “faced

The pace of digital health investments quickened in the first half of 2020, based on Rock Health’s look at health-tech financing in mid-year. Digital health companies garnered $5.4 billion in the first half of the year, record-setting according to Rock Health. Underneath this number were very big deals, shown by the size of the blue bubbles in the first graphic from the report. Note that in H1 2020, the average deal size exceeded $25 mm. Among the largest deals valued at over $100 mm were ClassPass (raising $285 mm), in the business of virtual fitness classes;  Alto Pharmacy, a digital

The 21st Century Cures Act emphasizes patients’ control of personal health information. ONC rules issues in March 2020 called for more patient-facing health tools and apps to bolster health consumer engagement and empowerment. But the emergence of the coronavirus in the U.S. revealed many weakness in the American health care system, one of which has been health inequities faced by millions of people — especially black Americans, who have sustained higher rates morbidity and mortality for COVID-19. There have also been digital health divides found in the COVID-19 pandemic, discussed in a timely essay in JAMA, Digital Health Equity as

The barbershop and beauty salon are important community touch points for health, wellness, and social connection in so many peoples’ lives. In my book, HealthConsuming: From Health Consumer to Health Citizen, I feature the black barbershop to introduce a chapter on “The New Retail Health.” In the COVID-19 pandemic, how we’re dealing with hair is a metaphor for personal control, for political statements, for mental health, and for overall well-being. Check out Geoff Coates’ (known as Sadochicken, from Vancouver) take on “how quarantine hairdos are lookin’,” here. Can you see yourself? I can (it’s the “Corona Bangs” style for me,

Patients in the U.S. are self-rationing care in the era of COVID-19 by cutting spending on health care visits and prescription drugs. The coronavirus pandemic’s impact on health consumers’ spending varies depending on whether the household is generally a healthy family unit, healthy “enthusiasts,” dealing with a simple or more complex chronic conditions, or managing mental health issues. PwC explored how COVID-19 is influencing consumers’ health care behaviors in survey research conducted in early April by the Health Research Institute. The findings were published in a May 2020 report, detailing study findings among 2,533 U.S. adults polled in early April

“We’re not getting back to business as usual any time soon,” Sage Growth Partners and Blackbook Research introduce their latest report on the COVID-19 pandemic, As the Country Reopens Safety Concerns Rise. One of the areas that won’t be getting “back to business” soon will be patients’ visits to doctors’ offices, hospitals, and urgent care centers, the report notes, based on a survey conducted among 591 U.S. consumers on April 28 and 29, 2020. Millions of U.S. health consumers’ feel unsafe, an increase among those who feel that way compared with SGP/Blackbook’s study from last month, a concern that ratcheted

The hashtag #StayHome was ushered onto Twitter by 15 U.S. national healthcare leaders in a USA Today editorial yesterday. The op-ed co-authors included Dr. Eric Topol, Dr. Leana Wen, Dr. Zeke Emanuel, Dr. Jordan Shlain, Dr. Vivek Murthy, Andy Slavitt, and other key healthcare opinion leaders. Some states and regions have already mandated that people stay home; at midnight last night, counties in the Bay Area in California instituted this, and there are tightening rules in my area of greater Philadelphia. UBS economist Paul Donovan talked about “Lockdown Economics” in his audio commentary today. Paul’s observations resonated with me as

The coronavirus has shaken U.S. consumer confidence, both in terms of financial markets and personal health risks. COVID-19 is re-shaping peoples’ behavior and daily choices, from using public transit to choosing where to shop, based on Morning Consult’s National Tracking Poll #200276 conducted February 28-March 1, 2020. Morning Consult surveyed 2,200 U.S. adults, finding that 3 in 4 Americans were concerned about the coronavirus outbreak. The first chart from the survey shows various consumer activities by peoples’ likelihood of choosing to do them. Clearly, our daily life-flows outside of our homes have been impacted by our perceived risks of the coronavirus:

Patients are now front-line payors in the U.S. health care system. As such, American health consumers are wrestling with sticker shock from surgical procedures, surprise medical bills weeks after leaving the hospital, and the cost of prescription drugs — whether six-figure oncology therapies or essential medicines like insulin and EpiPens. To manage personal health finances, patients-as-payors are increasingly willing to face trade-offs and change personal behaviors to lower health care costs, based on research in The Future of Health Care Study from USC’s Center for the Digital Future. The Center analyzed the perspectives of 1,000 U.S. adults in August 2019 regarding

More U.S. doctors are using digital health tools in patient care, with quickening adoption of telehealth and remote monitoring technology, according to a study from the American Medical Association (AMA). This survey, conducted in 2019 among 1,359 U.S. physicians, follows up AMA’s research conducted in 2016 and largely reflects the original questionnaire to be able to understand real changes among doctors’ use of tech in practice. As part of this rigorous study design, AMA used particular definitions for the seven tools the study gauged: remote monitoring for efficiency, remote monitoring and management for improved care, clinical decision support, patient engagement,

Most people dealing with chronic conditions, and those who care for them, believe that “home is where the health is,” according to a survey about the “21st century house call” from CareMore Health. To gain peoples’ perspectives on health care at home and chronic disease management, CareMore Health and Aspire Health commissioned a survey among 2,009 U.S. adults 23 years of age and over in September and October 2019. The survey sample included people dealing with chronic disease themselves, as well as caregivers attending to people with chronic illnesses. The definition of that “modern house call” is largely based on the

The digital health presence at CES 2020 is the fastest-growing segment of consumer technologies at the Show this year, increasing by 25% over 2019. Heart-focused technologies are a big part of that growth story. In fact, in our search for devices and tools underpinned with clinical proof, evidence is growing for consumer-facing technology for heart-health, demonstrated by this year’s CES. Wrist-worn devices, digital therapeutics, patient engagement platforms, pharma and health plans converged at this year’s CES, with the professional association “blessing” of the American College of Cardiology who granted a continuing medical education credit for physicians attending a one-day “disruptive

In CTA’s 2020 Consumer Tech Forecast launched yesterday at Media Day 1 at CES, Steve Koenig VP of Research, said that, “digital health is an ecosystem of ecosystems.” Health, medical and wellness trends featured large in the forecast, which brought together key trends for 5G, robotics, voice tech, AR/VR/XR, and the next iteration of IoT — which Steve said will still be called “IoT,” but in this phase will morph into the “Intelligence of Things.” That speaks to Steve’s phrase, “ecosystem of ecosystems,” because that’s not just “digital” health — that’s now the true nature of health/care, and what is

There’s something like cognitive dissonance as I prepare my 2020 Health Populi TrendCast of what to expect in the health/care ecosystem in the new year. One of my key pillars for health-making is food-as-medicine, and that opportunity in this moment resonates in this holiday season with Dickens’ “Best of Times, Worst of Times” context-setting that kicks off Great Expectations. In the “best of times” part of the food+health equation, we recognize the growing role of grocery stores, food-tech and food manufacturers in the health/care landscape. A current example comes from Kroger, partnering with Ascension’s health system in Tennessee, enhancing the organization’s

On the demand side of U.S. health care economics, patients are now payors as health consumers with more financial skin in paying medical bills. As consumers, people have great expectations from the organizations on the supply side of health care — providers (hospitals and doctors), health insurance plans, pharma and medical device companies. But as payors, health consumers face challenges in getting care, so great expectations are met with frustration and eroding trust with the system, according to the latest Connected Healthcare Consumer report from Salesforce published today as the company announced expansion of their health cloud capabilities. This is

Patients searching online for health information and health care provider reviews is mainstream in 2019.  Digital health tracking is now adopted by 4 in 10 U.S. consumers. Rock Health’s Digital Health Consumer Adoption Report for 2019 was developed in collaboration with the Stanford Medicine Center for Digital Health. Rock Health’s research has tracked peoples’ use of telemedicine, wearable technology, digital health tracking, and online health information since 2015, and the results this round show relative flattening of adoption across these various tools. Rock Health’s top-line findings were that: Patient-generated health data creates opportunity, and potential challenges Online health information is

“Bold thinking is great. Bold doing is better,” Dr. Eric Topol introduced his talk yesterday at Medecision’s Liberation 2019 conference. I have the opportunity, for which I’m so grateful, of not only attending this meeting but playing a role as a speaker, a sometimes stage “emcee,” and a keynote speaker. And as an attendee, I learn so much from other speakers, fellow attendees, and Medecision staff all sharing perspectives during breakouts and networking breaks. In mode of attendee (and self-confessed collegial-groupie of Dr. Topol’s), I took in his remarks taking notes as fast as I could thanks to Mom teaching

SelfCare is health/care, particularly as patients, everyday people, take on greater responsibility for clinical decisions and paying for medical services. We’re convening today through Sunday in Indianapolis with GMDC, the Global Market Development Center and Retail Tomorrow to brainstorm the current and future prospects for SelfCare, health and wellness in the hands, hearts, and homes of consumers. To bolster the message and engage with industry stakeholders, GMDC collaborated with the Hamacher Resource Group to develop a SelfCare Roadmap, an interactive tool that provides insights into twelve conditions where consumers typically looking to DIY their health using over-the-counter medicines, supplies and

“Digital transformation” is the corporate strategy flavor of the moment across industries, and the health are sector isn’t immune from the trend. As this 13th year of the annual Health 2.0 Conference kicks off this week, I’m focused on finding digital health innovations that engage people — consumers, caregivers, patients, health citizens all. This year’s conference will convene thought leaders across a range of themes, and as is the Health 2.0 modus operandi, live demo’s of new-new things. As Health 2.0 kicks off today in pre-conference sessions, there is useful context described in a new report from the American Hospital

Did you know that September is Attendance Awareness month? Me, neither. But reading one of last Sunday’s national newspapers, I noticed a full-page ad that read, “Whirlpool is helping keep kids in schools with washers and dryers.” Reading further on, the copy called out two data points making the point about laundry and education: One in five students don’t have access to clean clothes, making them more likely to miss school; and Students who miss school are 7 times more likely to drop out of educational system. The full ad’s theme in the words of Whirlpool is that, “Education has a

Today, I am speaking with marketing leaders who are members of CHPA, the Consumer Healthcare Products Association on this very topic. This is CHPA’s 2019 Marketing Conference being held at the lovely historic Hotel du Pont in Wilmington, DE. The gist of my remarks will be to focus on the evolving retail health ecosystem, with my HealthConsuming lens on health/care, everywhere. And timing is everything, because today is International Self-Care Day to promote peoples’ health engagement. The plotline begins with a tale of two companies — CVS/health and Best Buy — discussing these two organizations’ approach to acquiring companies to expand

A “one layered delivery network through which patients can move seamlessly as they age and their needs evolve” will be the new health care platform to meet patients’ demands by 2030, according to a forecast from KPMG’s Healthcare and Life Sciences Institute. In Healthcare 2030: The consumer at the center, the KPMG team explores the demographic shifts and market drivers that will challenge the health care industry in the current U.S. delivery and financing system. The lens on that 2030 future is a consumer-centric delivery model that KPMG believes will be a solution to dealing with a demographic divide between

The health care section of Mary Meeker’s 334-page annual report, Internet Trends 2019, comprises 24 of those pages (270 through 293). These two dozen exhibits detail growing adoption of digital tech in health care, the growth of genomics and EHR adoption, examples of these tools from “A” (Apple) to “Z” (Zocdoc), and on the last page of that chapter, medical spending in the U.S., the highest in raw and per capita numbers versus the rest of the world. But the most important implications for American health care aren’t found in those pages: they’re in other parts of the report addressing

“How should we define ‘health?'” a 2011 BMJ article asked. The context for the question was that the 1948 World Health Organization definition of health — that health is, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”– was not so useful in the 21st century. The authors, a global, multidisciplinary team from Europe, Canada and the U.S., asserted that by 2011, human health was marked less by infectious disease and more by non-communicable conditions that could be highly influenced, reversed and prevented through self-care by the individual and public health policy