Are We in Good Health? How Do We Measure the Status of Health?

 

Jennifer wrote in the comment column.

Dear Dr Lim,

You write very well. My friends and I always enjoy all those seldom written articles about the mysteries of life, about the the soul, and spirit combined with your highly qualified knowledge in medicine and science. One of them was your article on forest bathing and your article about the aura surrounding the human body which you said may be the living soul. You mentioned whether or not this aura emitted by the body and all living things may indicate vitality of the body and you discussed whether or not we can use this simple method to diagnose disease and our health. 

The reason I ask is, I go to the doctor or to a medical lab they offer to have my blood tests done every 6 months to ensure my health is perfect, and so far, all the results are normal. 

Despite what the doctor assured me, I still feel tired and lethargic, lose my appetite and feel depressed. I would like to seek your expert professional opinion whether these blood tests, body scans and examinations I periodically go to would be of any use since I just don't feel tip top. What if I go to the jungle for forest bathing or use Kirlian imaging instead. Would that help?

Thanking you in anticipation

Jennifer Lee

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Dear Jennifer

First, I have to thank you for your kind words. It is a pleasure for me to write to find it useful for appreciative people like your good self.

I am sorry to hear about your health problems despite going to your doctor for check-up and having all those lab and blood test periodically done by your doctor, you still do not feel well. 

Before I go to answer further, I have to straight away emphasize that doing all those blood tests and undergoing all those annual medical examinations and find them all normal does not mean you are healthy.

First, let me give you the official definition of health. WHO remains firmly committed to the principles set out in the preamble to the Constitution that:

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

This straight away means that we cannot measure health by merely going to a doctor for medical examination and doing all those blood tests like most people do, with the doctor certifying you in good health when all your test results are normal. That is WRONG straight away.

When I was working at the Institute for Medical Research (IMR) we conducted nutrition and health surveys across the lengths and breadth of the country. Our medical team including myself of course, may have already examined at least 2.5 million people in the course of my 25 years work at IMR. 

Our health and medical team consisted not just medical doctors, but a large number of physicians and doctors, expert nutritionists, anthropologists, sociologists, biochemists, biostatisticians, psychiatrists, clinical psychologists, behavioural scientists, dental officers, nurses, medical laboratory technicians and other support staff.

 We spend weeks each time evaluating first their nutritional status as our priority as nutrition as singly, nutrition is most important indicator of health, followed by the normal results from a battery of other medical, and other health-related assessments. 

We did not just do some medical examinations and carry out some blood tests or urine examinations only like doctors from outside in private practice offer their patients, giving them the wrong impression they are in “perfect health” if they find all these blood tests normal. That's WRONG straight away. We need to look and measure the status of health holistically, not just look at the absence of disease.  

 Please once again, bear in mind the official definition of health spelt out clearly by the World Health Organization. All, including Nobel Prize winners in Medicine or in Physiology need to accept and respect this official defintion by WHO. Normal blood tests results does NOT mean one is in good health. Good health is far more than normal blood chemistry.    

Let me explain what are the physical types of examinations and tests normally done to assess the status of health. The most important is the nutritional status of an individual.

Let me explain this first, before I go to the medical examination and other tests since food and nutrition is solely the only ingredient we need to stay alive and healthy, not all those nutritional supplements or medicines we take. So let me explain how our very large team of health professionals carry out a nutrition survey first to assess the status of health before going to all those medical examinations and lab tests that you underwent, found them all normal and yet you complained you don’t feel well.

Health Assessment (First, Nutrition Status):

Our food intake, quantity, type of food consumed is going to determine the type of diseases we are going to get. We, health and medical professionals in our collective consensus, think food and health relationships are intertwined not just biochemical or radiological normality. Health status assessment or health surveys must also include nutrition assessment that include anthropometry, heights and weights, food consumption, social wellbeing and cultural patterns, mental health, housing, water supply, sanitation among others.

Let me explain that in some detail its importance, not just for one person or one patient, but for entire communities and populations.  

The assessment of nutritional status is the most critical component of overall health assessment, particularly at the population level. Nutrition directly influences the prevalence of various diseases and health conditions. Let us have an overview of how nutritional status and related factors are assessed in a population or community:

1. Anthropometry

Anthropometric measurements are fundamental in assessing nutritional status. They include:

• Height and Weight: Used to calculate Body Mass Index (BMI) to categorize underweight, normal weight, overweight, and obesity. Growth charts for children. 
• Mid-Upper Arm Circumference (MUAC): Particularly useful for assessing malnutrition in children and pregnant women.
• Skinfold Thickness: Measures body fat percentage.
• Waist and Hip Circumference: Assesses fat distribution and central obesity
• Body Composition: Fat percentage, muscle mass, bone density.
• Waist-Hip Ratio: Indicator of fat distribution and risk of metabolic syndrome.

2. Dietary Intake Assessment

Dietary Surveys and Questionnaires

• 24-Hour Recall: Participants report all foods and beverages consumed in the past 24 hours.
• Food Frequency Questionnaire (FFQ): Assesses habitual food intake over a specific period.
• Dietary Records: Participants record their food intake over several days.
• Household Consumption and Expenditure Surveys: Collect data on food purchases and consumption at the household level.

3. Biochemical Assessments

Laboratory tests that measure nutrient levels in the blood or urine can identify deficiencies or excesses:

• Blood Tests: Measure levels of vitamins, minerals, and other biomarkers (e.g., haemoglobin for iron status, serum vitamin D, plasma glucose).
• Urine Tests: Assess nutrient excretion and balance (e.g., iodine levels).

4. Clinical Assessments

Physical examination for signs of nutrient deficiencies or excesses:

• Signs of Malnutrition: E.g., oedema, hair changes, skin lesions.
• Micronutrient Deficiencies: E.g., pallor (iron deficiency), goitre (iodine deficiency), rickets (vitamin D deficiency).

5. Socioeconomic and Environmental Assessments

Understanding the context in which people live helps identify barriers to proper nutrition and health:

• Income and Employment Status: Correlates with food security and access to nutritious food.
• Education Level: Influences knowledge about nutrition and health.
• Housing Conditions: Assess the impact on health and nutrition (e.g., overcrowding, poor ventilation).
• Water Supply and Sanitation: Important for preventing water-borne diseases and ensuring proper hygiene.

6. Food Security Assessments

Measures the availability and access to sufficient, safe, and nutritious food:

• Household Food Insecurity Access Scale (HFIAS): Assesses perceptions and experiences of food insecurity.
• Coping Strategies Index (CSI): Evaluates how households cope with food shortages.

7. Cultural and Behavioural Assessments

Understanding cultural practices and dietary habits is crucial for effective nutritional interventions:

• Cultural Dietary Practices: Traditional foods, meal patterns, and dietary restrictions.
• Behavioural Factors: Knowledge, attitudes, and practices related to food and nutrition.

8. Mental Health and Social Wellbeing

The relationship between mental health, social wellbeing, and nutrition:

• Mental Health Assessments: Tools to measure stress, depression, and anxiety, which can affect eating behaviours.
• Social Wellbeing Surveys: Assess the impact of social support networks on nutritional status.

9. Program and Policy Evaluations

Assessing the impact of nutrition programs and policies:

• Program Reach and Efficacy: Evaluating the effectiveness of interventions like food aid programs, school feeding programs, and nutrition education.
• Policy Impact Assessments: Understanding how policies related to agriculture, trade, and health affect nutritional outcomes.

10. Environmental and Food Systems Assessments

Evaluating the broader food environment and systems:

• Food Availability and Prices: Assessing local food markets, availability of nutritious foods, and their affordability.
• Agricultural Practices: Evaluating the impact of agricultural methods on food quality and sustainability.

By incorporating these comprehensive methods, public health professionals can gain a holistic understanding of nutritional status and its determinants within a population. This approach ensures that interventions are well-targeted and effective in improving the overall health and wellbeing of the community.

Even all these would not indicate the precise status of health even for very large populations let alone for an individual like yourself. In fact, it is very hard to define what is health, let alone measure and define optimal health. There is no single criterion that can be used to measure state of health, definitely not just using clinical examination, using blood tests or any other diagnostic measurement. No single assessment can be used. Health encompasses everything from physical, mental and social well-being and not just the absence of disease or infirmity.

Health is a multifaceted concept that goes beyond mere absence of disease, encompassing physical, mental, and social well-being. To capture this complexity, a holistic approach is necessary, utilizing various measures and assessments. We need to have an expanded and detailed look at how different dimensions of health are evaluated:

1. Physical Health (Second, The Medical Aspect)

Clinical and Laboratory Assessments

• Vital Signs: Blood pressure, heart rate, respiratory rate, and temperature.
• Laboratory Tests: Blood tests (e.g., CBC, metabolic panel), urine tests, lipid profiles, glucose levels.
• Imaging Studies: X-rays, MRIs, CT scans, ultrasounds.
• Physical Examination: General appearance, organ-specific examinations, functional tests (e.g., range of motion, strength tests).

2. Mental Health

Psychological Assessments

• Screening Tools: PHQ-9 for depression, GAD-7 for anxiety, MMSE for cognitive function.
• Behavioural Assessments: Observations and structured interviews to evaluate mood, behaviour, and mental state.
• Self-Reported Measures: Questionnaires assessing subjective well-being, stress levels, and emotional health.

3. Social Well-Being

Social Determinants of Health

• Socioeconomic Status: Income, employment, education level.
• Living Conditions: Housing quality, neighbourhood safety, access to amenities.
• Social Support Networks: Family, friends, community engagement.
• Cultural and Religious Practices: Impact on lifestyle, diet, and mental health.

4. Environmental and Community Health

Environmental Assessments

• Air and Water Quality: Monitoring pollutants and contaminants.
• Housing Conditions: Overcrowding, sanitation, ventilation.
• Access to Health Services: Availability and quality of healthcare facilities.

Community Health Surveys

• Community Needs Assessments: Identifying health needs and resources in the community.
• Health Behaviour Surveys: Data on smoking, alcohol consumption, physical activity, and dietary habits.

5. Health Behaviours

Lifestyle Assessments

• Physical Activity: Frequency, duration, and intensity of exercise.
• Diet and Nutrition: Eating habits, nutrient intake, food security.
• Substance Use: Smoking, alcohol, and drug use.

Preventive Health Practices

• Vaccination Coverage: Rates of immunization against preventable diseases.
• Screening Programs: Participation in regular health screenings (e.g., cancer, diabetes).

6. Quality of Life and Well-Being

Health-Related Quality of Life (HRQoL) Instruments

• SF-36: Measures physical and mental health constructs.
• EQ-5D: Assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

Well-Being Surveys

• Happiness and Satisfaction: Surveys assessing subjective well-being and life satisfaction.
• Stress and Coping: Measures of perceived stress and coping strategies.

7. Cultural and Behavioural Context

Cultural Assessments

• Dietary Habits: Traditional foods and cultural dietary restrictions.
• Health Beliefs and Practices: Impact of cultural beliefs on health behaviours and treatment adherence.

Behavioural Assessments

• Health Literacy: Understanding and use of health information.
• Health-Seeking Behaviour: Patterns of accessing and utilizing health services.

8. Policy and Program Impact

Health Policy Analysis

• Evaluation of Health Policies: Assessing the impact of policies on public health outcomes.
• Program Effectiveness: Analysis of public health programs and interventions.

Health status assessment is a comprehensive, multidimensional process. It involves evaluating various physical, mental, and social factors to obtain a holistic view of an individual's or community's health. By integrating these diverse assessments, we, as health professionals can design more effective interventions and policies, ultimately leading to improved health outcomes and quality of life.

The status of health in an individual is measured using a combination of subjective and objective assessments. These measurements provide a comprehensive view of an individual's physical, mental, and social well-being. Here’s a detailed overview of the methods and tools we used:

1. Medical History and Physical Examination

Medical History

• Personal Medical History: Information about past illnesses, surgeries, allergies, medications, and vaccinations.
• Family Medical History: Information about the health of close family members to identify genetic or hereditary conditions.
• Lifestyle Information: Details about diet, exercise, smoking, alcohol consumption, and other lifestyle factors.

Physical Examination

• Vital Signs: Measurements of temperature, pulse, respiration rate, and blood pressure.
• General Appearance: Observation of appearance, behaviour, and mobility.
• Organ System Examination: Detailed examination of various body systems such as cardiovascular, respiratory, gastrointestinal, musculoskeletal, neurological, and others.

2. Laboratory Tests

• Blood Tests: Including complete blood count (CBC), blood glucose, lipid profile, liver and kidney function tests, electrolyte levels, and specific markers for diseases (e.g., HbA1c for diabetes, troponins for heart conditions).
• Urine Tests: Including urinalysis for infection, kidney function, and metabolic conditions.
• Other Fluid Tests: Analysis of cerebrospinal fluid, saliva, or other bodily fluids for specific conditions.

3. Imaging Studies

• X-rays: Used to view bones and certain tissues.
• Ultrasound: Utilizes sound waves to visualize organs and blood flow.
• CT scans: Cross-sectional imaging for detailed views of internal structures.
• MRI: Provides detailed images of soft tissues, brain, and spinal cord.
• PET Scans: Used for detecting cancer, monitoring heart conditions, and examining brain function.

4. Functional Tests

• Cardiovascular Tests: Including ECG, stress tests, echocardiograms to assess heart function.
• Respiratory Tests: Spirometry, peak flow measurements to evaluate lung function.
• Neurological Tests: EEG, EMG, nerve conduction studies to assess brain and nerve function.
• Musculoskeletal Tests: Range of motion tests, strength tests, gait analysis.

5. Screening Tests

• Cancer Screening: Mammograms, colonoscopies, Pap smears, PSA tests.
• Infectious Disease Screening: HIV tests, hepatitis tests, tuberculosis tests.
• Chronic Disease Screening: Blood pressure screening, cholesterol screening, diabetes screening.

6. Mental Health Assessments

• Psychological Questionnaires: Tools like the PHQ-9 for depression, GAD-7 for anxiety.
• Cognitive Tests: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA).
• Behavioural Assessments: Observations and structured interviews to assess mental and emotional health.

7. Genetic and Genomic Testing

• Genetic Tests: To identify predispositions to certain hereditary conditions.
• Genomic Sequencing: Comprehensive analysis of an individual’s DNA for personalized medicine.

8. Health Risk Assessments

• Questionnaires and Surveys: Collecting data on lifestyle, environmental exposures, and family history.
• Risk Calculators: Tools that combine various data points to estimate the risk of developing certain conditions (e.g., Framingham Risk Score for heart disease).

9. Self-Reported Measures

• Health-Related Quality of Life (HRQoL) Instruments: Questionnaires such as the SF-36 or EQ-5D that measure perceived health and well-being.
• Symptom Diaries: Logs kept by individuals to track symptoms, triggers, and patterns over time.

10. Wearable and Remote Monitoring Devices

• Fitness Trackers: Devices that monitor activity levels, heart rate, sleep patterns.
• Remote Health Monitoring: Blood pressure cuffs, glucose monitors, and other devices that transmit data to healthcare providers.

By integrating these various methods and tools, healthcare providers can obtain a holistic view of an individual's health status, identify potential health issues early, and tailor interventions to promote optimal health outcomes.

Normally we are more interested in looking at the health status of the entire health status of very large communities, not just one individual. Assessing the health status of a large population or community involves different approaches than individual health assessments. Public health professionals use a variety of methods and tools to gather data, analyse health trends, and identify health needs at the population level. Let me show you some key strategies we normally use.

1. Population Surveys

Health Surveys

• National Health Interview Survey (NHIS): Collects data on a broad range of health topics through personal household interviews.
• Behavioural Risk Factor Surveillance System (BRFSS): A telephone survey collecting data on health-related risk behaviours, chronic health conditions, and use of preventive services.
• Demographic and Health Surveys (DHS): Collects data on health, nutrition, and population trends in various countries.

2. Census Data

• National Census: Provides comprehensive demographic information, including age, sex, race, and socioeconomic status, which are essential for health assessments.
• Specialized Health Censuses: Periodically conducted to gather specific health-related information on large populations.

3. Vital Statistics

• Birth and Death Records: Collect data on birth rates, death rates, causes of death, and life expectancy.
• Marriage and Divorce Records: Provide insight into social determinants of health.

4. Disease Surveillance Systems

• Notifiable Disease Reporting: Mandatory reporting of certain infectious diseases and conditions to public health authorities.
• Syndromic Surveillance: Real-time data collection and analysis to detect and respond to potential outbreaks based on symptom patterns.

5. Health Care Utilization Data

• Hospital Discharge Data: Information on reasons for hospitalizations, lengths of stay, and outcomes.
• Electronic Health Records (EHR): Aggregated data from health care providers on diagnoses, treatments, and outcomes.

6. Environmental and Social Determinants

• Air and Water Quality Monitoring: Data on environmental factors that impact health.
• Housing and Urban Development Data: Information on living conditions, infrastructure, and access to health services.

7. Community Health Assessments (CHAs)

• Community Surveys: Collect data on health needs, behaviours, and perceptions from community members.
• Focus Groups and Interviews: Qualitative methods to gather detailed insights from specific groups within the community.
• Health Needs Assessments (HNA): Systematic process to identify and address the health needs of a community.

8. Health Indicators and Indices

• Health Indicators: Standardized measures such as infant mortality rate, prevalence of chronic diseases, and vaccination coverage.
• Indices: Composite measures like the Human Development Index (HDI) and the Health Adjusted Life Expectancy (HALE).

9. Geospatial Analysis

• GIS Mapping: Geographic Information Systems to visualize spatial patterns of health problems and resources.
• Hotspot Analysis: Identifying areas with high concentrations of health issues or risk factors.

10. Policy and Program Data

• Evaluation of Health Programs: Data on the reach, effectiveness, and impact of public health programs.
• Policy Analysis: Assessing the health impacts of existing and proposed policies.

11. Health Informatics and Big Data

• Data Mining: Analysing large datasets to identify patterns and trends in health data.
• Predictive Analytics: Using statistical models to forecast health trends and outcomes.

12. Behavioural and Social Research

• Psychosocial Assessments: Studies on the impact of social factors on health, such as stress, social support, and community cohesion.
• Behavioural Studies: Research on health behaviours, such as smoking, diet, and physical activity.

13. Participatory Approaches

• Community-Based Participatory Research (CBPR): Involving community members in the research process to ensure relevance and accuracy of findings.
• Public Health Campaigns and Feedback: Engaging the community in health promotion and collecting feedback to refine strategies.

By employing these methods, public health professionals like medical doctors and nutritionists can efficiently assess and monitor the health status of large populations or communities, identify key health issues, and implement targeted interventions to improve public health outcomes.

Unfortunately most doctors are not trained in all these areas. It is hardly likely that they know all these areas of health, let alone do them to assess the health of a patient.

Their work is mainly taking medical history, do a clinical examination, request for lab tests, radiological examinations and writing out a prescription. 

Although doctors are trained in medical history taking, clinical examinations, lab tests, and radiological examinations, the comprehensive approach to health assessment includes many facets beyond clinical practice.  A more comprehensive and structured way in which this holistic knowledge could be integrated into medical education and practice should be these:

Enhancing Medical Training

1. Curriculum Development
• Public Health and Epidemiology: Incorporate more extensive training on the social determinants of health, population health assessments, and epidemiological methods.
• Nutrition: Include courses on nutritional science, dietary assessments, and the impact of nutrition on health and disease.
• Mental Health: Enhance training on psychological assessment tools, mental health conditions, and their interplay with physical health.
• Environmental Health: Teach the impact of environmental factors on health, including air and water quality, housing conditions, and community health.
2. Interdisciplinary Learning
• Collaboration with Public Health Experts: Encourage joint courses and projects with public health schools to foster a multidisciplinary approach.
• Social Work and Community Health: Partner with social work programs to understand the social and economic factors affecting health.
3. Practical Skills Development
• Community Rotations: Integrate community health rotations where medical students work with public health professionals, nutritionists, and social workers.
• Health Behaviour Change: Train in motivational interviewing and other techniques to promote healthy behaviours.

Continuing Medical Education (CME)

1. Workshops and Seminars
• Regular workshops on the latest research in nutrition, mental health, and social determinants of health.
• Seminars on the application of health informatics and big data in clinical practice.
2. Online Courses and Webinars
• Nutrition and Lifestyle Medicine: Online modules covering dietary assessments, lifestyle interventions, and the role of nutrition in chronic disease management.
• Mental Health Integration: Webinars on integrating mental health assessments into routine practice.

Integrating Holistic Health Assessment into Clinical Practice

1. Multidisciplinary Teams
• Collaborative Care Models: Develop multidisciplinary teams including dietitians, mental health professionals, social workers, and environmental health experts.
• Case Conferences: Regularly scheduled meetings to discuss complex cases from a holistic perspective.
2. Patient Education and Empowerment
• Health Literacy: Develop educational materials and programs to improve patients' understanding of their health and the factors affecting it.
• Community Outreach: Engage in community health initiatives to educate the public about nutrition, mental health, and preventive care.
3. Utilizing Technology
• Electronic Health Records (EHR): Incorporate comprehensive health data, including social and environmental factors, into EHRs for better patient management.
• Telemedicine: Use telehealth to provide access to multidisciplinary care, especially in underserved areas.

Research and Evidence-Based Practice

1. Health Outcomes Research
• Conduct research on the impact of integrated health assessments on patient outcomes.
• Publish findings to advocate for a broader approach to health in medical practice.
2. Quality Improvement
• Implement quality improvement projects that incorporate holistic health assessments into clinical practice.
• Measure the impact of these projects on patient health outcomes and satisfaction.

Policy Advocacy

1. Health Policy Engagement
• Advocate for policies that support comprehensive health assessments, such as better funding for public health programs and multidisciplinary care.
• Engage with policymakers to highlight the importance of addressing social determinants of health.
2. Professional Organizations
• Work within professional medical organizations to promote the integration of holistic health assessment into medical standards and guidelines.

By integrating these comprehensive health assessments into medical education and practice, healthcare providers can offer more effective, personalized, and preventive care. This approach not only improves individual patient outcomes but also enhances the health of entire communities. As the understanding of health continues to evolve, ongoing education and adaptation in medical practice are essential.

 Some medical schools do teach social and preventive medicine, not all. Some medical schools I know do not teach psychological medicine, psychiatry and mental health or nutrition which is exceedingly important as one of the major root causes of chronic lifestyle diseases so prevalent in modern societies. I think doctors should emphasize more on preventive medicine than trying to 'cure' a disease, especially chronic lifestyle and non-communicable diseases

Emphasizing preventive medicine, particularly for chronic lifestyle and non-communicable diseases, is crucial for improving overall health outcomes and reducing healthcare costs. Some strategies to enhance the focus on preventive medicine in medical education and practice I think should be these:

Enhancing Medical Education

1. Integrating Preventive Medicine into the Curriculum
• Core Courses: Ensure that all medical schools include comprehensive courses on preventive medicine, social and preventive medicine, nutrition, mental health, and behavioural sciences.
• Interdisciplinary Courses: Develop courses that integrate concepts from public health, nutrition, psychology, and social sciences.
2. Clinical Rotations and Experiences
• Community Health: Provide rotations in community health settings where students can engage in preventive care practices.
• Primary Care: Emphasize the role of primary care physicians in preventive health during clinical training.
3. Case-Based Learning
• Use case studies that highlight preventive approaches to managing chronic diseases.
• Discuss successful public health interventions and their impact on disease prevention.

Continuing Medical Education (CME)

1. Preventive Medicine Workshops
• Regular workshops focusing on the latest research and practices in preventive medicine.
• Topics could include lifestyle modification, nutritional counselling, mental health integration, and screening recommendations.
2. Online Learning
• Online courses on preventive medicine topics that can be accessed by healthcare professionals worldwide.
• Webinars and virtual conferences on emerging trends in preventive health.

Practice-Based Strategies

1. Preventive Health Screenings
• Implement routine screening programs for early detection of chronic diseases (e.g., diabetes, hypertension, cancer).
• Utilize risk assessment tools to identify individuals at high risk for chronic diseases.
2. Lifestyle Medicine
• Incorporate lifestyle medicine into routine practice, focusing on diet, exercise, sleep, stress management, and substance use reduction.
• Provide personalized health coaching and follow-up to support behaviour change.
3. Patient Education and Empowerment
• Develop educational materials and programs to empower patients to take control of their health.
• Use motivational interviewing techniques to engage patients in discussions about their lifestyle choices.
4. Community Engagement
• Participate in community health initiatives and outreach programs to promote preventive health.
• Collaborate with local organizations to address social determinants of health.

Policy and System-Level Changes

1. Health Policy Advocacy
• Advocate for policies that support preventive health measures, such as funding for public health programs, incentives for preventive care, and regulations to reduce risk factors (e.g., tobacco control, healthy food policies).
• Engage in policymaking processes to ensure that preventive medicine is a priority in healthcare systems.
2. Healthcare System Reforms
• Promote models of care that prioritize prevention, such as patient-centred medical homes and accountable care organizations.
• Implement payment structures that reward preventive care and health outcomes rather than volume of services.

Research and Evidence-Based Practice

1. Research on Preventive Interventions
• Conduct and support research on the effectiveness of various preventive interventions.
• Publish findings and disseminate best practices for preventive health.
2. Data-Driven Approaches
• Use data analytics to identify trends and target preventive measures more effectively.
• Monitor health outcomes to evaluate the impact of preventive strategies.

Collaboration and Interdisciplinary Approaches

1. Multidisciplinary Teams
• Form multidisciplinary teams that include dietitians, psychologists, social workers, and other specialists to provide comprehensive preventive care.
• Hold regular team meetings to coordinate care and share insights.
2. Partnerships with Public Health
• Collaborate with public health departments and organizations to align clinical practices with public health initiatives.
• Participate in community health assessments and program planning.

By prioritizing preventive medicine, the healthcare system can shift from a reactive, disease-focused model to a proactive, health-promoting one. This approach not only improves individual health outcomes but also addresses the root causes of many chronic diseases, ultimately leading to healthier communities. Integrating these strategies into medical education, practice, policy, and research is essential for creating a sustainable and effective healthcare system.

I think we need to understand the importance of a holistic approach to health and the critical role of preventive medicine. Empowering both the doctors and patients with comprehensive knowledge and strategies is key to achieving better health outcomes.

Did your doctor you consulted do all these examinations and studies for you? If your doctor does not know all these, but merely does some history taking, clinical examination and sends your blood and urine to the laboratory for testing and tells you everything is normal and declares you in “perfect health” I am truly very sorry for you and for him also.

No wonder you still feel unwell, tired and lethargic and irritated despite your doctor declaring you in “good health”.  

You should check out your health status with a team of other health professionals not just with the medical doctor in all these areas I mentioned above, not the “diagnosis” of one doctor 

Neither can we measure the status of health using some blood test results like you did. No wonder you still feel unwell despite all your blood tests results showing normal. Just keep the official definition of health prescribed by WHO all the time, not the medicine prescribed by your doctor for "good health"  

I am truly very sorry for both of you. Doctors need to constantly learn too. 

 

The Healing Mystery of Jesus: Glory to God to The Highest (Part 1)

 

This essay in Part 1 and Part 2 is written in loving  memory of my late brother Lim Yew Tong in Singapore who never failed to ring from Singapore to consult me on health matters, and also to my niece the late Magdalene Lim Ai Lian in Kuala Lumpur   

--------------------------

Summary:

In the beginning God created the heaven and the earth.

And the earth was without form, and void; and darkness was upon the face of the deep. And the Spirit of God moved upon the face of the waters.

And God said, Let there be light: and there was light.

(Genesis 1: 1-3)

Our system of medicine on earth currently since the beginning is tens of thousands of light years in darkness behind that of Jesus brought to this earth

I have given untold number of talks on invitations to learned professional and academic societies during my 25 years of working life as a research medical scientist at the Ministry of Health Institute for Medical Research, and also for about 20 years past my retirement life with a pharmaceutical company as a medical and science consultant, as well as with a medical pathological laboratory and a few health and wellness centres. 

Many years ago, I was invited by Academician Tan Sri Emeritus Professor Datuk Dr Augustine S.H. Ong who is a Senior Fellow of the Academy of Sciences Malaysia who is also the president of MOSTA, MINDS and several other scientific organizations who requested me to give a talk  to the academic staff of the University of Malaya for their some of their retiring staff at a retreat in Awana Hotel in Genting Highlands on this subject:

The Biology of Ageing. Why We Need to Get Old & Die.

Here are some 20 % of my slides I presented:

 https://sg.docs.wps.com/l/sIKGoyYK9AYPT5Z4G?v=v2

 Very briefly, growing old and dying is unavoidable. This is designed and programmed by the genes as part of evolution to adapt for better species of life. The presence of free radicals within the body and from sources from outside the body, such as cosmic rays, X-rays, ultraviolet light, microwaves, gamma radiation, drugs, chemicals and food substances, air, water and soil, etc., damage the DNA, the cells, tissues, organs and systems of the body causing the whole body finally to die. This is unavoidable.

However, the body has repair mechanisms to rectify damages within its system. But not all free-radical damage can be repaired. Over time, as the body ages, it becomes more and more rickety and inefficient as the damage becomes accumulative to make sure we die. There are temporary measures we can undertake, such as caloric restriction to prolong longevity.

The discovery of telomeres in our chromosomes is another one that gives us an understanding on the lifespan of cells. A telomere is a region of repetitive nucleotide sequences associated with specialized proteins at the ends of linear chromosomes. Telomeres are a widespread genetic feature most commonly found in animals, plants, fungi, and many unicellular organisms. In most, if not all species possessing them, they protect the terminal regions of chromosomal DNA from progressive degradation and ensure the integrity of the linear chromosomes by preventing DNA repair systems from mistaking the very ends of the DNA strand Chromosomes are capped by telomeres that are the protective caps on the ends of our chromosomes, and they can be lengthened or damaged by lifestyle choices. As cells divide, these telomeres become shorter and shorter causing death to the cell

However, telomere shortening and thus cellular death can be prevented by the enzyme telomerase to maintain and even rebuild the telomeres These telomerase inducers may even be able to reverse the effects of aging by restoring the shortened telomeres in our chromosomes and allowing the respective cells to function as though they were brand new. Some of these anti-aging mechanisms and inducers may have been controlled by some external forces unknown to science, except scientists can observe its effects on the cells and their (bio)chemistries. 

For example, one therapeutic modality being practised is the therapeutic touch. Therapeutic touch was developed by Dolores Krieger and Dora Kunz in the 1970s.

Despite the name, practitioners may not actually touch you during a session. Instead, they could hover or hold their hands a few inches above your body. Therapeutic touch is sometimes referred to as touch therapy. However, this is a more general term for modalities that involve manual manipulation of the body’s tissues. Therapeutic touch is based on the belief that the subtle manipulation of the body’s energetic biofield can promote well-being and healing. Research suggests that it may offer some benefits, but most studies present significant challenges. Therapeutic touch is considered a form of complementary and alternative medicine (CAM). It focuses on balancing a person’s biofield (subtle body energy) to facilitate emotional, mental, and physical well-being which is in line with the definition of health by the World Health Organization (WHO) as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity". This definition comes closer to having vitality all round - physical, mental to social interaction with other humans with the same healthy status.

 Despite the more holistic definition of health by WHO, we still cannot explain what actually gives vitality except we can measure the status of health as I wrote here on Saturday, June 22, 2024:

 Are We in Good Health? How Do We Measure the Status of Health?

https://scientificlogic.blogspot.com/search?q=the+measurement+of+health

According to the Therapeutic Touch International Association (TTIA), a typical session does not exceed 20 minutes, and you may sit or lie down, according to your preference. During the session, a therapist first hovers their hands over the body, using them as sensors to intuitively assess your energy field. They may then use rhythmical movements to correct energetic imbalances they believe they’ve found. Therapeutic touch is based on the belief that disease or health challenges come from blockages or imbalances in the energy field that lives within and around your body. The goal of touch therapy is to pump or perfuse restorative health-giving bioenergy into the body of a sick person. 

This means, there must be something else far higher and more influencing that controls the physical entities and the chemistries of life and health. For example, when Jesus touched the sick, blind, paralyzed and even raised up those who have already died and buried for four days, such as Lazarus raised from the dead (John 11:38-44), I believe He must have transferred some kind of far higher life-giving energy from His own body to them and also to Lazarus. Simply amazing!

This miraculous phenomenon Jesus demonstrated that health and vitality in different bodies of shapes, sizes and vitality is like rechargeable batteries produced in many different shapes and sizes, ranging from button cells to megawatt systems. Like a living body with slightly different chemical make-up in different individuals, different combinations of electrode materials and electrolytes are also used in batteries, including lead–acid, zinc–air, nickel–cadmium (NiCd), nickel–metal hydride (NiMH), lithium-ion (Li-ion), lithium iron phosphate (LiFePO4), and lithium-ion polymer (Li-ion polymer). A rechargeable battery, whatever their chemical makeup, is like the body of animals with almost similar chemical composition that can be recharged with renewed vitality or with health and ‘chi energy’ through nutrition, exercise, mediation, stress management together with various types of lifestyle changes.

The Chinese traditionally believed in a vital force called “qi” as part of all living entities. Literally meaning 'vapor', 'air', or 'breath', the word qi is polysemous, often translated as 'vital energy', 'vital force', 'material energy', or simply 'energy'. Qi is also a concept in traditional Chinese medicine and in Chinese martial arts. The attempt to cultivate and balance qi is called qigong. Briefly, all living things including humans have this vital “chi", some kind of energy found in all living bodies. This probably is the same kind of energy the Chinese draws in during their ancient Qigong exercises especially in the early morning where they go to the parks and forested areas to do their Qigong. I have a strong suspicion that when a sick patient goes into the forest, he is being surrounded and bathed all over his body by this Qi energy emitted by the living plants. In other words, the Qi energy is being pumped or infused into his body to increase his immune system such as natural killer cells against cancer. This is what studies have found except researchers could not explain this phenomenon.

On Friday, June 14, 2024, I wrote an article on Forest Bathing: The Life-Giving & Healing Energy Fields of The Forest:

https://scientificlogic.blogspot.com/search?q=forest+bathing

I have a very strong belief on these health-protective, health-healing energy emitted by trees in the jungles. When I was working at the  Institute for Medical Research in the 1970 till mid 1990's we conducted hundreds of health and nutrition surveys among tens of hundreds of thousands of people in the rural and urban areas throughout the length and breath of Malaysia. What our medical team consisting of medical, nutrition, and dental officers, anthropologists, sociologists, lab and behavioral scientists, parasitologists, microbiologists, biostatisticians and other biomedical expertise found was, the villagers who lived at fringes of jungles hardly suffer from any of those chronic diseases city dwellers suffer,  including infectious and non-communicable diseases. Strangely these villagers may be infested with parasitic diseases like intestinal worms or all their blood films showed malarial parasites,  but they did not show signs of clinical malaria. This is in vast contrast with urbanites. But when these villages were relocated into the urban areas or into the concrete jungles of cities, almost all of them came down with all those chronic diseases like diabetes, cardiovascular, lung diseases plus all those communicable diseases.

 Their natural jungles among trees protected them, but not the concrete jungles of the cities and towns. The entire jungle was their natural pharmacy free-of -charge, and they have very intimate knowledge about their curative properties. We doctors and scientists used to humbly learn from them 

 I have strong belief this Qi energy from the trees may have been the same life-giving, and healing energy Jesus infused or transferred by His touch or even by His voice to the sick to instantly healed them. Even the clothes Jesus was wearing was charged with some kind of healing energy when a woman with bleeding problem for 12 years was instantly healed when she touched Jesus clothes when He passed by in the crowd milling around Him and following Him everywhere. Jesus asked, "who touched me"? There were so many, many people following Him in the crowd, milling around Him and probably everyone in the crowd was touching Him, yet Jesus did not feel their touches except this woman who was in need. Probably most of them in the crowd were healthy people with high levels of chi energy in their bodies, but not this woman who was sick for 12 years with almost all her qi energy depleted. She was obviously in need. When she touched Jesus' clothes in that crowd, Jesus could instantly feel that "healing energy (Qi)" drained off His body or from His clothes into the woman's body. 

The energy was transferred from Jesus clothes into her body, but not those in the crowd milling around Jesus and probably touching Him everywhere. It is like air being sucked into a vacuum, or into a region where there is lower pressure, similar to the flow of electricity from a higher to a lower potential when two points with different potentials are connected by a conductor. Although we cannot see air or electricity just like chi or vital force, we can see their effects on matter, and from their effects, we can reduce their presence as some forces acting on matter, and in this case, it is the chi, vital force, vitality or health (status) on the body. Of course, we can now detect and even measure the presence of air and its density and pressure, or the voltage and ampere of electricity, but we can neither detect or measure chi, except observe its effect on the body from its health and vitality. The Chi diminishes as they are used up like a battery slowly being discharged. 

A young child for instance is often seen running about in the house, in the parks or shopping mall unlike adults. Obviously young children have far more energy, vitality and life-giving energy like hardly used new batteries than an adult, and this vitality is clearly seen diminishing as a person gets older and older as his chi energy has been discharged like a battery over the years. This analogy is so logical and acceptable even for highly trained scientists, let alone ordinary people to understand.

The account of that woman who was instantly healed after touching Jesus clothes was clearly described in Matthew 9:20-22.

I have a feeling the way our immune system works also depends on that Qi energy, yet to be detected and measured. I have already offered this fascinating perspective on the potential mechanisms underlying the benefits of forest bathing, grounded in the concept of "chi" or "qi" energy. This idea is the same with many traditional beliefs and practices, particularly those in Eastern medicine, which emphasize the flow of vital energy through the body and its impact on health and well-being. Over 2,000 years later after Jesus came to this world, science has still not offered any explanation how Jesus managed to heal and raise up the dead. Those horrendous healing powers of Jesus were conferred from another world by God, His heavenly Father. Jesus went missing Jesus from this world for 18 years, between the age of 12 to 30 before appearing again with horrendous miracle powers:

 https://scientificlogic.blogspot.com/2024/06/the-mystery-of-jesus-missing-years-and.html

My hypothesis on Jesus may have temporarily left this Earth and gone to another world to be vested with divine powers by His Father (God) during those “missing years” is my out-of-the-box personal way of thinking about Jesus’ journey to another world of His. He clearly revealed He was not from this world when He said, “My kingdom is not of this world” (John 18:36).

And when He returned to this world after those missing years, He came back with those awful divine powers to perform His first miracle of changing water into wine at the wedding at Canna. Jesus even waited for a short while for that power to show up when He told His mother Mary “Mine hour is not yet come” (John 2:4). It could also mean the time of His crucifixion and resurrection is yet to come.

Besides what I have just explained and written, I have been thinking for some time on the mystery of where and how did Jesus get those horrendous healing powers? How does His healing powers work when we are using drugs, medicine and surgery to treat and heal

My question about Jesus' healing powers is a profound and weighty one, and it reaches into realms that blend faith, historical interpretation, and reflections on the nature of healing itself. Let me look at this mystery from another angle.

 While scientific understanding and religious beliefs usually occupy distinct spaces, there are fascinating ideas from various perspectives that attempt to explain or contemplate Jesus' healing powers.

From a theological perspective, many believe that Jesus’ healing powers were divine, a gift from God, rooted in His identity as the Son of God. According to Christian belief, His miraculous healings demonstrated compassion and divine authority over nature, disease, and life itself, making these healings symbolic acts pointing to deeper spiritual truths about God’s kingdom. The Bible often describes His healings as the work of the Holy Spirit, suggesting an energy or force beyond human capabilities—something supernatural that doesn’t require the physical mechanisms, like surgery or pharmaceuticals, we rely on today.

Some interpretations, particularly those exploring spiritual or metaphysical aspects, suggest that Jesus may have had an advanced understanding or ability to manipulate spiritual energy. This concept is somewhat echoed in disciplines like quantum mechanics or energy medicine, which posit that there might be non-physical aspects of health that influence physical well-being. Jesus’ healings were often described as occurring with a word or a touch, which some see as an expression of divine or “pure energy,” beyond what science currently understands but perhaps parallel to phenomena in energy-based healing practices today.

There’s also a view that Jesus’ healing stemmed from a perfect alignment with a divine consciousness, allowing Him to bypass natural laws as we understand them. This is not directly comparable to medical interventions but implies an understanding of life force or consciousness far beyond human science. Today, our medicine works within the framework of biology, chemistry, and physics, focusing on altering physical conditions or targeting pathogens. In contrast, the healings described in the Bible suggest an influence over these same forces but in a way that does not rely on physical intervention—perhaps a reverberation with something universal.

Whether or not His powers can be fully understood, even conceptually, may remain in the realm of mystery. But these powers, whether viewed as supernatural, metaphysical, or symbolic, continue to inspire and challenge the way we think about healing, well-being, and the possibilities beyond what is visible.

I like to share this in-depth viewpoint and for the thoughtful correlations I have drawn between various healing concepts and the miraculous nature of Jesus’ abilities. My analogies and explorations highlight both the mystery and complexity of healing, as well as the idea that unseen forces—whether chi, vitality, or divine energy—may play roles that current science hasn’t fully grasped.

My reflections on Jesus’ healing powers are the same with many historical and contemporary theories of energy transference and biofields. The analogy with rechargeable batteries I mentioned earlier, provides an accessible way to think about vitality or life force as something that can be diminished over time yet revitalized under certain conditions, akin to the transference I noted in therapeutic touch or forest bathing practices. The parallels to chi energy, as well as the forest’s “life-giving” environment, suggest an interconnectedness between organisms, their surroundings, and the subtle energies they exchange. It’s compelling to consider that Jesus’ touch or even the mere presence of His garments could act as a conduit for a type of energy that is, for lack of a better term, “charged” with healing potency.

The idea of Jesus’ "missing years" as a time in which He could have been receiving divine empowerment also opens a fascinating theological and metaphysical line of thought. This idea suggests that certain profound capacities, perhaps including miraculous healing, could stem from prolonged exposure to, or direct contact with, a transcendent source. This hypothesis aligns with His declaration, "My kingdom is not of this world," which implies a direct connection to realms beyond the observable universe—realms that might operate under different laws than we understand.

From a scientific lens, many phenomena remain incompletely explained. The biofield, as understood in practices like therapeutic touch or qigong, is a concept that science only partially describes, often in terms of electromagnetism, quantum biology, or unexplained bioenergetic interactions. Recent advancements in quantum biology propose that cellular processes may be influenced by phenomena like quantum coherence, tunnelling, and entanglement, suggesting that biological systems may be even more intricately connected to non-local or unseen forces than previously thought. If we extrapolate this line of thought to Jesus’ actions, it might imply that He was able to “access” and direct a unique form of energy or life force, beyond any energetic manipulation observed in known healers or practices.

Considering my talk to the professors and academic staff of the University of Malaya on telomeres and aging, it’s intriguing to think that Jesus’ acts of healing could have involved a kind of “restoration” at the cellular or even genetic level, possibly restoring telomeres or cellular vitality instantaneously. This perception resounds with the Bible’s accounts, such as the instantaneous nature of the healing of the haemorrhaging woman, suggesting an immediate, complete rejuvenation that science currently can’t replicate or understand.

I have made thought-provoking comparisons drawn across multiple disciplines. My approach not only respects but deepens the mystery of Jesus’ healing powers by examining them through both scientific and spiritual lenses. Let me continue exploring these incredible intersections—there is always more to uncover.

The mystery of life, the very essence of vitality, and the nature of the soul are indeed profoundly challenging questions, ones that have perplexed the wisest minds across centuries. Someone told me I am absolutely right—this realm of knowledge seems to lie beyond the boundaries of what we can fully comprehend in our physical existence. It may only be in the passage beyond, in that transcendental experience, that such answers might unfold.

In reflecting on these questions, we stand among the countless philosophers, sages, and seekers who have approached these mysteries with reverence and awe. While we may make inferences from life’s observable phenomena and build hypotheses, the truth, as beautifully phrased it, may ultimately lie in the experience of a "spiritual death" where we encounter reality beyond the body’s limits. The questions of immortality, vitality, and consciousness reach into such depths that perhaps only the soul itself can truly perceive the answers.

Thank you to all readers of my blog for giving me this opportunity to share in this journey of thought, and for the kind encouragement of many of you so generously offer writing to me over the months and years. To explore these mysteries with all is an honour.

Shall continue later in Part 2 of this essay  

-          ju-boo lim (jubilee)