What Is Holistic Interconnected Public Health?
Holistic interconnected public health is a framework and conceptual model that recognizes that individual human health and well-being are:
- Made up of eight dimensions of wellness,
- Actively shaped by overlapping layers of influence and overarching determinants of health, and
- Inextricably linked to the health of animals and the planet.
Why Is Holistic Interconnected Public Health Necessary?
If we want to build systems that truly protect and promote health, we need to shift how we think about and talk about public health. We need to expand our scope beyond the physical and mental health of humans and the social determinants of health to also address all dimensions of wellness and the other determinants of health. We need to help people understand the forces shaping their health and what they can do, individually and collectively, to improve their well-being and create healthier environments. We also need to help them see how their day-to-day choices and behaviors affect not only the health of other people around the world but also that of animals and the planet.
Holistic interconnected public health provides a framework for public health professionals to put their leadership and systems thinking skills into practice. It paints the larger picture, integrating several established public health frameworks into a single framework. Public health professionals can use this framework to:
- Describe how determinants of health impact the health of individuals, families, and communities in their jurisdiction.
- Systematically assess the layers of influence and determinants of health that may influence the public health programs and services in their community/jurisdiction.
- Identify potentially relevant cross-sector partners with interrelated systems and policies that impact health or the determinants of health within their community/jurisdiction.
- Brainstorm opportunities for collaboration among those partners to improve health in their community/jurisdiction.
- Develop a shared vision to engage with the public, partners, and stakeholders to advocate for public health and promote collective action in their community/jurisdiction.
A Tool for the Transition from Public Health 3.0 to 4.0
The framework also provides a tool to support the transition from Public Health 3.0 (cross-sector partnerships to mobilize local community action and address social determinants of health) to Public Health 4.0 (synergy with clinical care [Health 4.0] to maximize healthy longevity [healthspan]). [1, 2, 3, 4, 5] The framework includes key priorities for public health practice from both approaches, including:
The framework also provides a tool to support the transition from Public Health 3.0 (cross-sector partnerships to mobilize local community action and address social determinants of health) to Public Health 4.0 (synergy with clinical care [Health 4.0] to maximize healthy longevity [healthspan]). [1, 2, 3, 4, 5] The framework includes key priorities for public health practice from both approaches, including:
- Factoring in and addressing the determinants of health to mitigate health disparities and improve health trends across the lifespan (see Determinants of Health).
- Implementing population-level primary, secondary, and tertiary prevention to create opportunity
for healthy aging and improving health outcomes in older age (see Social Ecological Model). - Addressing environmental considerations, including climate change, to create inclusive and resilient indoor and outdoor spaces and healthy ecosystems that support active aging and aging in place (see One Health).
- Addressing politics and polarization to navigate systemic barriers, build bipartisan consensus, and advocate for sustainable health-in-all-policies that support healthy longevity (see Political Determinants of Health).
- Leveraging AI and technology responsibly to develop effective lifecourse prevention strategies and deliver predictive, personalized interventions (see Digital Determinants of Health).
- Promoting and facilitating good health, functional ability, and quality of life for all across the lifespan (see the Eight Dimensions of Wellness).
Definitions for Key Terms
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Public Health
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An organized activity of society to promote, protect, improve, and – when necessary – restore the health of individuals, specified groups, or the entire population. It is a combination of sciences, skills and values that function through collective societal activities and involve programmes, services and institutions aimed at protecting and improving the health of all people.
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Health
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A state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.
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Well-Being
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A positive state experienced by individuals and societies. Similar to health, it is a resource for daily life and is determined by social, economic and environmental conditions.
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Definitions pulled from the World Health Organization's Health Promotion Glossary of Terms, 2021.
How Does Holistic Interconnected Public Health Work?
When most people think of “health”, they think about their individual physical (and more recently mental) health [6, 7]. Holistic interconnected public health aims to change this thinking. It takes four established public health frameworks and visually demonstrates how they interact and overlap.
At the heart of the framework is individual human health across the lifespan. From there, the framework prompts users to expand their thinking to include One Health, the Eight Dimensions of Wellness, the Social Ecological Model, and the Determinants of Health.
At the heart of the framework is individual human health across the lifespan. From there, the framework prompts users to expand their thinking to include One Health, the Eight Dimensions of Wellness, the Social Ecological Model, and the Determinants of Health.
One Health
One Health is an approach that recognizes that the health of people is closely connected to the health of animals (e.g., pets, livestock, and wildlife) and our shared environment (e.g., farms, natural habitats, and the overall planet) [8]. It also encourages collaboration, communication, coordination, and capacity-building among the core public health sciences (e.g., epidemiology, laboratory sciences, and environmental health sciences) and with relevant cross-sector partners (e.g., healthcare, veterinary sciences, agriculture, and ecology) to improve the health of people, animals, and our shared environment. This approach also provides a framework for addressing disease prevention, detection, preparedness, response, and management, and promoting global health security.
For more information on One Health efforts globally, visit: https://www.who.int/health-topics/one-health#tab=tab_1.
- Collaboration: Working together actively across different fields to achieve a shared goal.
- Communication: The open, transparent, and regular sharing of information, data, and findings.
- Coordination: Aligning actions, policies, and responses so that everyone's efforts complement each other rather than overlapping or conflicting.
- Capacity-building: Strengthening the skills, infrastructure, tools, resources, and workforce to handle multi-sector threats.
For more information on One Health efforts globally, visit: https://www.who.int/health-topics/one-health#tab=tab_1.
Eight Dimensions of Wellness
Wellness is the active, intentional pursuit of holistic health and well-being. Achieving wellness involves making proactive choices, building positive habits, and creating balance across eight interconnected dimensions that build on one another. These dimensions are also sometimes referred to as behavioral determinants of health or health behaviors and can promote or harm health and well-being. [9] Health-promoting behaviors include:
For more information on the Eight Dimensions of Wellness, visit: https://library.samhsa.gov/product/creating-healthier-life-step-step-guide-wellness/sma16-4958.
- Physical Wellness: Caring for your body to stay healthy, active, and functioning at its best, including getting adequate sleep, eating a balanced diet, engaging in physical activity, receiving preventive medical care, and safely managing medications.
- Emotional Wellness: Understanding, accepting, and effectively managing your feelings, and developing healthy coping mechanisms for stress, including meditation, breathwork, and seeking treatment from a psychotherapist or psychiatrist.
- Intellectual Wellness: Engaging in creative, mentally stimulating activities and continuously learning new skills, including reading, taking classes, having hobbies, solving puzzles, playing games, and having thought-provoking conversations.
- Spiritual Wellness: Discovering meaning, purpose, and values in your life and acting in alignment with those beliefs, including exploring faith and philosophy, practicing mindfulness, journaling, singing, dancing, and spending time in nature.
- Social Wellness: Building and maintaining healthy, meaningful, and supportive relationships with others and fostering a sense of belonging, including volunteering and joining clubs or community groups.
- Financial Wellness: Having a healthy understanding of your financial situation and effectively managing your resources, including creating and maintaining a budget, building an emergency fund and savings, managing and minimizing debt, contributing to retirement accounts, setting financial goals, and seeking financial advice and guidance.
- Occupational Wellness: Finding personal fulfillment, growth, and enrichment in your work, whether paid or voluntary, including aligning your work with your passion and values, participating in professional development, engaging in mentorship, optimizing your workspace ergonomics, and setting and enforcing work-life boundaries.
- Environmental Wellness: Fostering a connection with nature and ensuring your physical surroundings (both home and work) are safe, tidy, organized, clean, and sustainable, including spending time outdoors, reducing consumption and waste, reusing items, and properly recycling.
For more information on the Eight Dimensions of Wellness, visit: https://library.samhsa.gov/product/creating-healthier-life-step-step-guide-wellness/sma16-4958.
Social Ecological Model
The Social Ecological Model is a conceptual framework designed to understand human development and how health and health behaviors are shaped by six interacting layers/levels of influence.
For more information on the Social Ecological Model, visit: www.doi.org/10.1177/1090198111418634.
- Individual: What we know, what we believe, how we feel, and the skills we have can influence the choices we make about our health.
- Interpersonal: The people around us — our partners, family, friends, coworkers, neighbors, and even online influencers — can support or change the choices we make.
- Organizational: The places in which we spend a lot of time, such as schools, workplaces, religious spaces, and healthcare facilities, have policies and environments that can shape our options and behaviors.
- Community: Our neighborhoods and local communities have shared norms, cultures, resources, and physical conditions that can shape our chances for health, safety, stability, and connection, as well as our access to services, support, and healthy environments.
- Public Policy/Societal: The laws and rules created by governments — along with global relationships that shape trade, labor, migration, security, the environment, and public health — can determine which resources, protections, rights, and opportunities we do or don’t have.
- Global: The planet-wide systems, ecological realities, and macro-forces—such as climate change, pandemics, international agreements, global directives, global supply chains, transnational corporate practices, and geopolitical conflicts—that transcend national borders and ultimately dictate the stability of the entire interconnected ecosystem for humans, animals, and the environment. This layer of influence is sometimes added to account for the globalization of social-ecological systems. [10]
For more information on the Social Ecological Model, visit: www.doi.org/10.1177/1090198111418634.
Determinants of Health
The Determinants of Health are the personal, social, economic, and environmental factors that influence healthy life expectancy among individuals and populations.
For more information about the Determinants of Health, visit: https://www.who.int/news-room/questions-and-answers/item/determinants-of-health.
- Social determinants: The conditions that determine whether we can live healthy, fulfilling lives, such as access to housing, education, transportation, food, and social support.
- Commercial determinants: The activities conducted by businesses, corporations, and other private sector/commercial entities that determine whether we can live healthy, fulfilling lives, including creating and marketing unhealthy products or paying employees low wages.
- Political determinants: Political decisions, policies, and systems made and enacted by voters, policymakers, and governments that determine whether we can live healthy, fulfilling lives, such as electing government officials who enact significant staff and budget cuts to agencies protecting public health.
- Biological determinants: Genetic traits, age, sex, internal bodily mechanisms, and homeodynamic function that cause infectious and chronic disease.
- Digital determinants: The design, validation, use, dissemination, and incorporation of technology within healthcare and its influence on how people access care, navigate health information, and engage with digital health services.
- Historical determinants: The effect that historical factors like war, economics, intellectual movements, and mass migration can have on the long-term health of populations.
For more information about the Determinants of Health, visit: https://www.who.int/news-room/questions-and-answers/item/determinants-of-health.
Credits
Authors:
- Monique Thornton, MPH - CEO, Let's Talk Public Health
Suggested Citation:
Let's Talk Public Health. (2026, Jul 17). Holistic Interconnected Public Health. https://www.letstalkpublichealth.com/holistic-interconnected-public-health.html
- Monique Thornton, MPH - CEO, Let's Talk Public Health
Suggested Citation:
Let's Talk Public Health. (2026, Jul 17). Holistic Interconnected Public Health. https://www.letstalkpublichealth.com/holistic-interconnected-public-health.html
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