What is wellness?

Have you seen the word wellness? Likely, yes. It’s on everything these days, from fitness centers to supplement stores to pet food! But what does it mean? Long before it got commercialized, the term was coined by Halbert Dunn, MD, PhD (1896–1975) in the 1950s and 60s, when he introduced the concept during a series of 29 lectures. His concepts were then made into a book in 1961 called High Level Wellness.

In Dunn’s lectures and book, he aimed to expand the concept of health and our tendency to only look at the physical body. He explained that we are made up of five dimensions — physical, intellectual, emotional, spiritual, and social — and these operate within a continuously changing multidimensional environment (i.e., physical, biological, social, and cultural environments).

“[Wellness] is an integrated method of functioning which is oriented towards maximizing the potential of which the individual is capable of functioning within the environment.” (Dunn, 1961)

Let’s unpack that quote in thirds. First, wellness is “an integrated method of functioning,” meaning it is the integration of all the dimensions as an operational system. Second, wellness is “oriented towards maximizing the potential of which the individual is capable of functioning,” meaning it is our focus, intention, or the direction that we are facing, not our ability to transcend our situation. In any given moment, and in any given situation, we can focus on the negative or focus on the positive; we can focus on our illness, disease, or potential death, or we can focus on our health, living, and life that we have today. Third, wellness is based on “the environment,” meaning that everything is contingent upon what is happening all around us.

Dunn influenced many throughout the 60s and 70s, so much so that those decades have been called, “The Wellness Movement.” A few notable men at that time, Dr. John Travis, Don Ardell, and Bill Hettler of the University of Wisconsin–Stevens Point got together and helped to create the nation’s first wellness organization, The National Wellness Institute (NWI) in Stevens Point, Wisconsin, and organized an annual National Wellness Conference (NWC), which is still in operation today.

The NWI and each of those men over the years have expanded on Dunn’s concepts, creating their own versions of wellness models and related concepts, and many others have followed in their footsteps. If you Google “wellness model” and click on images, many come up. The most expanded model to date, which has gotten recent attention, is the Eight Dimensions of Wellness Model from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Those eight dimensions are: physical, intellectual, emotional, spiritual, social, environmental, occupational, and financial. Environmental was added to the model, rather than have it separate from it. Occupational (job or hobby) was added because what we do for most of the hours of our day — and how we feel about it — impacts our health. And financial was added because our financial situations — and how we feel about them — also impact our health.

Why is defining wellness important? In the wellness field, especially worksite wellness, we often point to someone’s health status (e.g., conditions like Type 2 diabetes) or their biometrics (e.g., weight, blood pressure, glucose, or cholesterol) as a way to assess them. But physical health status is just an indicator that something is happening with all the systems at play. We can’t help or cure the physical health status by looking at it alone. We must assess what is going on in all the dimensions in order to help. 

You may be thinking, isn’t physical health really just about lifestyle behaviors though? The answer is yes and no. Have you ever known someone who tries to do everything healthy, eats nutritious foods, works out regularly, gets plenty of sleep, doesn’t use alcohol or tobacco, and still is overweight or has high blood pressure, or high cholesterol, or other health issues? Conversely, have you ever known someone who doesn’t do anything healthy, their diet is poor, they don’t get any physical activity, they stay up late, drink alcohol freely, and yet, their biometrics are in recommended ranges? Yes? So, how do we explain that?

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It’s all genetics, some might say. Again, yes and no. Genetics is a factor, but not the only factor. Our health status is the end result of all of the systems interacting. It’s not just about the body, and it’s not just about the lifestyle behaviors.

Is it the mind? Again, yes and no. The mind is powerful. You’ve heard of the placebo effect. Belief alone can impact how something affects the body. Things like stress, anxiety, and depression could impact the body and create physical symptoms, but what are the causes of things like stress, anxiety, and depression? Is it just the physical brain alone? Possibly, but it’s usually a combination of things, including how we grew up, the experiences we’ve had, the relationships we were or are in, the social groups we spend our time with, the culture we live in, the work we do, the finances we have, the buildings we are in, the environment that we are in, the resources available, the situations we are in, and so on. Basically, everything contributes!

Wellness is truly the supra-system of all the systems that are operating, and the root cause of any biometric, or injury, illness, or disease, is usually never one thing. Most if not all of the time, it’s a perfect storm of multiple things happening. But there is hope!

Change in one thing affects change in all things. We are one unit, even though we are multidimensional. Change in the body affects change in the mind, and vice versa. A change in job affects change in meaning and purpose, or finances, which in turn affects the mind and body. Why is this point important? Because you can start anywhere (in any dimension of wellness) and get changes in all of the dimensions. Often we think that when we have a physical health issue, we need a physical health intervention; or when we have a mental health issue, we need a mental health intervention. While that is sometimes true, it may not always be the case — or it’s just not possible at the moment. The beauty in the wellness concept is that those related interventions aren’t the only options, and change in any of the other dimensions can (and usually does) affect changes in all of the dimensions simultaneously.

So, what does this mean for employers, and helping their employees with health and wellness? It means to move beyond the physical. Offer the physical health programs, yes, but don’t limit yourself to those. Wellness is about all of the dimensions. What can you do, as an employer, to help your employees’ mental health, spiritual health, social health, and environmental health?  Intriguing concept, yes? Well, stay tuned! Next month, we’ll discuss “What is worksite wellness?”

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