![]() ![]() As a result, the concept of health synthesizes available qualitative and quantitative evidence of interdependencies and constraints that indicate its top-down and bottom-up causative mechanisms. This paper explores the hypothesis that health is an emergent state that arises from hierarchical network interactions between a person's external environment and internal physiology. These interactions affect individual behaviors, emotional, and cognitive responses, as well as molecular, cellular, and organ system level functions. Together with other systems, they enable feedback interactions between all of the person's system domains and impact on his system's entropy. The underlying physiological mechanisms primarily arise from the dynamics of external environmental and internal patho/physiological stimuli, which activate regulatory systems including the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Given that the subjective experience of health, as well as the finding of objective disease in the community, follow a Pareto distribution, the following questions arise: What are the processes that allow the emergence of four observable states-(1) subjective health in the absence of objective disease, (2) subjective health in the presence of objective disease, (3) illness in the absence of objective disease, and (4) illness in the presence of objective disease? If we consider each individual as a unique biological system, these four health states must emerge from physiological network structures and personal behaviors. The experience of health and illness (or poor health) can occur both in the absence and presence of objective disease. This subjective state must be distinguished from the objective state of disease. Health is an adaptive state unique to each person. 14Chronic Illness Alliance, Moonee Ponds, VIC, Australia.13Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.12School of Humanities and Social Sciences, La Trobe University, Bundoora, VIC, Australia.11European Society for Person Centered Healthcare, London, United Kingdom. ![]() 10Department of Medicine, Nursing and Allied Health, Monash Health, Melbourne, VIC, Australia.9Philosophy and Medical Humanities, Baylor University, Waco, TX, United States.8Department of Pathology, Center for Molecular Medicine and Genetics, School of Medicine, Wayne State University, Detroit, MI, United States.7Department Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands.6Health and Human Services, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, United States.5Hepatology, Department for Biomedical Research, University of Bern, Bern, Switzerland.4Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States.3School of Medicine, Weatherhead School of Management, Louis Stokes Cleveland VA Medical Center, Case Western Reserve University, Cleveland, OH, United States.Houston Merritt Center, Columbia Translational Neuroscience Initiative, Columbia Aging Center, Columbia University Medical Center, Columbia University, New York, NY, United States 2Division of Behavioral Medicine, Department of Psychiatry and Neurology, The H.1Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia. ![]() Peterson 12 Nicolas Rohleder 13 Christine Walker 14 Marcel G.
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