Illness-Wellness Continuum

The Illness-Wellness Continuum is a graphic representation of the factors of mental, emotional, and physical health that determine overall wellbeing. It is also referred to as the Wellness Paradigm. Instead of seeing the absence of illness as the ideal, the continuum promotes the idea that it is possible to reach toward a higher goal of optimal levels of physical, mental, and emotional health.

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Background

The Illness-Wellness Continuum originated in 1972. American author and physician John W. Travis first proposed the continuum during his preventative medicine residency at Johns Hopkins University. At the time, the prevailing view was that a person who did not have a physical illness or disability was considered to be “healthy.” Physicians used a tool called the Health Risk Assessment, or HRA. This tool helped identify people who were at risk of health problems. However, Travis noticed that while the tool identified individuals who could have health problems, it did nothing to address conditions that increased their health risks.

Travis introduced the idea that true wellbeing should address not only the presence or absence of physical illness but also a person’s mental and emotional health. He theorized that these aspects influenced the health-related choices people made, and that finding ways to optimize one aspect of health would have a positive effect on others. Travis published his theory in “The Wellness Inventory” in 1975. He went on to found several wellness resource centers.

Overview

The Illness-Wellness Continuum is represented as back-to-back arrows pointing to the right and left. The right-side arrow indicates degrees of wellness while the left-side arrow indicates degrees of illness. Between the two arrows is a narrow space referred to as a neutral point, where neither illness nor wellness is identified. The area at the far right is defined as high-level wellness while the area to the far left is labeled as premature death. The treatment paradigm moves from an outcome of premature death toward the neutral area, moving through stages of disability, symptoms, and signs on the way. The wellness paradigm also starts at premature death but moves beyond the neutral point through awareness, education, and growth to the status of high-level wellness.

Travis believed that that the typical approach of treating illness and injury until symptoms were no longer present was insufficient. He noted people could continue to suffer from mental and emotional complications, such as depression and anxiety, even after physical symptoms were alleviated. The Illness-Wellness Continuum proposed that by making people aware of the factors affecting their health, educating them about the factors, and helping them grow and develop healthy mental, emotional, and physical habits could move people beyond the absence of illness to an even better state of health.

According to the continuum, people can be in different stages of wellness at different times. They can also be at different stages in relation to emotional, mental, and physical health at the same time. The continuum proposes that wellness is process, not a destination. It addresses the idea that symptoms and states of health are only part of the overall picture of a person’s wellbeing, and that a holistic approach is ideal for maximizing patient outcomes. It also recognizes that an individual’s wellbeing is affected by a variety of influences, including family, social, educational, spiritual, and other factors.

Bibliography

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Sharlin, Ken. “The Illness-Wellness Continuum.” Sharlin Health and Neurology Functional Medicine, 28 Oct. 2015, functionalmedicine.doctor/the-illness-wellness-continuum/. Accessed 10 Feb. 2021.

Stelmasiak, Ewa. “Wellness Coaching as An Integral Component of the Evolutionary Vision for Medicine.” Health and Wellness, Jan. 2013, neurocentrum.pl/dcten/wp-content/uploads/Stelmasiak‗e2a.doc. Accessed 10 Feb. 2021.

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