That showed some real foresight.

I pulled together a group of health policy people I knew that had an interest in this area, into a small working group called the SWAT group (Systems Wellness Advance Team) and we began working on what a health policy would look like, and scoured the works of a number of other efforts that are aligned with this goal. We put this together, based on an attempt to focus specifically on how you would transform a culture and an industry into one that focused on primary prevention (and especially lifestyle areas rather than only disease screenings).

Not that we’re against disease screening, but that’s a disease-based model and we’re interested in a health-based model, and the role of integrative practices in making that happen. There are hundreds of thousands of licensed integrative practitioners in our nation who hold a philosophy that is more aligned with creating health and resilience than disease treatment, and who manage illness with that model. And so integrative health practices have an important role, but they’re never on the radar screen when other policy issues are addressed, and so I thought that this initiative ought to at least get those two things onto the table this time. That was the reason for putting together this Wellness Initiative for the Nation. Then the Obama group said to have a community meeting [there were 8500-plus such meetings around the country in the last two weeks of 2008].

To what extent do you think that prevention and health promotion should be encouraged and delivered by health professionals and to what extent by others, including the new infrastructure proposed in WIN, with Health and Wellness Coaches?

I think that a large part of health promotion is figuring out how to create an optimal environment in which people can care for and manage their own health. That requires an element of trained health care professionals as part of it, but its primary focus is in education; it’s a training and educational model. It isn’t a model based on the diagnosis and treatment of disease. My basic feeling is that health practitioners can play a big role, but we will need to have a much more broadly focused group of individuals that support children in schools, that provide worksite health promotion for those in the labor force, that work with other groups like the military and the veterans, and work with the aging population, all of which have slightly different needs in terms of how to go about implementing health promotion and integrative health care. But at the same time there are basic, fundamental elements that cut across all of them—nutrition, exercise, social integration, and help for psychological stress.

To what extent does this need to be centrally coordinated?

I think there needs to be guidance and coordination, in order to create a culture and an industry in these areas. We have a wonderful system that, if it is fostered through either social values or through economic incentives, enables us to do a tremendous amount. We’ve got incredible innovators. All you have to do is look at the amazing technologies emerging every day around diagnostic imaging, around genomics and proteomics, and around new surgical techniques. These fantastic innovations are designed to better and better diagnose and treat disease.

If we were able to guide that industry into creating practices, products and people that are focused on enhancement of health and flourishing, we would be able to get that innovative power there. And so some central guidance needs to be there. We need to think about that and not just let it go randomly. We need to be trained at it; we need to have people think about how to do that across the sectors, because creating health is not just for the health care system. It involves transportation (walking and bike paths, for example), it involves education, and it involves experiencing health and healing across multiple sectors of the society.