what is bio health

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Biohacking: What Is It And How Does It Work?

Medically Reviewed

Table of Contents

What is biohacking, types of biohacking, is biohacking safe, current examples of biohacking, the bottom line on biohacking.

Biohacking is a term used to describe various tips and tricks for enhancing the body’s ability to function at peak performance—and maybe even extend one’s lifespan. While certain modalities of biohacking may seem extreme, forms like meditation and intermittent fasting are fairly commonplace and time tested, with extensive research supporting their use. What’s new, however, is the movement behind this overall quest for better biological function.

Read on to learn about biohacking and potential ways to use its principles to elevate one’s health.

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• Ideal for peak performers, longevity seekers and healthspan optimizers

Biohacking is the practice of employing methods drawn from fields like biology, genetics, neuroscience and nutrition to enhance physical or mental performance, improve overall health and well-being, or achieve a specific health outcome (like weight loss), according to Brea Lofton, a registered dietitian and nutritionist for health and wellness company Lumen. Sometimes biohacking is also called do-it-yourself (DIY) biology.

A Brief History of Biohacking

“[Biohacking] is a global movement based on the idea that you can change the environment around you and inside of you so you have full control of your own biology,” says Dave Asprey, author of Smarter, Not Harder: The Biohacker’s Guide to Getting the Body and Mind You Want . For most people, “control” means a desire to be better, not just okay, he shared during the 2023 national Biohacking Conference in Orlando, Florida.

In Asprey’s case, he was once seriously overweight and struggling with brain fog and chronic fatigue while working in Silicon Valley. His journey with what’s now called biohacking began when he decided to apply the principles of being a computer tech-hacker to his own personal biology instead.

“Hackers look at something they want to [access], and they don’t know what it is, but they start poking at it until they get the behavior they want, and then they gain control of the system by changing the way they get in,” he explains.

Asprey regularly shares how his hacking philosophy led him to extensive personal experimentation, including taking dozens of daily supplements and injecting his own bone marrow-harvested stem cells into various joints in his body. Healthy and full of energy, he now says he plans to live to 180 years old.

Asprey and a group of mostly affluent men like ex-Twitter CEO Jack Dorsey (another prominent biohacker) are largely responsible for pushing the biohacking term into pop culture prominence. But for people who aren’t as invested (or as financially wealthy) as the small subset of initial “billionaire biohackers,” the idea boils down to not leaving the status of your health to luck, chance or genetics. Instead, biohacking is the art and science of shifting one’s physiology and nervous system to function optimally, intelligently and efficiently.

Almost any tactic could be considered biohacking if an individual employs it with the goal of enhancing their biology in some way. Therefore, the categories and possibilities for biohacking are vast and almost overwhelming.

But according to Kien Vuu, M.D., author of Thrive State: Your Blueprint for Optimal Health, Longevity, and Peak Performance , most types of biohacking generally fall into one of the following categories below.

This category of biohacking focuses on making positive health and behavior choices, as well as embracing ways of life that activate the biology of performance and longevity. Lifestyle is probably the most accessible way most people can start experiencing biohacking, as it includes factors like dietary shifts , breathwork , meditation and exercise , according to Dr. V.

Molecular biohacking involves the use of natural and synthetic molecules that can help shift one’s biology. Taking supplements would fall into this biohacking category.

“Molecular biohacking incorporates a small particle that has some kind of biological effect,” says Dr. V. “It’s your vitamins, it’s your minerals, it’s peptides (small protein fragments).”

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Biologics are cellular or biological products that are meant to improve or enhance biology. “Biologics function like some sort of human cellular material,” explains Dr. V. “They could be cells, or they could be small little information packets like exosomes, which are basically biological bundles of DNA, mRNA proteins and growth factors.”

Biologics typically need to be ingested, injected (such as stem cells) or delivered intravenously (i.e. by IV transfusion). Some biologics require a prescription from a health care provider, such as medications approved by the Food and Drug Administration (FDA), while others don’t, such as non-medical IV therapies offered in independent boutiques nationwide.

Biohacks in this category include devices like wearables (such as smartwatches ) and diagnostics (such as blood sugar monitors ). In such cases, biohacking uses technology to gather data about the body and its functioning so an individual can use that information to adjust their health as they strive for improved performance.

Technology biohacks also include the use of advanced machines like hyperbaric chambers or electromagnetic stimulators to try and stimulate more rapid physiological changes or healing.

Biohacking is fighting a bad reputation in some circles because it’s occasionally practiced “ahead of the science,” meaning people test hacks on themselves before they’re proven to work in a controlled clinical research setting. In fact, a 2020 article in Science expressed concern at the lack of scientific oversight of many genetic biohacking and other DIY science procedures currently surfacing on the consumer market [1] Zettler P, Guerrini C, Sherkow J. Regulating genetic biohacking . Science. 2019;365(6448):34-36. .

However, when approached with safety in mind and used incrementally, biohacking can be safe for most people. “It’s crucial to approach biohacking with caution, relying on evidence-based information and consulting with health care professionals when necessary,” says Lofton.

Below are some common areas people often wish to biohack and a few trending examples of how to approach each concern.

Age Biohacking

Many people become interested in biohacking as they start to advance in years. According to Asprey, one of the top biohacker demographics includes people between the ages of 35 and 50 because individuals in this life stage suddenly start noticing signs of aging.

Cellular senescence is one of the main concepts at play in age biohacking. As cells in the body are damaged by injury, stress or disease, they are removed by a natural process called apoptosis. But as the body ages, it becomes less efficient at clearing these senescent cells. Their accumulation may lead to inflammation that can damage other nearby cells, accelerating the aging process and the onset of disease.

Accordingly, many people in the age-related biohacking arena focus on cellular health and regeneration. They believe that if the production of senescent (damaged) cells can be stopped, or even reversed, then the aesthetic and physical changes that come with aging can as well.

Age-related biohacking examples include:

• Red light therapy
• Stem cell therapy
• Cryotherapy
• The use of at-home non-ablative lasers (NIRA)
• The consumption of anti-aging and mitochondrial support supplements like those containing coenzyme Q10, polyphenols, L-carnitine and Urolithin A

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Energy Biohacking

Biohacking for energy is one of the top areas explored, according to Asprey. What’s more, biohacks for sleep are often part of this category, because a person often can’t be energetic if they’re not well rested. Most U.S. adults fall behind here, with over one-third of adults included in the National Sleep Foundation’s 2020 Sleep in America Poll saying they don’t get the recommended amount of sleep [2] Sleep by the Numbers . National Sleep Foundation. Accessed 7/27/2023. .

This category can also include stress relief, as chronic stress can be very draining on a person’s overall energy.

Energy-related biohacking examples include:

• The use of sleep tracking devices
• The wearing of blue light-blocking glasses
• Light therapy for circadian rhythm regulation
• The use of meditation apps for sleep support, stress relief or both
• The consumption of supplements like vitamin B12 and magnesium
• Timed caffeine ingestion

Diet and Nutrition Biohacking

Whether a person is seeking weight loss , metabolic efficiency or better digestion , biohacking and food go hand in hand because controlling what, how and when one eats is a biohack most people can readily understand.

Biohacking often involves customizing one’s diet to optimize cellular nutrition. “Consuming a nutrient-dense diet rich in vitamins, minerals, antioxidants and essential fatty acids can provide the building blocks for healthy cells,” says Lofton. “Specific dietary approaches like ketogenic diets or fasting regimens may also affect cellular metabolism and energy production.”

Cellular nutrition aside, maintaining a healthy weight is crucial for metabolic health and longevity, explains Lofton. Excess body weight, especially visceral fat (fat around organs) can contribute to metabolic imbalance, insulin resistance and chronic disease.

“By optimizing metabolic function through healthy lifestyle choices, individuals can enhance their physical performance, support cellular health and potentially increase their lifespan,” says Lofton.

Diet- and nutrition-related biohacking examples include:

• The consumption of supplements for blood sugar control
• The use of continuous glucose monitors
• The consumption of prebiotics and probiotics
• The use of ketone breath analyzers
• The use of metabolism monitoring devices
• Intermittent fasting practices
• Understanding which foods cause gut inflammation
• Understanding and implementing principles of nutrigenomics (how nutrients and one’s genes interact)

Physical Health Biohacking

Athletes—including professionals or weekend warriors—are often looking to gain a competitive edge in their training, performance and recovery, which makes biohacking very common among the athletically inclined.

What many people don’t realize is that exercise itself is a biohack. “Regular exercise has numerous benefits at the cellular level,” says Lofton. “It promotes mitochondrial biogenesis (the creation of new mitochondria), improves cellular energy metabolism, enhances insulin sensitivity and stimulates the release of growth factors that support cellular repair and regeneration.”

A recent study in the Journal of Science and Medicine in Sport found participating in a single high-intensity interval training (HIIT) workout can also boost brain neuroplasticity (the brain’s ability to rewire or modify its neural connections) within 20 minutes of the session [3] Mellow M, Goldsworthy M, Coussens S, Smith A. Acute aerobic exercise and neuroplasticity of the motor cortex: A systematic review . J Sci Med Sport. 2020;23(4):408-414. .

That being said, people looking to boost athletic performance or accelerate recovery (from workouts or injuries) can choose from a wide range of high-tech biohack modalities. Physical health-related biohacking examples include:

• Cold plunging practices and the use of ice baths
• The use of heat therapy and saunas
• The use of smartwatches and other training feedback tools
• Whole body vibration therapy
• Pulsed Electromagnetic Fields (PEMFs) therapy
• Red light therapy (for healing and recovery)
• The consumption of athletic supplements like creatine and amino acids
• The consumption of electrolytes and energy drinks

Brain Biohacking

“The most powerful pharmacy is between your ears,” says Patrick K. Porter, Ph.D., the founder of brain-training platform BrainTap. “If you manage your brain, then the rest of your health follows. Neurons that fire together wire together.”

Thanks to mirror neurons, the brain “matches” its surrounding environment, says Dr. Porter. The function of these neurons can partially explain why a person generally feels differently at a spa than they do at a rave. The brain affects a person’s emotions, physiological processes, hormones, memory, focus, ability to learn and process information, and more.

Brain-derived neurotrophic factor (BDNF) is a term often discussed in brain biohacking because this specialized protein promotes neurogenesis (the birth of new neurons) and neuroplasticity (the ability of the brain to create new neural pathways). A number of scientists refer to it as “[like] Miracle-Gro for your brain.”

Higher levels of BDNF are associated with better overall cognitive function and memory and may even offer neuroprotective effects, according to Dr. Porter. Accordingly, many brain biohacks are intended to increase a person’s BDNF levels, but the main premise of brain biohacking is that one must care for and regularly train their brain .

“You have to become your own software engineer for your own mind,” says Dr. Porter.

Brain-related biohacking examples include:

• The consumption of nootropics, or cognition-enhancing supplements
• The use of psychotropics (like microdosing LSD)
• The practice of brainwave entrainment
• Transcranial magnetic stimulation (TMS) therapy
• Neurofeedback therapy
• Regular exercise to stimulate BDNF production
• Brain games like crossword puzzles and Sudoku

“Biohacking is a powerful concept that equips individuals with diverse tools and strategies, enabling them to take charge of their health like a CEO steering a successful company,” says Dr. V.

However, one must do their research, evaluate the safety of the biohacks they’re considering and keep their biohacking efforts in check, as too much of anything may not be a good thing.

“Biohacking can be a double-edged sword,” adds Dr. V. “While it offers tools to enhance health, an over-reliance on external products, services or technology can overshadow the most powerful medicine of all—the innate healing potential within you.”

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• Zettler P, Guerrini C, Sherkow J. Regulating genetic biohacking. Science. 2019;365(6448):34-36.
• Sleep by the Numbers. National Sleep Foundation. Accessed 7/27/2023.
• Mellow M, Goldsworthy M, Coussens S, Smith A. Acute aerobic exercise and neuroplasticity of the motor cortex: A systematic review. J Sci Med Sport. 2020;23(4):408-414.
• Kalluri R, LeBleu V. The biology, function, and biomedical applications of exosomes. Science. 2020;367(6478):eaau6977.
• Does Cellular Senescence Hold Secrets for Healthier Aging?. National Institute on Aging. Accessed 7/27/2023.
• Csekes E, Račková L. Skin Aging, Cellular Senescence and Natural Polyphenols. Int J Mol Sci. 2021;22(23):12641.
• Whole Body Cryotherapy. U.S. Food and Drug Administration. Accessed 7/28/2023.
• Nicolson G. Mitochondrial Dysfunction and Chronic Disease: Treatment With Natural Supplements. Integr Med (Encinitas). 2014;13(4):35-43.
• Liu C, Li X, Zhang Z, et al. Antiaging Effects of Urolithin A on Replicative Senescent Human Skin Fibroblasts. Rejuvenation Res. 2019;22(3):191-200.
• Picard M, McEwen B, Epel E, Sandi C. An energetic view of stress: Focus on mitochondria. Front Neuroendocrinol. 2018;49:72-85.
• Picard M, Prather A, Puterman E, et al. A Mitochondrial Health Index Sensitive to Mood and Caregiving Stress. Biol Psychiatry. 2018;84(1):9-17.
• How Blue Light Affects Sleep. Sleep Foundation. Accessed 7/27/23.
• Do Sleep Trackers Really Work?. Johns Hopkins Medicine. Accessed 7/27/23.
• Nutrigenomics. The Basics. The Nutrition Society. Accessed 7/28/23.
• Omidvar M, Alavinia S, Craven B. The effects of whole body vibration therapy on reducing fat mass in the adult general population: A systematic review and meta-analyses. J Musculoskelet Neuronal Interact. 2019;19(4):455-464.
• Hu H, Yang W, Zeng Q, et al. Promising application of Pulsed Electromagnetic Fields (PEMFs) in musculoskeletal disorders. Biomedicine & Pharmacotherapy. 2020;131:110767.
• Dietary Supplements for Exercise and Athletic Performance. National Institutes of Health. Accessed 7/28/23.
• Brigadski, T., Leßmann, V. The physiology of regulated BDNF release. Cell Tissue Res. 2020;382:15–45.
• Neuroplasticity. National Library of Medicine. Accessed 7/28/23.
• Malík M, Tlustoš P. Nootropics as Cognitive Enhancers: Types, Dosage and Side Effects of Smart Drugs. Nutrients. 2022;14(16):3367.
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Kimberly Dawn Neumann is a New York City-based magazine and book writer whose work has appeared in a wide variety of publications, including Women’s Health, Health, Cosmopolitan, Fitness, Prevention, Redbook and more. She graduated summa cum laude from the University of Maryland’s College of Journalism, and she holds certifications as an American Council on Exercise fitness professional, a certified life coach, a 200-hour RYT yoga instructor, and an Active Isolated Flexibility Technician. She is a top barre and dance instructor, a former National Competitive Aerobics Champion Bronze Medalist and a Broadway performer. She has also starred in 10 exercise videos. For more, visit: www.KDNeumann.com.

Dr. Jill Stocker is traditionally trained in family medicine with advanced certification in age management medicine and hormone optimization. She focuses on the whole person—physically, mentally, emotionally, spiritually and sexually. Her professional, evidence-based training combined with her personal and life experiences, intuitive gifts and commitment to helping others fully awaken and thrive in all areas of their lives makes for a transformational experience for her patients. She also added psychedelic medicine (particularly ketamine assisted psychotherapy) and trauma informed medicine to her practice to help her patients further expand into themselves and their lives. Her goal is to help change the medical and mental health care paradigm from numbers-oriented, medication-based sick care to individual-focused well care and liberation to the most realized version of self.

College of Science

Biohealth sciences major, our biohealth sciences program is one of the nation's best.

"You learn so much in the BioHealth Sciences program that is hands-on besides things that you would learn in a textbook. I have worked with plasmids, origin of replication, glycolysis and I was able to apply my knowledge of everything I learned in the classroom."

Van Ahn Vu (BioHealth Sciences '16), Clinical Pharmacy Specialist, Portland, Ore.

The BASICS: BioHealth Sciences (BHS)

• Department: Microbiology
• Degrees offered: Bachelor of Science, Honors Bachelor of Science
• Online option: Learn about getting your BioHealth Sciences degree online

This field applies biological science to human health and society, studying the interrelationships between biological, physical, health and social sciences. OSU's interdisciplinary BioHealth Sciences major equips students to excel in professional health programs like medical school as well as pharmaceutical and clinical research.

Oregon State’s BioHealth Sciences curriculum is designed to give you the skills you need for a healthcare career. Your BioHealth Sciences degree from OSU will:

• prepare you for a rewarding healthcare career after graduation.
• help you drive future innovations in clinical practice, medical research and biomedical technologies.
• expose you to cutting-edge research techniques and technology you’ll use to interpret medical and research data.

Health scientists perform a crucial role in promoting and preserving human health. Their work encompasses a wide array of responsibilities to improve healthcare outcomes. If BioHealth Sciences is the major for you, we think you'll be thrilled by research happening in OSU's Department of Microbiology — it's the kind of work that gets recognized worldwide. Our researchers cover:

• Applied microbiology
• Cellular metabolism
• Microbes, microbiomes and health
• Microbial informatics and data science
• Microbial threats to food security

Check out our department's research

The PROGRAM: Studying BioHealth Sciences at OSU

This major gives you a strong biological and physical science foundation while incorporating a variety of health and social sciences courses. Through our BioHealth Sciences major, you can be prepared for a future as a healthcare provider, taking a blend of courses designed to meet the your needs as a student interested in a healthcare career.

Fun fact: Our medical school acceptance rate is 67 percent, well above the national average of 40 percent!

BioHealth Sciences degree options

In the BHS program, you can choose among seven academic options that prepare you for a specialized career in healthcare.

This option prepares you for a career as a clinical laboratory scientist (also known as medical laboratory scientist or medical technologist). You’ll learn the fundamental skills for performing routine and highly specialized diagnostic procedures in clinical laboratories. Learn more about this option and course requirements here. The average annual pay for a Clinical Laboratory Scientist in Oregon is nearly $85,000 a year (ZipRecruiter). Learn more about salaries for this career here .

Students pursuing this option will study advanced anatomy courses and select among microbiology, biochemistry and nutrition courses based on your interests. Learn more about this option and course requirements here . The average annual pay for a Dentist in Oregon is over $184,500 a year (ZipRecruiter). Learn more about salaries for this career here .

There are two traditional paths to becoming a doctor: allopathic medicine (Doctor of Medicine degree) or osteopathic medicine (Doctor of Osteopathy degree). A podiatrist is a Doctor of Podiatric Medicine (DPM), trained specifically to diagnose and treat conditions of the foot, ankle, and related structures of the leg. This option includes advanced courses in microbiology, zoology and the humanities. Learn more about this option and course requirements here .

The average annual pay for a Medical Doctor in Oregon is over $197,000 a year (ZipRecruiter). Learn more about salaries for this career here .

Optometry focuses on vision care and the diagnosis, examination and treatment of eyes. The option includes advanced courses in biology and elective courses in physics and biochemistry and biophysics. Learn more about this option and course requirements here .

The average annual pay for an Optometrist in Oregon is over $120,000 a year (ZipRecruiter). Learn more about salaries for this career here .

The pre-pharmacy option is designed to meet most or all of the requirements for admission to pharmacy schools across the U.S., including OSU’s Doctor of Pharmacy (PharmD) professional program. The option includes advanced courses in biology and core courses in economics focused on market structure and consumer behavior. Learn more about this option and course requirements here .

The average annual pay for a Pharmacist in Oregon is over $110,000 a year (ZipRecruiter). Learn more about salaries for this career here .

Physical therapists help injured clients with mobility and pain management. Patients in need of rehabilitation or those who suffer from chronic conditions rely on physical therapists. This option includes advanced courses in biology, kinesiology and psychology. Learn more about this option and course requirements here .

The average annual pay for a Physical Therapist in Oregon is over $80,000 a year (ZipRecruiter). Learn more about salaries for this career here .

Physician assistants work in collaboration with doctors and are licensed to diagnose illness, develop and manage treatment plans and prescribe medications. This option includes advanced courses in biology, public health and psychology. Learn more about this option and course requirements here .

The average annual pay for a Physician Assistant in Oregon is over $105,000 a year (ZipRecruiter). Learn more about salaries for this career here .

These degree options are designed to meet most or all of the requirements for admission to corresponding health programs across the U.S. Satisfactory completion of your option facilitates, but does not guarantee, admission to a specialized health program; applicants are selected on a competitive basis.

Learn more about your BioHealth Sciences curriculum

Wondering what kind of classes you'll take? Your BHS major includes in-depth curriculum, including courses like

• Human Bacteriology
• Microbial Influences on Human Health
• Principles of Immunology

BioHealth Sciences courses

Want to know more about coursework requirements? Use the OSU Catalog to learn more about:

• your typical sequence of courses
• what pre-requisite courses you'll need
• your major's core curriculum

BioHealth Sciences course requirements

What does your four-year course load look like as a BHS major? Check out this sample plan for one example of how to map out your academic journey.

BioHealth Sciences: sample plan

Biohealth sciences online degree.

• You can also pursue the BHS major online , learning from the same Department of Microbiology faculty that teach on campus. Online students receive the same OSU diploma and transcripts as OSU's on-campus students.

Getting your BHS degree through OSU’s Ecampus

Watch: meet a biohealth sciences major.

Meet Nebiy, a BioHealth Sciences (BHS) major at Oregon State’s College of Science. Nebiy shares thoughts on the flexibility of our BHS major, the helpfulness of advisors and faculty, undergraduate research opportunities and much more.

The EXPERIENCE: Hands-on opportunities

What makes a BioHealth Sciences degree from Oregon State better? One big reason: our hands-on learning experiences!

Undergraduate Research

This is your chance to see up close what it means to be a scientist. Don’t just study science in the classroom — get in a lab and contribute to it, working alongside world-class faculty!

Learn why undergraduate research is better here

Internships.

Internships serve as your perfect transitional experience into a career field. Gain real-world career experience while exploring the career possibilities your degree opens up.

Learn about amazing internship opportunities

Study abroad.

Our students’ work spans the globe! Immerse yourself in another culture to gain a global perspective in your studies.

Take your science studies around the world

Clubs & organizations.

Here’s your chance to discover like-minded communities of peers who share your interests! Come together and engage in meaningful ways.

Connect with a club and more members of Team Science

The support: learning resources for science students.

Team Science is here to help you thrive. Our student support is another reason we always say, "science is better at Oregon State." As a Team Science student, you'll have access to a huge array of support services and resources designed to thrive both in and out of the classroom. Here are some places to get started:

Student resources

At OSU, support comes in a LOT of forms — here's where to start. From our Science Success Center to health and wellness resources, connect with the support you need to thrive as a college student.

Check out our student resources page

Learning assistant (la) program.

Love learning in smaller, collaborative group settings? Our Learning Assistant Program combines small-school attention with big-school resources. Your LA group replaces traditional lecture formats with active learning strategies, maximizing the way you engage with your STEM courses.

Explore our Learning Assistant Program

Tutoring centers.

Our tutoring centers are welcoming, friendly spaces where peer and faculty mentors offer guidance and share study techniques to help you grasp course materials and improve your academic performance.

Learn more about our science-focused tutoring centers

BioHealth Sciences majors benefit from our advising team in the Department of Microbiology. These advisors aim to work in partnership with you and help you to tend to the logistics of getting your degree, maximize your educational experience and set the stage for life after you graduate. They'll help with selecting courses, getting engaged in campus and academic culture and finding learning experiences outside of the classroom.

Visit the department's advising page

And of course, you can always reach out to our student Peer Advisors at [email protected] with questions, as well! Our Peer Advisor team is friendly, helpful and can share their first-hand knowledge of the Oregon State experience.

The PAYOFF: Careers in BioHealth Sciences

What jobs can you get with a biohealth sciences degree.

Our students find rewarding and relevant jobs thanks to degree options in pre-clinical laboratory science, pre-medicine/pre-podiatry, pre-dentistry, pre-pharmacy, pre-optometry, pre-physician assistant and pre-physical therapy.

Here are just several examples of jobs our BHS alumni have earned:

• Neurosurgery Physician Assistant | Providence
• Senior Biologist | Eli Lilly and Company
• Physical Therapist | ProMotion AFR
• Optometrist | Mile High Eye Institute
• Registered Nurse | Providence St. Vincent Health Center
• Clinical Research Associate | Formosa Biomedical Technology Corporation
• Formulation Technical Team Lead | BioFire Diagnostics
• Oral and Maxillofacial Surgery Intern | John Peter Smith Hospital
• Dental Student | OHSU School of Dentistry
• Pharmacist | Pacific University School of Pharmacy/Virginia Garcia Memorial Health Center

The PROOF: Successful students and alumni

As a 12 th -grader, Van Anh Vu was accepted into the College of Pharmacy as part of the college’s Early Assurance Program and completed her bachelor’s degree in biohealth sciences and international studies at Oregon State University.

Gabriela Cortes Cortes is proud not to have let any obstacle, including a pandemic or the challenges of a first-generation student, hold her back from earning a four-year degree in the College of Science.

Jacob Maynes, a senior majoring in biohealth sciences, will start medical school at Lake Erie College of Osteopathic Medicine (LECOM) in Erie, Pennsylvania, this July after only three years of college.

Meet Steven Kurtz, BioHealth Sciences alumnus who is studying to become a physician assistant and extreme sports enthusiast.

BioHealth Sciences junior Haelyn Epp used her SURE Science scholarship to do full-time research on motor proteins.

Biohealth Sciences major Sydney Phu selected for a prestigious bioethics summer internship at the Mayo Clinic.

APPLY NOW and more

• Transfer students: Join Team Science as a BHS major
• Current students: Make BHS your major
• Visit the Dept. of Microbiology website
• Apply to OSU as a BHS major!

Download BioHealth Sciences brochure 2022 (PDF)

What is Biotechnology?

At its simplest, biotechnology is technology based on biology - biotechnology harnesses cellular and biomolecular processes to develop technologies and products that help improve our lives and the health of our planet. We have used the biological processes of microorganisms for more than 6,000 years to make useful food products, such as bread and cheese, and to preserve dairy products.

Modern biotechnology provides breakthrough products and technologies to combat debilitating and rare diseases, reduce our environmental footprint, feed the hungry, use less and cleaner energy, and have safer, cleaner and more efficient industrial manufacturing processes.

Biotech is helping to heal the world by harnessing nature's own toolbox and using our own genetic makeup to heal and guide lines of research by:

• Reducing rates of infectious disease;
• Saving millions of children's lives;
• Changing the odds of serious, life-threatening conditions affecting millions around the world;
• Tailoring treatments to individuals to minimize health risks and side effects;
• Creating more precise tools for disease detection; and
• Combating serious illnesses and everyday threats confronting the developing world.

Biotech uses biological processes such as fermentation and harnesses biocatalysts such as enzymes, yeast, and other microbes to become microscopic manufacturing plants. Biotech is helping to fuel the world by:

• Streamlining the steps in chemical manufacturing processes by 80% or more;
• Lowering the temperature for cleaning clothes and potentially saving $4.1 billion annually;
• Improving manufacturing process efficiency to save 50% or more on operating costs;
• Reducing use of and reliance on petrochemicals;
• Using biofuels to cut greenhouse gas emissions by 52% or more;
• Decreasing water usage and waste generation; and
• Tapping into the full potential of traditional biomass waste products.

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Philosophy of Biomedicine

Despite the simple name, biomedicine is not simply the area of overlap between biology and medicine. It is a framework, a set of philosophical commitments, a global institution woven into Western culture and its power dynamics, and more. Biomedicine is the umbrella theoretical framework for most health science and health technology work done in academic and government settings. Western medical practices and the surrounding healthcare infrastructure are principally biomedical. Health-related corporations are predominantly biomedical in orientation (with the exception of a few homeopathic producers and other scattered outliers). International medical aid mainly offers biomedical resources. Biomedicine, in other words, is the name for how most powerful global institutions envision the relations between biological sciences and medicine.

The biomedical model is in fact so commonplace that it is easy to overlook how philosophically weighty (and contentious) its core commitments are: that health phenomena must be understood in terms of physical/biochemical entities and processes, that experimental techniques are the preferred means of acquiring and assessing health-related knowledge, and that human bodies are best understood as composed of a collection of subsidiary parts and processes (Krieger 2011: 130). In addition to critiquing those core commitments, philosophers have also disputed connected issues regarding the meanings of health and disease, the nature of biomedical knowledge and expertise, the value of reductionist thinking, the value of biomedicine’s global institutions, etc. Some philosophers have also proposed alternative frameworks for understanding the relations between biology and medicine. Though, relatively little literature is directed at biomedicine per se .

The fact that the philosophical literature is so critical is in part because

• biomedicine is so expansive that there is no shortage of flaws to identify, and
• biomedicine is deeply embedded in the current global order, and hence is tied directly or indirectly to all of the goods and ills of that order.

This entry will, as much as possible, avoid duplicating the work done in the thorough Philosophy of Medicine entry. That entry focuses on elucidating the work done by that branch of philosophy, which according to entry, has

dedicated journals and professional organizations, a relatively well-established canon of scholarly literature, and distinctive questions and problems. (Reiss & Ankeny 2016)

Most of the “medicine” examined in “philosophy of biomedicine” is medicine pursued within a biomedicine framework, so there is much overlap. Yet, this entry will accomplish something other than what that entry does. This entry will review the philosophical literature (and some literature in allied fields, such as history of medicine) that scrutinizes the biomedical framework itself, in whole or in part.

1.1 What is biomedicine?

1.2 the history of biomedicine, 2.1 ontology of the body and life in biomedicine, 2.2 biomedical conceptions of health and disease, 3.1 epistemology of expertise and experimental clinical data in biomedicine, 3.2 epistemology of basic and applied science in biomedicine, 3.3 epistemology of measurement in biomedicine, 3.4 reductionism in epistemology of biomedicine, 4. biomedicine as an institution, 5.1 traditional healing practices, 5.2 narrative and phenomenological approaches, 5.3 gentle medicine and population health framework approaches, other internet resources, related entries, 1. biomedicine as a framework for medicine + biology.

Consult with a primary care physician when feeling ill. Perhaps they send you to a medical lab that will take a blood sample to run a biochemical analysis. After the results arrive, consult with a physician specialist whose expertise is the particular bodily organ or system where the ailment is localized. The specialist prescribes a drug that has been mass-produced in a factory, after a biology laboratory extracted the active ingredient from a natural source, or perhaps synthesized it from scratch. The drug’s efficacy has been proven by testing the drug experimentally on two groups with the relevant disease, randomly sorted into an experimental group and a control group so that the drug’s measurable bodily effects could be scrutinized and counted. This is biomedicine. It has quickly grown to be so pervasive around the globe that it is difficult to characterize biomedicine.

As explored in this entry, and outlined in how the sections are divided in the entry, biomedicine has many facets. It is a very large and complex thing. It is a morphing historical product of the post-World War Two West. It is a contemporary global social institution. It is an epistemology of medical research and practice (albeit with factions). It is a set of ontological and metaphysical commitments. And more.

The US National Cancer Institute defines biomedicine as synonymous with “allopathic medicine, conventional medicine, mainstream medicine, orthodox medicine, and Western medicine” (NCI Other Internet Resources , accessed 12 March 2020). By contrast, A. E. Clarke, Mamo, Fishman, Shim, and Fosket (2003) takes an expansive view of the nature of biomedicine, contending that it is an evolving entity, a cohesive and developing whole that consists of elements ranging from the assertion that good health is a personal moral obligation to the increasing reliance on “computerization and data banking” (A. E. Clarke et al. 2003: 173).

Krieger offers a detailed examination of the history and philosophy of the “biomedicine approach,” and extracts three key tenets of the view.

Among the many features of a biomedical perspective, three stand out as fundamental regarding its approach to investigating disease (Lock & Gordon 1988; Fee & Krieger 1994; Krieger 1994; Lawrence & Weisz 1998; Cambrosio & Keating 2001; Bynum 2008). They are: First, specific to biomedicine: the domain of disease and its causes is restricted to solely biological, chemical, and physical phenomena; Second, shared with many natural sciences: an emphasis on laboratory research and technology and, as translated to health research, a discounting of research questions that cannot be studied by randomized clinical trials (or their analogs, e.g., “natural experiments”); and Third: an embrace of “reductionism,” a philosophical and methodological stance (discussed more fully below) that holds that phenomena are best explained by the properties of their parts. (Krieger 2011: 130)

Krieger’s account of biomedicine offers a compelling distillation of the philosophical commitments of biomedical science. Though since this is an entry on philosophy of biomedicine, the entry will be organized around philosophical dimensions and debates, rather than being organized directly around these core theoretical tenets (e.g., the upcoming section is on ontological and metaphysical commitments). Additionally, this entry will supplement the tenets identified by Krieger with discussion of connected issues, such as philosophical critiques of biomedicine as a social institution ( Section 4 ).

The terms “framework” and “approach” are used here to describe biomedicine, in an attempt to avoid narrowly overcommitting to any particular philosophical system. Biomedicine may or may not qualify as one of Thomas Kuhn’s “paradigms”, in the way that the heliocentric model of the solar system is a paradigm—a complex worldview in which the viewpoints cannot be straightforwardly translated back-and-forth with an alternative paradigm (i.e., if we try to translate the concepts of biomedicine to the pre-biomedical concepts of humoral theory, discussed in Section 1.2 (Kuhn 1962). Alternatively, biomedicine seems to qualify as one of Imre Lakatos’ Research Programmes, a different way of conceiving of the way that research communities intellectually cohere (Lakatos 1968). It’s a question of how biomedicine serves as a means of organizing and guiding research.

Without getting too lost in the technical criteria, biomedicine shares the Kuhnian paradigm quality of being incommensurable (or at least more or less so) with other conceptions of biology and health. Scholars of complementary medicine have spent enormous effort searching for ways that traditional medical practices—e.g., herbal treatments handed down over generations—can get a foothold in a medical world dominated by biomedicine. It is telling that there is no question that ‘proof’ of a treatment’s efficacy requires starting from scratch, by examining the herb’s chemical makeup, isolating and analyzing which chemical components are the active ingredients, and then testing safety and efficacy, all entirely within biomedicine’s rules. Whatever explanations might have been offered by herbalists (e.g., ‘it calms turmoil in the stomach’) are irrelevant untranslatable knowledge. Biomedicine also shares the Lakatosian Research Programme quality of (largely implicitly) dictating what sorts of internal dispute about biomedicine is permissible. Within the biomedical Research Programme, one is invited to question whether a particular experimental design is suitable; one is not permitted to reject experimentation entirely.

Biomedicine as a global institution coevolved with its characteristic philosophical positions. While key elements, such as laboratory biology, were present in the nineteenth century and even before, “World War II is usually presented as a turning point in the ‘biomedicalization’ process” (Löwy 2011: 117). The term “biomedicine” was first used between the two world wars as a shorthand for some of the medical and scientific work being done on radioactive materials (Keating & Cambrosio 2003; Löwy 2011: 49–55). But biomedicine only came into its own during the period of economic and social transformation in industrialized Western countries that followed World War Two:

In industrialized countries, the post-World War II era was also characterized by important increases in public funding for medical research, the extension of health insurance to large parts of the population (a process that, in nearly all the Western countries, the United States excepted, was also supported by the state), and the rapid growth of the pharmaceutical industry. (Löwy 2011: 117)

If biomedicine is a recent historical development, then what exactly came before it? Many different frameworks for health existed before the rise of biomedicine, though many such frameworks exist now despite the dominance of biomedicine. Some have been distinctly influenced by or merged with biomedicine. For instance, osteopathic medicine has gradually gone from a full alternative system of medicine (focusing on manipulation of body via pressure, stretching and other means of readjustment of bodily structure in order to rebalance internal processes), to an alternative track of medical education/practice that has in large part converged with the biomedical/allopathic medicine track (McClain 2017; Stark 2013).

Insofar as biomedicine formed in the West, it is helpful to see it in contrast to the medical and philosophical traditions that preceded it. The most influential Western tradition prior to biomedicine is the Hippocratic tradition—the views attributed to Hippocrates and over two millennia of re-interpretations, riffs, amendments, and other alterations. At the core of Hippocratic medicine were two views. First, it made a commitment to methodological naturalism—a refusal to attribute disease processes to the work of gods and other supernatural beings (Conrad, Neve, Nutton, Porter, & Wear 1995). Though, it is worth noting that for much of that history, elements of astrology, talismans, and some forms of magic were understood as essentially natural phenomena (e.g., the sun obviously affects health via sunburns and such, so it is not absurd to have inferred that planets could have their own subtle effects on bodies too). Second, it understood health as a matter of balance—and disease as a matter of imbalance—of the humors. Humoral theory was interpreted in many different ways, but centered on the idea that heath and disease are attributable to the interactions of anatomical humors (blood, phlegm, yellow bile, and black bile), which were in turn directly tied to a much larger cosmology of the elements (e.g., blood is linked to air, the springtime, a combination of heat and moisture, the heart, and the astrological influence of the planet Jupiter) (see additional internet resources below) (Conrad et al., 1995).

There is long-standing debate in health policy over exactly how successful the biomedical model has been over its relatively short historical trajectory. The growth of the biomedical model in Western countries occurred at the same time as other social and economic transformations (industrialization, urbanization, globalization, etc.) and at the same time as improvements in life expectancy and a large number of disease outcomes. The ‘received view’ of these historical relations is that social and economic changes allowed the growth of biomedicine, which in turn created new institutions, professional health care practices, and technologies that, in turn, caused vast improvements in health outcomes for the populations served by biomedical institutions. Penicillin is the go-to example for illustrating the positive health impacts of biomedicine (Löwy 2011). It is a medicine extracted from nature (mold), made into a widely available ‘magic bullet’ thanks to biomedical techniques of identifying its active components, and manufacturing controlled doses of it at reasonable cost at massive scale. Suffering and death from bacterial infections was rapidly alleviated; once hopeless diseases were suddenly curable with a few (usually) benign pills.

Thomas McKeown was an influential critic of the biomedical institution (including the work done during its early twentieth century prehistory), having authored the blockbuster volume The Role of Medicine: Dream, Mirage, or Nemesis (1976). McKeown reevaluated the historical record and available evidence to instead hypothesize that the social and economic changes in the West were more responsible for the health improvements than biomedicine’s growth. Put bluntly, he argued that twentieth century modernity (economic development, improved nutrition, etc.) caused populations in the West to get healthier over time, then modernity went on to also cause the growth of contemporary medicine/biomedicine, but the medical advances themselves played a generally secondary role in supporting the health improvements. His works has inspired decades worth of debates over the validity of his bold claims, which have been largely overturned or largely vindicated, depending on whom one asks (Link & Phelan 2002).

Health theorist Nancy Krieger shows how the activity of finding ratios of how much biomedical healthcare vs. socioeconomic environment contributed to health improvements since the twentieth century is the sort of debate that easily falls victim to the “fallacy of treating causes of population health as if they sum to 100%” (Krieger 2017). Causes overlap and interact in complex ways; e.g., individual diet, exercise, medications, and changing exposures to smoking, etc. have all been contributing to changes in heart disease rates. How much of the credit goes to biomedicine for studying the effects of exercise on heart attack risk, for helping make the case for the heart risks of smoking, and so on? Extracting and assessing the contributions of biomedicine, an enterprise fully embedded in Western countries’ social systems and economies, is not possible; biomedicine is firmly embedded. That is not to deny it is impossible to attribute health effects in particular populations to particular causes in general—there are methods allowing such calculations—just that causes’ interactions need to be taken into consideration (Krieger 2017).

2. Ontological and Metaphysical Commitments in Biomedicine

Biomedicine is built around a conception of disease as a disfunction of particular physical parts (organs, tissues, cells) of the body. Despite being hegemonic in the global research community, biomedicine’s ontological and metaphysical commitments are not self-evident, historically long-lived, nor universally embraced. In contrasting Classical Chinese Medicine with biomedicine, Lee explains that biomedicine is set apart by

the metaphysical thesis that only what is ascertainable by means of the five senses and by extension the use of instrumentation is real and exists

and a connected epistemic claim that legitimate health knowledge must come to us via those means (Lee 2017: 2).

What makes patients and their bodies special? Some philosophers of biomedicine have attempted to make headway in this question by provocatively asking what it means for biomedical sciences to be ‘chauvinist’ and whether this is proper. Biomedical discussions are in large part defined by what they exclude from discussion. Curiously, there are two sides to the coin of biological chauvinism: one that directly supports the biomedical framework and one that challenges it. Both help shed light on the relationship between biology and medicine.

Broadbent (2009) uses the helpful term, “biological chauvinism” to describe the way that biomedicine actively excludes consideration of entities and processes that don’t fit into its worldview: “a refusal to countenance causes of ill health that are not biological” (Broadbent 2009: 305). Biological chauvinists might appeal to ontological or epistemic commitments, e.g., the assumption that knowledge of the body is nothing but knowledge of organic chemical processes, and any processes not clearly reducible to such terms are not yet worthy of being given full consideration. But the strongest case for this chauvinism rests more on pragmatic grounds than on such philosophical assumptions. Biomedicine has built itself into a massive global institution and research enterprise while operating under that assumption (to repeat Krieger’s phrasing from Section 1.1 , the assumption is that “the domain of disease and its causes is restricted to solely biological, chemical, and physical phenomena” (Krieger 2011: 130)). This is a powerful argument, though it cuts both ways; Section 5 discusses critiques attempting to undercut the value of what biomedicine has indeed built while operating under that approach.

On the other side of the coin, “biochauvinism” is the term applied to the view that there is something philosophically unique about biological organisms—due to their basic nature and/or the limitations of human knowledge’s access to them—that makes them the biological world fundamentally unlike the rest of the world (Wolfe 2015). Vitalism—the view that life has some animating entity (along the lines of spirit) that animates matter into a living being—is one form of such biochauvinism (Wolfe 2015). Another form of biochauvinism is the use of phenomenology to assert that human lived experience partly operates within a space-time context that is different from that of a rock (Wolfe 2015). Wolfe finds that sort of view inside the influential phenomenological work of Maurice Merleau-Ponty (Wolfe 2015) (See Section 5 on phenomenology). Thus there are two rather opposite senses in which we can chauvinistically hold that the biological world is special:

• a specialness through what life excludes (medicine is nothing but applied biology) or
• a specialness through what life includes (an intangible vital spirit; a unique frame of time and space).

Version (1) of biomedicine is consistent with biomedicine and version (2) generally is not. The fact that the valorizing of biology can cut both ways helps to show, though, that biomedicine has staked out a sort of middle ground by insisting that understanding health and medicine is accomplished through understanding the innumerable subtleties of biological processes and substances, but that those biological processes and substances must not be so subtle or mysterious as to become untethered from properties and processes condoned by physics and chemistry.

Put another way, the biomedical framework of the body can be understood by considering what it excludes: spirit, vitality, and any other entity or property unknown to mainstream physicists or chemists. The concept Physicalism is closely related, but the term is perhaps not a perfect fit since it has taken on conceptual connotations and baggage through its use by analytic philosophers of metaphysics. The connection is that in the psychological biosciences, the “hard problem of consciousness” looms over everything:

It is widely agreed that experience arises from a physical basis, but we have no good explanation of why and how it so arises. Why should physical processing give rise to a rich inner life at all? It seems objectively unreasonable that it should, and yet it does. (Chalmers 1995)

While the human mind and consciousness attract a special sense of awe, the hard problem of consciousness is not all that different from the problems facing attempts to make sense of the patient as a whole. Patients live ; their bodies function every second of the day, via an astounding series of interconnected processes. It stretches the imagination to think that a vital spirit or such is giving unity to each life (human or non-); it stretches the imagination in another way to think that we humans are simply skin bags of chemical reactions.

The preceding section on purpose in biomedicine leads directly to the related issue of how health and disease are conceptualized in biomedicine. This is something that will only be dealt with very briefly here, in part to avoid duplicating the content in the entry on Concepts of Health and Disease . Debates over the meaning of health and disease—including how the two are connected—are central to philosophy of medicine. This entry will not attempt to summarize that complex literature, and rather focus on how conceptions of health and disease relate to biomedicine, including related disputes over how disease relates to disability justice matters, and ways in which purportedly objective biomedical conceptions of disease can be co-opted for dubious purposes.

Of the different philosophical accounts of health and disease, Christopher Boorse’s naturalistic Biostatistical Theory (BST) of disease gives the account that is perhaps most tightly linked with the philosophical commitments of biomedicine. Boorse’s revised account of the BST states:

The reference class is a natural class of organisms of uniform functional design; specifically, an age group of a sex of a species. A normal function of a part or process within members of the reference class is a statistically typical contribution by it to their individual survival [or] reproduction. Health in a member of the reference class is normal functional ability : the readiness of each internal part to perform all its normal functions on typical occasions with at least typical efficiency. A disease [later, pathological condition ] is a type of internal state which impairs health, i.e. , reduces one or more functional abilities below typical efficiency (Boorse 2014: 684, amending Boorse 1977: 562).

The idea is that we can wield insights of biochemistry, pathology, and evolutionary biology to together yield an objective means of ‘reading’ nature to tell us which states are pathological or diseased states, without the interference of messy and culturally rooted/biased evaluations. One line of rebuttal is that there is no principled way of objectively choosing a reference class against which to judge that a given part or process is falling short (my blood sugar levels are objectively too high compared to…what exactly?) (Kingma 2014). Even if that problem is resolvable, Krueger argues that an objective set of criteria for defining states as pathological or not would be a very limited accomplishment. Knowing that my blood sugar levels are objectively pathological does not really tell me much about what, if anything, I or my physician ought to do about that (Krueger 2015).

Fraught as it is to approach health via the functioning of components in the body, it is also quite conceptually difficult to measure health in a broader sense. Biomedical science practitioners tend to get twisted into conceptual and epistemic knots when attempting to measure general/overall health or well-being in a population (Hausman 2015). One key philosophical dispute among health scientists engaged in patient health measurement activities is over what sorts/amounts of knowledge patients have about their own health states, and how this knowledge ought to be accessed (McClimans forthcoming). How much can we glean about a patient’s physical comfort by asking them to rate their level of pain on a scale of 1–10? How do we solicit such information without repeating unethical patterns of trust or mistrust, rooted in racist/sexist/etc. stereotypes about patients (Buchman, Ho, & Goldberg 2017)?

The notion of disease is biological malfunction is also tied to a pair of critiques of the “medical model” of disability and of “medical model” of mental health. Both models are criticized for reducing the complexities of disability or psychological welfare to only the individual-level signs, symptoms, and variables recognized by biomedicine (see: Disability: Definitions, Models, Experience ). As traced in Hogan’s history of the concept, the medical model is either critiqued as insufficiently attentive to other dimensions (especially the social dynamics that drastically shape the relevant health experiences) or oppressive (since the model empowers biomedical experts to unilaterally dictate the disability/psychiatric categories, relevant evidence, diagnoses, treatments, etc.) (Hogan 2019). This is in part a dispute over functioning since debates over normality, difference, and pathology depend on whether/how we commit to the notion that bodies or parts thereof have functions at all. If one’s legs do not perform the function of walking, are the legs pathological? Is the person with those legs inherently diseased? Disabled? Worse off than if they had legs that could walk? One solution is to simply throw out the notion of normal functioning (Amundson 2000). Another related option is to embrace pluralism in the sense of accepting that the relationship between disability and well-being or health is complex, variable, and dependent on individual and social contingencies (Campbell & Stramondo 2017).

One philosophical complication is that a naturalistic concept of disease, like Boorse’s, does not prevent social processes from altering the standards and practices of how the boundaries of these natural categories are drawn in practice. Chronic diseases such as cardiovascular diseases and type 2 diabetes have been targeted by drug companies to not only create new treatments but to redraw the boundaries between healthy vs. pathological, including boundary zones such as “prediabetes” (Greene 2006). These efforts are in part accomplished via the design of clinical trials, which have the dangerous distinction of having very high epistemic value in the biomedical community, while remaining highly susceptible to manipulations to the experimental setup that push the evidence one direction or another (González-Moreno, Saborido, & Teira 2015).

While a naturalistic concept of disease is the most consistent with the ontological assumptions and methodological practices of biomedicine, that has not prevented biomedicine from accommodating a certain type of dissent from the biomedical tenet that biomedicine ought to focus on diseases and (only) the biological, chemical, and physical aspects thereof (Krieger 2011: 130). The World Health Organization (WHO)—founded in the same post-World War Two period as biomedicine—adopted a holistic positive concept of health at its founding. i.e., it said that health is the presence of complete well-being (including mental and social well-being) rather than just the absence of disease. This created a direct tension with the core tenets of biomedicine, especially the reduction of disease to a set of concrete observable and measurable physical bases (Valles 2018). Historically, the tension was resolved in the case of the WHO by the organization, shortly after its founding, effectively self-suppressing the use of its own definition of health in favor of pursuing a narrower set of initiatives to combat particular diseases (e.g., the celebrated Smallpox Eradication Program) (Irwin & Scali 2007). This seems to have been in part because cold war politics made it pragmatic to not antagonize the United States with pushing a health concept concerned with “social” well-being, sounding a bit reminiscent of social ism (Irwin & Scali 2007). While a WHO-type understanding of health is in genuine tension with the philosophical tenets of biomedicine, the tension is manageable in this case by simply pursuing areas of overlap between the different conceptions of disease (e.g., investing in infectious disease-control strategies for a population) while ignoring any purported aspects of health beyond the absence of pathologies (e.g., declining to invest in assessing how human-environment relations contribute to a population’s happiness or misery).

3. Epistemology of Biomedicine

There are philosophical disputes happening at the heart of the biomedical enterprise and those disputes offer a means of understanding the epistemological dimensions of biomedicine: the nature of evidence and knowledge in the framework. The most contentious of those internal biomedicine disputes center on what the epistemology of biomedicine ought to be, with the rise of “evidence-based medicine” (EBM) being the event that provoked the largest segment of these disputes. By examining the disputes surrounding EBM, we can gain a better understanding of the epistemology of biomedicine, as illustrated in work such as Solomon’s Making Medical Knowledge (2015).

Evidence-based medicine is a tricky concept, since its name misleadingly raises the question of who is practicing medicine that is not based on evidence (Goldenberg 2006). Instead, the dispute is over which evidence is best and how it ought to be used. For instance, physicians will often advise patients on which home treatments to use for minor lower back pain, with individual physicians varying in which treatments they recommend, even aside from differences in the advice based on differing patient characteristics. Ibuprofen? Acetaminophen? Heat and/or cold compresses? Exercise? The standard twentieth-century medical response would be to let physician groups (including consensus groups convened for this purpose) lay out the options and perhaps use their collective expertise to make a recommendation, but giving great leeway to individual physicians to use their individual accumulated expertise to choose another of the available options seen as viable options by their peers. EBM instead treats this as a matter to be largely decided by empirical research. I.e., we ought to run randomized control trial experiments that compare the efficacy of alternative options by randomly assigning patients with lower back pain into Treatment A or Treatment B —controlling for the single variable—and measure the effects on patients using predetermined metrics (change in reported pain severity, incidence of major side effects, etc.). After doing multiple experiments we can then do a “systematic review and meta-analysis” that compiles the data trends across parallel research studies and helps us build an evidence base for creating guidelines for which treatment clinicians ought to use. Those guidelines dictate the proper default practices, which individual clinicians can contravene if specific individual patient needs are in conflict (e.g., a patient history of not responding well to a certain medication).

EBM began as a self-described Kuhnian scientific revolution of biomedicine—a fundamental change of worldview that is incommensurable with the previous one; a paradigm shift (Evidence-Based Medicine Working Group 1992). The most fundamental dispute between advocates of the EBM movement and skeptics within the biomedical community is, in one sense, over the epistemic and power relationships between the two halves of biomedicine: biology and medicine. In biology, experimental methodologies and attempts to find generalizable population trends are valued highly; in clinical medicine, the single patient and the clinician’s accumulated (and ineffable) expert evaluation of them has long been valued very highly—much attention is paid to that individual patient’s contingencies (the particulars of their body and symptoms), with the clinician’s accumulated knowledge and know how being relied on when determining how to proceed. Evidence-based medicine is not a simplistic adoption of biology principles and their application to medicine; it is not the triumph of biology over medicine in biomedicine. Instead, EBM has helped to draw out deeper disagreements about what it means to do and use biomedical science well.

There is a large philosophical literature on evidence-based medicine, with the first monograph appearing in 2002 (Goodman 2002). Most of the literature takes at least a partially skeptical stance on EBM practitioners’ various hardline stances on evidentiary matters: the suitability of clinicians relying primarily on brief synopses that attempt to synthesize massive bodies of evidence (Borgerson 2009); the room for hidden biases in the process of evaluating medical data (Stegenga 2011), and more. EBM has also inspired passionate disputes among clinicians over how to apply its principles (Berwick 2005; Greenhalgh, Snow, Ryan, Rees, & Salisbury 2015). One line of criticism is that its aims are noble, but have been hijacked by bad actors, namely corporations that learned to that by getting involved in the production of randomized control trial evidence they could sway the evidence for the apparent safety and efficacy of their own products (Ioannidis 2016). Philosophy of EBM is given extensive discussion in the entry on Philosophy of Medicine , and as with the rest of this entry, this entry will avoid needless repetition and keep the focus on biomedicine per se .

Biomedicine is in a state of tension, between

• a history of resolving evidentiary disputes using mechanistic reasoning, consensus, and authority (see, e.g., Solomon [2015] on the roles played by ‘consensus conferences’) vs.
• a recent practice of creating predetermined evidentiary ranking/​evaluating procedures designed to minimize the ability of biased or erratic human judgments to unduly influence the resolution of evidentiary disputes.

Clinical guidelines were once routinely created by what is pejoratively called GOBSAT: Good Old Boys Sat Around A Table (and reached a consensus by talking amongst themselves as leading experts in the subject matter). As Greenhalgh puts it, “it is a major achievement of the EBM movement that almost no guideline these days is produced by GOBSAT!” (Greenhalgh 2014: 7). It remains a point of philosophical contention just how epistemically different it is to generate clinical practice guidelines using a consensus-based model vs. an evidence-based model, in large part since, no matter what evidence is prioritized, a group of experts will ultimately need to interpret the data and make judgment calls on how to generate practical guidelines based on the compiled evidence (Djulbegovic & Guyatt 2019). Though even the meaning of clinical expertise is itself not clearly defined and agreed upon, a matter further complicated by the way that the meaning of expertise is tangled up with views about what roles expertise ought to be playing in clinical practice (Wieten 2018).

Evidence-based medicine prizes certain types of biomedical evidence—highly controlled and systematic evidence—more highly than others. But that preference is a matter of much contention. As noted above, experimental evidence from a randomized experiment testing a treatment (a “randomized control trial”) is held as the best sort of evidence: the gold standard. The one exception is that “meta-analyses” of multiple experimental studies are perhaps a platinum standard better than gold (Stegenga 2011), i.e., the thinking goes that the only evidence that might be better than such experimental data is a rigorous quantitative study rigorously looking for patterns and lessons by analyzing the results many rigorous experimental studies. While the rigidity of EBM thinking gets a great deal of criticism, there are elements of the EBM’s philosophy that implement the sort of pragmatism that many critics desire, such as an epistemic openness in the community to engage in “open-ended critical inquiry” (Goldenberg 2009).

The status of laboratory evidence is a major point of contention in philosophy of biomedicine disputes. “Bench science” is often used as a catchall term in EBM for a wide variety of laboratory evidence (biochemistry, pathology, digital models of drug metabolism, animal studies of a treatment, etc.), and that evidence is pushed to the very bottom of the evidence hierarchy (B. Clarke, Gillies, Illari, Russo, & Williamson 2014). For example, green tea contains epigallocatechin gallate (EGCG), which seems to be effective at killing cancer cells in petri dishes and in mice (Eisenstein 2019). EBM supporters would be inclined to look down on inferences that green tea is therefore a wise anti-cancer home health behavior, until there is at least epidemiological evidence that green tea drinkers genuinely do have better cancer outcomes. Even then, EBM supporters would want to know if the anti-cancer effects are due to EGCG, some combination of multiple components of green tea, or perhaps just the relaxing social act of having a hot beverage. Biomedicine has always valued the sort of research that investigates EGCG in petri dishes, in mice, or other models used on the laboratory bench, but the dispute is over how reliable one takes that research to be for guiding real medical decisions (ought physicians tell patients to drink green tea?).

The problem of how highly to value bench science is distinct from the general objection to hierarchies of evidence (Bluhm 2005). Even if evidence isn’t treated as inherently rankable in value, one key philosophical objection is that much of the biomedical research world is treated by EBM as less important than clinical patient experiments, or meta-analyses of such experimental data. Solomon explains that this position is in tension with a simultaneous trend in biomedicine, an increased concern with translational medicine (an effort to improve the process of moving candidate treatments from (the laboratory) bench to (the patient’s) bedside (Solomon 2011). This effort to better manage the biomedical research enterprise has brought with it,

a restoration of the recognition that clinical research requires an engagement with basic theory (e.g., physiological, genetic, biochemical) and a range of empirical techniques such as bedside observation, laboratory and animal studies. (Solomon 2011: 451)

In an openly conciliatory move, the “EBM+” group of philosophers and clinicians (see Other Internet Sources ), offers a defense of the view that mainstream EBM has erred by essentially relegating mechanistic evidence, such as EGCG having anti-cancer chemical properties, to a subsidiary role (B. Clarke et al. 2014).

While epidemiology-focused EBM is partly in tension with most of the rest of laboratory-focused biomedicine—needing it but seeing it as in service to randomized control trials on patients—both EBM and other branches of biomedicine are united by a valuing of precise measurement. While precise measurement is achievable in the biochemistry lab, the practical and philosophical challenges are thornier when doing measurement at the level of the whole person or the population. What is well-being (Alexandrova 2017)? By what standards can we call a population healthy (Hausman 2015)? What sorts of social structures, policies, and interventions are effective for promoting health (Valles 2018)? How do we identify which subgroups are left out of the benefits and prevent injustices being done to them (Maglo 2010, 2012)? What sorts of values are at stake when we debate biomedical evidence surrounding culturally issues such as birthing practices (McClimans 2017)? A common theme shared by these critiques is a concern about the fickleness and contingency of measurement leaving much room for practitioners’ values and motivations to shape the results of the measurement process, for good or for ill.

The biomedical quest for precise and objective measurements leaves some unsatisfied with the little room left for patient input in clinical care decision-making. What roles are there for patient input in the process of deciding the best course of treatment (Chin-Yee & Upshur, 2018)? According to critiques, by trying to sideline subjective factors in medical care and replace them with increasingly objective factors, EBM especially (even among than other biomedical perspectives), risks losing the humanistic aspects of medicine, an ethical loss and an epistemic loss. By treating patients’ desires, goals, and values as largely irrelevant or a source of interference with an objective process, EBM loses sight of medicine as a means of helping real humans’ real problems. Relatedly, by shutting the patient out of the process, the notion of the best or right treatment becomes hollowed out (McClimans forthcoming).

In the background is the important—and meta-epistemic—problem that physicians are not educated to be comfortable with uncertainty, and what to do in an objective measurement-focused field when one finds oneself lacking the desired evidence: inconclusive tests, treatments designed for patients unlike the one being treated, etc. The very topic of uncertainty is conspicuously absent from medical education (Tonelli & Upshur 2019).

In biomedicine, it appears much of medicine is reduced to applied biology—patients are just biochemical substances processes and medical knowledge is just a complicated form of biological knowledge. Keating and Cambrosio see the relationship between this reductionism in biomedicine (the reducing of medicine to biology) as more a matter of the two being aligned for complex historical and philosophical reasons, instead of that reductionism being philosophically central to biomedicine (Keating & Cambrosio 2003). According to them, after World War Two, the fields of biology and pathology negotiated the creation of “the institutional and epistemic hybrid we call biomedicine,” and neither component of this hybrid rules the other (Keating & Cambrosio 2003, p. 368). They see this as undermining claims of biomedicine being reductionist because such assertions implicitly or explicitly mean that (micro)biology gets epistemic priority because it is the true and stable foundation.

Part of the challenge is that there are multiple varieties of Reductionism in Biology . And there are a number of different reductionism disputes in biology, and the overlaps with biomedicine vary—e.g., Rosenberg’s defense of reductionism in genetics overlaps with biomedicine in the area of medical genetics (Rosenberg 2006). As discussed in Section 1 , it is very difficult to tell the difference between the core components of biomedicine and the bits of philosophy/technology/sociology that aren’t inherently part of biomedicine, but have gotten tangled up in it. The rationale for reductionism in biomedicine is explained with great care by Andersen:

Being able to successfully take a disease as complex as sickle cell anemia or Parkinson’s and reduce it to a single genetic error that cascades through various systems, even if that reduction holds for only a proper subset of cases, illustrates that reduction can be a powerful tool for research and explanation in medicine. It cannot be the only tool in the toolkit, since some diseases or dysfunctions may be only partially reducible, or for which only some cases are reducible. But it is a good working assumption, as Oppenheim and Putnam put it, in tackling a problem with an unknown etiology, to look for ways to reduce it to a few or even a single causal driver at a molecular level (Andersen 2016: 86).

In other words, the potential for success and record of prior successes is an argument for at least operating under the assumption that biomedical scholars ought to continue treating biomedical mysteries as biochemical puzzles for which the relevant pieces have not yet been identified or assembled.

Reductionism in biomedicine has been targeted by some committed critics. For instance, Marcum explains that the process of reducing the body to such component parts yields a vision of the body as machine, a radically dehumanizing move.

From the biomechanical point of view, the patient’s body is often perceived as a material object that can be reduced to a system of physical parts. That body is viewed as a machine composed of individual body parts, which can be fixed or exchanged with new parts, when broken. By reducing the patient’s body to an assemblage of body parts, the patient qua person vanishes (Marcum 2005: 318).

While the critique stands on its own, it remains an open question what other view ought to be adopted if not a reductionist biomechanical one. Marcum contrasts the view most directly to phenomenological views—which will be discussed in Section 5 —arguing that a phenomenological approach is better suited to advancing medicine, which he presents as being in a state of crisis.

EBM’s reliance on randomized control trials as a cornerstone of health data collection doubles down on the general reductionism of biomedicine. Randomized control trials assume that health variables can be observed, manipulated and controlled as largely independent units. Yet, is a well-established problem that we simply don’t know all of the variables that might confound a clinical experiment (Worrall 2007), so randomization can at most hope that the ‘confounders’ (e.g., unknown dietary factors that affect metabolization of a drug) are randomly distributed between the different treatment populations in an experiment. Taking the reductionism a step further, the goal of exactly measuring the differences between Treatment A and Treatment B requires EBM to only look for effects that are precisely measurable in the first place. This limitation is a deeply-rooted problem since even the official list of clinical signs and symptoms of a given disease can diverge from accumulated patient observations, and in cases such as some psychiatric conditions, the symptoms—or lack thereof—are overtly difficult to measure or factor into an assessment of treatment efficacy (e.g., one’s sense of self and/or emotional life) (Kendler 2016).

While reductionist and antireductionist approaches are in direct opposition, it is possible to take a pluralistic stance toward them: both can be welcomed into health science. For instance, this is the position taken by Campaner (2010). Though, as discussed in the next section, the power of the biomedical institution makes it such that biomechanical reductionist approaches can easily overwhelm alternative views.

The disputes over biomedicine’s virtues and flaws are tied to the other aspects of Western cultural-political-economic influence that coevolved with it, and travelled with it around the globe. The dynamics between the institution of biomedicine—rooted in wealthy Western countries—and low/middle-income countries is in part a manifestation of the philosophical complexities of the international political scene. See, for instance, the literature on International Distributive Justice .

As discussed in Section 1.2 , biomedicine co-evolved with the West’s social and economic institutions in the aftermath of World War Two. Of particular importance, the individualism of Western capitalism has meshed with biomedicine’s ontological view of the body as effectively separable from its social context. Briggs and Hallin describe the how contemporary media and biomedicine work to coproduce public knowledge about health and disease, a process they dub biomediatization (Briggs & Hallin 2016).

Metzl and Kirkland’s influential edited volume Against Health: How Health Became the New Morality lays out a related case for how biomedicine exercised undue influence over culture, including casting health ills as personal failings deserving of public shaming and stigmatization (Metzl & Kirkland 2010). As an illustration of the sort of stigmatizing strategies that they condemn as unacceptable, bioethicist Daniel Callahan ethically endorsed the social practice of ‘fat shaming’ as a means of promoting public health (Callahan 2016). Empirical arguments on the harms of stigmatization (Hatzenbuehler, Phelan, & Link 2013), and contrary ethical arguments (Dean 2018), both rebut stigma as an ethically viable health-promoting intervention.

Health/body stigma, public rhetoric over health, and moralism about health behaviors are all subjected to scrutiny in critiques of ‘self-care’ strategies, e.g., telling ‘overweight’/overtired/overworked employees feeling stressed by their jobs that they should take better care of themselves by doing yoga, more closely monitoring their eating at work, etc. The critique is that the biomedical model can recast social problems (including outright abuses—usually capitalist ones) as individual responsibilities. Self-care can go well when it empowers, such as the Women’s Health Movement of the 1960s and 1970s that fought against sexism by calling upon women to know their own bodies and value that knowledge (Bueter 2017). Or self-care can become regressive when it becomes

inner-directed, authoritarian, victim-blaming, manipulated by dominant forces, or diversionary from struggles for radical change in both medicine and the broader society. (Sidel & Sidel 1981: 656)

In recent discourse, in which the problem of stress has garnered increased attention,

controlling the health problems associated with living in stressful situations therefore becomes the responsibility of the individuals—all too often, the responsibility of individuals who are already disadvantaged by their economic status, their race, or their social position more generally. (Kaplan 2019: 116)

Biomedicine has been used as one prong of colonial power dynamics between Western institutions and non-Western peoples (including indigenous peoples) (see Millum & Emanuel 2012). Colonial governments and cultural imperialism have long undermined or directly attacked local/indigenous medical frameworks and institutions. And since biomedical education and practice are based on technologies and education from the West, low- and middle-income countries are left dependent on wealthy Western countries (Nunn 2009). As a result, local would-be biomedical practitioners often travel to the West for biomedical education and then have little incentive to return to their home countries to practice techniques for which they will have relatively few biomedical tools, lower pay, etc. This raises further ethical questions related to which entities have which individual/collective responsibilities to address this so-called ‘brain drain’ trend (Yuksekdag forthcoming). Meanwhile, non-governmental organizations such as the Red Cross offer medical aid, but generally in the form of sending temporary trained personnel from the West, rather than building local capacity for medical training and practice. And well-meaning Western biomedical students travel to the same low- and middle-income countries, with limited biomedical skills and little or no knowledge of the populations or health needs, seeking to help populations assumed to be incapable of helping themselves (Pinto & Upshur 2009).

5. Alternative Frameworks

As noted at the beginning of this entry, critiques of biomedicine tend to focus on elements of biomedicine rather than the whole. There are exceptions to this. This section will review some of the frameworks that have been offered in place of biomedicine, though they vary in how similar they remain to the biomedical framework. Before delving into the alternative frameworks, it is important to discuss two prominent critiques of biomedicine that are influential primarily as holistic criticisms and not so much as sources of alternative visions of what ought to be offered in place of biomedicine.

Michel Foucault ’s work, and use of the concepts biopower and biopolitics, remain touchstones for much of the critical discourse surrounding biomedicine. Foucault’s critique of modern medicine is part of a career critiquing other aspects of modernity, including the related topic of psychiatry. His famous work The Birth of the Clinic is written as a history, though in the process it highlighted aspects of biomedicine that other scholars went on to critique as well, either based on his critique or in parallel to it: dehumanization, reductionism, measurement and observation methods of dubious value, and the problem of the biomedicine’s institutional power (Foucault 1963 [2002]).

Ivan Illich’s Medical Nemesis is perhaps the most influential critique of biomedicine (Illich 1976). It combines critiques of (bio)medicine for failing at its own goals (iatrogenic disease—harms caused by medical treatment—are a large component) and for having the wrong goals in the first place (he valorizes death, disease, and pain as proper components of the human experience rather than enemies to be automatically and constantly opposed).

“Complementary, alternative, or integrative medicine” is biomedicine’s ‘big tent’ category for non-biomedical systems of health care (see NCCIH in Other Internet Resources ). Philosophers have pointed out that biomedicine, specifically evidence-based medicine, puts advocates of such non-biomedical systems into a no-win position. One such philosophical challenge is that some of the claims made by non-biomedical systems are claimed to be non-measurable experiences, e.g., the experience of Qi life force in traditional Chinese Medicine (Tonelli & Callahan 2001). This means that advocates have to either submit to the epistemological framework of biomedicine (which may be incapable of assessing some of the effects claimed to exist), or refusing to play by medicine’s rules and hence being dismissed by as quackery by biomedicine. Epistemically, it seems like the latter option is the better option, but it would require advocates to “work to develop new research designs and new standards of evidence that reflect their approach to medical care” (Borgerson 2005: 502).

Classical Chinese Medicine (CCM) remains practiced in communities around the world, and Lee draws out two core philosophical differences between CCM and biomedicine. First, CCM has

a process ontology—it considers causal relationships between events and processes to be foundational, rather than things. Furthermore, it implies complex causal relationships between events and processes which may be said to be multi-factorial and non-linear. (Lee 2017: 2)

Second, it is holistic

the universe and everything in it, including human beings, constitute wholes which are different from the sum of their parts, and which in turn are related and as well as inter-related with other wholes. (Lee 2017: 2)

It is within this philosophical system that treatments such as acupuncture and herbal/dietary remedies are used. While the gulf between biomedicine and CCM is wide, it is not entirely dissimilar from some Western scientific practices: CCM’s approach to health and the human body bear some resemblances to the ways that epidemiologists approach populations’ health and how ecologists approach ecosystems. Among other similarities, in both fields there is great respect for balance and dynamic interconnected processes (Lee forthcoming).

Ayurvedic medicine takes a somewhat similarly holistic and balance-oriented approach to the person and their health (Rastogi, 2014) (note also that holistic bodily balance is central to the Hippocractic medicine described in Section 1.2 ). One way that manifests in Ayurvedic practice—in contrast with biomedicine—is that the biological characteristics of two individuals might be similar but their recommended treatments might be quite different. For instance, while biomedicine routinely hands out standardized advice on what sorts of foods are best for someone of a given age and sex, Ayurvedic medicine rejects the assumption that such standardization within a single age-sex grouping is even a good default. Other factors play larger roles than in biomedicine, including bodily changes over the course of the day and one’s (internal) body type (affecting how one metabolizes specific foods, etc.). Complicating matters is that Ayurvedic medicine grew as a part of Hinduism in South Asia, and Hinduism itself is a substantially heterogeneous family of beliefs/practices that vary between communities (Desai 1988).

Among the numerous humanistic critiques of biomedicine, coming from the broad field of medical humanities (for an overview, see Marcum 2008), philosophers have paid particular attention to narrative and phenomenology (Ferry-Danini 2018).

Narrative medicine offers a revision to the biomedical model alternative based around the centrality of the story or narrative in human life (Charon 2006). This notion that narrative is central to human experience offers a variety of potential operationalizations in clinical biomedical practice. For instance, it places additional value on the patient consultation and asks for improved active listening skills among clinicians, who must learn to elicit, receive, and understand patients’ stories about their health conditions. Such listening has many potential benefits, including the potential to understand the meaning(s) of what human dignity means for a given patient, an important benefit given that biomedical settings are known for being “dehumanizing” (Parsons & Hooker 2010). Though, the proposition that humans are indeed narrative beings has itself been disputed (Woods 2011).

As shown by Carel, phenomenology’s value to medicine comes from its insistence on taking illness seriously (Carel 2016).

…we must enlist philosophical analysis in order to fully appreciate the existential transformation illness brings about. This transformation cannot be accounted for as merely physical or mental (in the case of psychiatric disorder) dysfunction. Rather, there is a need for a view of personhood as embodied, situated, and enactive, in order to explain how local changes to the ill person’s body and capacities modify her existence globally (Carel 2016: 14).

Biomedicine takes illness seriously, but the philosophical framework of biomedicine leaves no space for the notions of existential transformation as part of illness—disease is reduced to the state of a system in which there are malfunctioning parts (pathologies in body parts). See also the discussion of phenomenology in Section 3.4 .

Stegenga has argued in favor of “gentle medicine,” a conservative treatment mindset that stands in contrast to the biomedical pursuit of ever-more interventions (Stegenga 2018)—a pill for each ailment. This is in one sense a challenge to biomedicine more in quantity than in quality; he does not advocate for switching from pills to naturopathic diet-based treatments. He recommends this (purportedly gentler) conservatism as a response to an epistemic devaluing of biomedicine knowledge which he calls: “medical nihilism…the view that we should have little confidence in the effectiveness of medical interventions” (Stegenga 2018: 1). This follows in the loose tradition of other writings, such as the text by Illich discussed at the start of Section 5 (Illich 1976). But Stegenga’s critique and replacement remains a radical challenge to biomedicine in the sense that it undercuts the epistemic practices of biomedicine and pushes back on the institutional practices (and the related infrastructure, including massive pharmaceutical companies) by arguing that (bio)medical treatments ought to be applied sparingly.

Valles offers an alternative—the population health framework—that partly meshes with Stegenga’s concluding suggestion that “gentle medicine” ought to be accompanied by interventions that refocus health promotion efforts on social determinants of health, including “clean drinking water, better nutrition, and greater socio-economic equality” (Stegenga 2018: 198). Valles expounds and defends the merits of the population health framework, a view developed in response to frustrations with biomedicine that coalesced in the 1990s in Canada as an alternative theoretical framework, before expanding internationally (Evans, Barer, & Marmor 1994; Valles 2018). The population health framework is not nihilistic about medical care, but rather seeks to decenter medicine and healthcare in the overall pursuit of health; most of the problems and most promising solutions to ill health lay outside the scope of biomedicine (safer workplaces, an end to racist housing discrimination, neighborhoods where people can safely walk, socialize and play, etc.) (Valles 2018).

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How to cite this entry . Preview the PDF version of this entry at the Friends of the SEP Society . Look up topics and thinkers related to this entry at the Internet Philosophy Ontology Project (InPhO). Enhanced bibliography for this entry at PhilPapers , with links to its database.

• NCI (National Cancer Institute), “ Biomedicine ”, in NCI Dictionary of Cancer Terms , accessed 12 March 2020.
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disability: definitions and models | Foucault, Michel | health | justice: international distributive | medicine, philosophy of | Merleau-Ponty, Maurice | phenomenology | physicalism | reduction, scientific: in biology

Acknowledgments

I am indebted to Robyn Bluhm and Maya Goldenberg for their helpful comments on a draft of this work.

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What is biomedicine?

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Modern western scientific medicine is often called "biomedical" because it explains health in terms of biology. It attaches importance to learning about body structure (anatomy) and systems (physiology), in particular to understanding mechanisms like the heart, arteries, nerves, brain and so on.

Health is seen as a state where all the parts of the body function normally, like a new repaired car. If bits go wrong—if the body is struck down by a virus, internal changes damage it, or parts wear out—it goes in for repair by specialists. This view offers a particular and distinctive way of ‘seeing’ and understanding bodies and health, a set of guidelines about relating to them and dealing with them—to look after them as systems which need care and proper maintenance by their owners.

So a biomedical account is one which gives a physical or biological explanation for health, and offers physical/biological methods for ‘repairing’ bodies when they are not working correctly. Certain tests establish what is wrong. Then antibiotics or other medicines act as a cure, or surgery can repair or replace body parts. The biomedical model is an integral part of western cultures and the way health and healthcare are perceived. It is, in many instances, an efficient and effective model of healthcare (consider broken legs, tumours, tuberculosis, slipped discs and a host of other illnesses or physical problems).

People’s views of their health, how it can be maintained and the appropriate action to combat illness when it is identified are, of course, individual. However, individual understandings emerge partly from wider historical and cultural patterns and trends. It is therefore worth reflecting on how the biomedical way of conceptualising health has come to dominate in the West.

Biomedicine, public health and germ theory

With the rise of biomedicine came greater knowledge about the causes of infectious diseases. With greater urbanisation during the Industrial Revolution came widespread disease, which led to the public health movement. The key tenet of public health theories, of whatever type, was (and is) that health and disease arise from the relationship of individuals and populations with their natural or manufactured environment, and that the promotion of health and wellbeing requires intervention to modify or transform that environment.

In the late nineteenth century, however, the significance of public health theory was challenged by the germ theory of disease which suggested that disease was caused by bacteria, and that a specific micro-organism would be present in every case of a particular disease. Most medical research was by now being done within a dominant scientific paradigm. Germ theory was derived from nineteenth century microscopic research by Louis Pasteur and Robert Koch, among others. Pasteur demonstrated the existence of micro-organisms, which could be killed by sterilisation and the exclusion of ‘impure air’, or made to multiply rapidly in suitable media. Koch succeeded in isolating the anthrax bacillus, growing it in culture, and proving by experiment that its spores could reproduce rapidly even after a long delay, when conditions became favourable. This provided the other principles: that the micro-organism should be able to be grown outside its host, and should still be capable of producing the disease again in the host body.

Germ theory resulted in an enhanced status for laboratory science, and for hospital medicine and surgery. Laboratory scientists such as Louis Pasteur, Marie Curie, James Lister and Robert Koch could isolate and classify bacteria; medical people could use this knowledge to diagnose more accurately and operate more safely. Germ theory focused attention on the specific aetiology and the immediate cause of disease. It also focused attention on the individual and on interpersonal contact, rather than on the significance of the wider social environment in promoting health. Within the public health field, greater attention was given to personal hygiene and to educating working-class women in mothering skills. Germ theory reinforced the official attack on personal filth—spitting, lice, scabies, dirty bodies—but provided no commentary on the social conditions which made such problems widespread in poorer districts.

Germ theory and laboratory science remain important today as doctors rely more and more on laboratory testing to help them diagnose and monitor specific conditions or diseases. However, specific aetiology (that is, the same micro-organism causing the same illness) became increasingly open to question by the mid-twentieth century as scientific research revealed the significance of co-factors, host state, as well as invading organism. In the 1970s Engel called for a ‘new medical model’ which emphasised multi-causality. Research into AIDS, for example, has produced theories which emphasise multiple causes.

Biomedicine has been a dynamic model and played a hugely important part in people’s understandings of health and illness and (perhaps for a majority of people in the UK today) their compliance with the system that supports biomedicine. Proponents of biomedicine suggest that it stands with many fantastic accomplishments: the reduction of high mortality rates such as those found in childhood in the earlier part of the twentieth century, and the eradication of some of the major killers, such as smallpox, polio etc. However, an opposing argument has been put forward that mortality has been dramatically reduced during the past century because of improved housing and working conditions and particularly improved nutrition, rather than because of any particular preventive or biomedical measure, such as immunisation or the widespread use of antibiotics. Whereas biomedical discourse tends to focus our attention on medical advances and interventions at an individual level, others might wish to emphasise links between the total environment and health.

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Module 1 Introduction to Health Psychology

What is biomedicine.

Biomedicine  (also referred to as  Western medicine ,  mainstream medicine  or  conventional medicine ) [1]  is a branch of  medical science  that applies biological and physiological principles to  clinical practice . Biomedicine stresses standardized, evidence-based treatment validated through biological research, with treatment administered via formally trained doctors, nurses, and other such licensed practitioners.  [2]

Biomedicine also can relate to many other categories in  health  and biological related fields. It has been the dominant system of medicine in the  Western world  for more than a century. [3] [4] [5] [6]

Biomedicine is the cornerstone of modern  health care  and  laboratory diagnostics . It concerns a wide range of scientific and technological approaches: from  in vitro diagnostics [7] [8]  to  in vitro fertilisation , [9]  from the molecular mechanisms of  cystic fibrosis  to the population dynamics of the  HIV   virus , from the understanding of molecular interactions to the study of  carcinogenesis , [10]  from a  single-nucleotide polymorphism  (SNP) to  gene therapy .

Biomedicine is based on  molecular biology  and combines all issues of developing  molecular medicine [11]  into large-scale structural and functional relationships of the  human  genome ,  transcriptome ,  proteome ,  physiome  and  metabolome  with the particular point of view of devising new technologies for prediction, diagnosis and therapy  [12]

Biomedicine involves the study of ( patho -)  physiological  processes with methods from  biology  and  physiology . Approaches range from understanding  molecular interactions  to the study of the consequences at the  in vivo  level. These processes are studied with the particular point of view of devising new strategies for  diagnosis  and  therapy . [13] [14]

Depending on the severity of the disease, biomedicine pinpoints a problem within a patient and fixes the problem through medical intervention. Medicine focuses on curing diseases rather than improving one’s health. [15]

In social sciences biomedicine is described somewhat differently. Through an anthropological lens biomedicine extends beyond the realm of biology and scientific facts; it is a  socio-cultural  system which collectively represents reality. While biomedicine is traditionally thought to have no bias due to the evidence-based practices, Gaines & Davis-Floyd (2004) highlight that biomedicine itself has a cultural basis and this is because biomedicine reflects the norms and values of its creators. [16]

The  medical model of disability , or medical model, arose from the biomedical perception of  disability . This model links a disability diagnosis to an individual’s physical body. The model supposes that this disability may reduce the individual’s  quality of life  and the aim is, with medical intervention, this disability will be diminished or corrected. [1]

The medical model focuses on curing or managing illness or disability. By extension, the medical model supposes a “compassionate” or  just  society invests resources in health care and related services in an attempt to cure or manage disabilities  medically . This is in an aim to expand functionality and/or improve functioning, and to allow disabled persons a more “normal” life. The  medical  profession’s responsibility and potential in this area is seen as central.

Before the introduction of the  biomedical model , patients relaying their narratives to the doctors was paramount. Through these narratives and developing an intimate relationship with the patients, the doctors would develop treatment plans in a time when diagnostic and treatment options were limited. [2]  This could particularly be illustrated with aristocratic doctors treating the elite during the 17th and 18th century. [3]

In 1980, the  World Health Organization  (WHO) introduced a framework for working with disability, publishing the “International Classification of Impairments, Disabilities and Handicaps.” The framework proposed to approach disability by using the terms Impairment, Handicap and Disability. [4]

• Impairment = a loss or abnormality of physical bodily structure or function, of logic-psychic origin, or physiological or anatomical origin
• Disability = any limitation or function loss deriving from impairment that prevents the performance of an activity in the time lapse considered normal for a human being
• Handicap = the disadvantaged condition deriving from impairment or disability limiting a person performing a role considered normal in respect of age, sex and social and cultural factors

Components and usage

While  personal narrative  is present in  interpersonal interactions , and particularly dominant in Western Culture, personal narrative during interactions with medical personnel is reduced to relaying information about specific symptoms of the disability to medical professionals. [1]  The medical professionals then interpret the information provided about the disability by the patient to determine a diagnosis, which likely will be linked to biological causes. [1] [2]  Medical professionals now define what is “normal” and what is “abnormal” in terms of biology and disability. [3]

In some countries, the medical model of disability has influenced legislation and policy pertaining to persons with disabilities on a national level. [5] [6]

The  International Classification of Functioning, Disability and Health  (ICF), published in 2001, defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (such as cerebral palsy, Down syndrome and depression) and personal and environmental factors (such as negative attitudes, inaccessible transportation and public buildings, and limited social supports). [7]

The altered language and words used show a marked change in emphasis from talking in terms of disease or impairment to talking in terms of levels of health and functioning. It takes into account the social aspects of disability and does not see disability only as a ‘medical’ or ‘biological’ dysfunction. That change is consistent with widespread acceptance of the  social model of disability

The medical model of disability focuses on the individual’s limitations and ways to reduce those impairments or use adaptive technology to adapt them to society. Current definitions of disability accept biomedical assistance but focus more on factors causing environmental and social exclusion. Uncritical reliance on the medical model produces unwanted consequences.

Among advocates of  disability rights , who tend to subscribe to  the social model  instead, the medical model of disability is often cited as the basis of an unintended social  degradation  of disabled people. Resources are seen as excessively misdirected towards an almost-exclusively medical focus when those same resources could potentially be used towards things like  universal design  and  societal inclusionary practices . This includes the monetary and societal costs and benefits of various interventions, be the medical, surgical, social or occupational, from  prosthetics , drug-based and other “cures”, and medical tests such as genetic screening or  preimplantation genetic diagnosis . According to disability rights advocates, the medical model of disability is used to justify large investment in these procedures, technologies and research, when adaptation of the disabled person’s environment could potentially be more beneficial to the society at large, as well as financially cheaper and physically more attainable.

Also, some disability rights groups see the medical model of disability as a  civil rights  issue and criticise  charitable organizations  or medical initiatives that use it in their portrayal of disabled people, because it promotes a  pitiable , essentially negative, largely  disempowered  image of people with disabilities rather than casting disability as a political, social and environmental problem (see also the  political slogan  “ Piss On Pity “).

• Biomedicine. Provided by : Wikimedia, inc. Located at : https://en.wikipedia.org/wiki/Biomedicine . License : CC BY-SA: Attribution-ShareAlike
• Biomedical Model. Provided by : Wikimedia,inc. . Located at : https://en.wikipedia.org/wiki/Medical_model_of_disability . License : CC BY-SA: Attribution-ShareAlike

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• Research article
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• Published: 21 February 2014

Biological health or lived health: which predicts self-reported general health better?

• Cristina Bostan 1 , 2 ,
• Cornelia Oberhauser 3 ,
• Gerold Stucki 1 , 2 ,
• Jerome Bickenbach 1 , 2 &
• Alarcos Cieza 2 , 3 , 4  

BMC Public Health volume  14 , Article number:  189 ( 2014 ) Cite this article

4444 Accesses

16 Citations

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Metrics details

Lived health is a person’s level of functioning in his or her current environment and depends both on the person’s environment and biological health. Our study addresses the question whether biological health or lived health is more predictive of self-reported general health (SRGH).

This is a psychometric study using cross-sectional data from the Spanish Survey on Disability, Independence and Dependency Situation. Data was collected from 17,739 people in the community and 9,707 from an institutionalized population. The following analysis steps were performed: (1) a biological health and a lived health score were calculated for each person by constructing a biological health scale and a lived health scale using Samejima’s Graded Response Model; and (2) variable importance measures were calculated for each study population using Random Forest, with SRGH as the dependent variable and the biological health and the lived health scores as independent variables.

The levels of biological health were higher for the community-dwelling population than for the institutionalized population. When technical assistance, personal assistance or both were received, the difference in lived health between the community-dwelling population and institutionalized population was smaller. According to Random Forest’s variable importance measures, for both study populations, lived health is a more important predictor of SRGH than biological health.

Conclusions

In general, people base their evaluation of their own health on their lived health experience rather than their experience of biological health. This study also sheds light on the challenges of assessing biological health and lived health at the general population level.

Peer Review reports

Self-reported general health (SRGH) is the most widely used measure of health in both population and clinical health surveys and the most frequent tool for health comparisons between populations. A Medline literature search showed that in the year 2002, 1,991 scientific papers were published using this question [ 1 ]. Most of these studies relied on the standard ‘In general, how would you rate your health?’ question answered on a five-point Likert-type scale: very bad, bad, fair, good, very good, or poor, fair, good, very good, excellent. This question is also included in widely-used questionnaires, such as the Short-Form 36 [ 2 ] and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [ 3 ].

The studies using SRGH usually belong to one of two types: SRGH is used either as a predictor of specific health outcomes, such as mortality [ 4 , 5 ], social-psychological well-being [ 6 , 7 ], morbidity [ 8 , 9 ] and health care utilisation [ 10 ], or as an outcome of other factors such as medical diagnoses, physical symptoms and functioning [ 11 ], social role activities, social relationships [ 12 ] and emotional factors [ 13 ].

SRGH is not, however, an approach to measuring health that fits all purposes. Salomon et al . [ 14 ] claim that SRGH may not be suitable for tracking changes in population health over time and for comparing the level of health of subpopulations.

We claim in this paper that one reason to question the validity of SRGH for tracking health over time and for cross-population comparability involves the different meanings of health that respondents have in mind when answering the SRGH question.

To test what respondents have in mind when answering the SRGH question, qualitative studies are a good place to begin. These studies scrutinize what respondents are thinking about when answering. Some of these studies have already shown that SRGH is a multidimensional construct and that the perception of health is determined not only by the presence or the absence of health problems (that is, biological health), but also by one or more of the following factors: (1) functional factors - the extent to which people are able to perform actions and tasks; (2) coping factors - the person’s level of adaptability, or his or her attitudes towards the health condition, and (3) wellbeing factors - their emotions or feelings [ 15 ]. These qualitative studies also suggest that it is very important to anchor the assessment of SRGH to age, gender and time [ 15 , 16 ].

Bearing in mind the value of these studies, the question we wish to answer in this investigation is whether we can psychometrically study what respondents have in mind when answering the SRGH question. To address this question we will use the conceptual basis of the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO) [ 17 ]. According to the ICF model the construct of capacity reflects the intrinsic features of a person to do an action or execute a task independent of the positive or negative influence of the person’s physical, attitudinal or social environment. The construct of performance, on the other hand, refers to health in terms of what one’s level of capacity in different functioning domains allows us to do in life, taking full account of the impact, positive or negative of one’s environment, such as the assistive devices one may use. Health in the sense of capacity is what we mean by ‘biological health’ and performance is what we mean by ‘lived health’. The ICF provides the best framework to describe and measure people’s limitations and restrictions and was explicitly not intended to measure quality of life understood as how people feel about these limitations and restrictions.

For this investigation, we selected a population-based study, namely the 2008 Spanish National Disability Survey. We selected this study because it captured both the concepts of biological health and lived health, making it possible for us answer the question whether SRGH is more related to one or the other. The questionnaires used for this survey contained the SRGH question as well as questions about the extent of problems in different domains of functioning, with and without assistive devices or personal assistance. We believe that the extent of problems in domains of functioning without any aids or personal assistance captures biological health, whereas questions about the extent of problems in the same domains but taking into consideration personal or technical assistance addresses the concept of lived health. The aim of this study is, again, to determine whether biological health or lived health is more predictive of SRGH.

Study design and participants

This is a psychometric study using cross-sectional data from the Spanish National Disability Survey from 2008 (Survey on Disabilities, Independence and Dependence Situations - EDAD). This survey included two residence-based population samples, one community-dwelling and the other institutionalized. The 2008 EDAD design has been described previously [ 18 ]. Data was only collected for people who fulfilled the disability criterion of having ‘important limitations to carrying out everyday activities that have lasted, or are expected to last, more than one year, and whose origin is an impairment in one of the following eight domains: seeing, hearing, communication, learning and application of knowledge and development of tasks, mobility, self-care, home life, interactions and interpersonal relationships .

Forty-two questions were used to assess the level of difficulty in carrying out activities without any technical aid or personal assistance. In our judgment, these are questions about a person’s biological health. Thirty-one questions assessing the level of difficulty in most of the same activities but taking into account any kind of technical aid or personal assistance were also asked. These we judged to be lived health questions. The ordinal scale used to assess the limitation level consisted of the following response options: 1 = Without difficulty or with little difficulty; 2 = With moderate difficulty; 3 = With severe difficulty and 4 = Cannot carry out the activity.

When people did not use technical assistance or have personal assistance, only the question about the level of difficulty ‘without’ was asked. Additional questions about medical conditions, diagnosis, professional life, education, discrimination, social contacts, accessibility and main caregivers were also asked. The SRGH level was collected using the five point scale, with response options: very bad, bad, fair, good, very good.

Data analysis

The questions referring to vision and hearing were not considered because no differentiation was made between with and without assistive devices or personal assistance. Furthermore, only people that had a difficulty in at least one of the remaining biological health questions were included in the analyses. As a result, 17,739 people from the community-dwelling and 9,707 from the institutionalized population were kept in the analyses.

We used descriptive statistics to present the characteristics of both study populations, taking sampling weights into account. The response options ‘With moderate difficulty’ and ‘With severe difficulty’ in both biological health and lived health questions showed a low frequency. Thus, we collapsed them into a single option called ‘with moderate/severe difficulty’.

To answer the question whether biological health or lived health is more predictive of SRGH, we (1) calculated a biological health and a lived health score for each person by constructing a biological health scale (BHS) and a lived health scale (LHS) using the Item Response Theory (IRT) Model called Samejima’s Graded Response Model (GRM); and (2) calculated the variable importance measures using Random Forest with SRGH as the dependent variable and the biological health score and lived health score as independent variables.

For step one, three specific steps were followed:

We evaluated the assumptions of Item Response Theory (IRT) - unidimensionality, local independency and monotonicity - separately for biological health and lived health questions to find out whether IRT could be used for our data. Unidimensionality was examined with bifactor analysis with the analytic bifactor rotations [ 19 , 20 ]. Local independency was tested by examining the residual correlations among questions in one-factor model confirmatory factor analysis [ 21 ]. We estimated GRM with and without the flagged local dependent questions (residual correlations higher than 0.2) to see if results were robust to question dependencies [ 22 ]. Monotonicity was studied by examining graphs of the question mean scores conditional on ‘rest-scores’ (i.e. total raw scale score minus the question score). Questions that failed one of these three assumptions were not considered in the final model [ 23 ].

Biological health questions and lived health questions that satisfied the IRT assumptions were used to create a BHS and a LHS using GRM [ 24 ].

Biological health questions and lived health questions were tested for differential item functioning (DIF) for study population (institutionalized and community-dwelling), gender (male and female), age groups (≤65 and >65) and reported number of health conditions groups (0, 1-2 and >2) using iterative hybrid ordinal logistic regression with change in McFadden’s pseudo R-squared measure (above 0.02) as DIF criterion [ 25 , 26 ]. Questions showing DIF were calibrated separately for each of the groups showing DIF and after DIF correction final GRMs were calculated. Based on the resulting biological health question parameters and lived health question parameters, a summary score of biological health and a summary score of lived health for each of the individuals in the sample were calculated. For a more intuitive summary score for the biological health or lived health of individuals, we transformed the resulting scores into more meaningful values, ranging from 0 (best biological health or lived health) to 100 (worst biological health or lived health). For both study populations, the relation between biological health and lived health was studied using the Pearson correlation analysis.

For step two, for each of the community-dwelling and institutionalized data sets, we (1) studied the association between biological health scores, lived health scores and SRGH by using Spearman correlation coefficient (r S ) and box-plots which displayed the distribution of biological health scores and lived health scores in each of the five SRGH response options; and (2) compared the importance value of the biological health score with that of the lived health score obtained from Random Forest regression with 1000 trees and mtry = 2, where 2 means the number of randomly preselected independent variables, which in Random Forest are called split variables. The Random Forest regression provides an improved prediction accuracy compared to other regression techniques (e.g. logistic or linear regression) because it deals with the collinearity and the main and interaction effects of independent variables. The variable importance measure is the average of the frequency with which the independent variables (biological health and lived health) appear in all 1000 trees calculated to predict the dependent variable (SRGH) over all 1000 trees. It takes values from 0 to 1, the higher the value, the better the prediction of SRGH. The permutation importance was computed with the conditional permutation scheme proposed by Strobl and colleagues, which controls for the correlation of the predictor variables [ 27 ].

All the analyses were performed with R version 2.15.1 [ 28 ].

Characteristics of both study populations are presented in Table  1 . In both study populations around 60% were female. Most of the institutionalized people were aged more than 65 years (82%). The percentage of respondents reporting very good or good health is 38.2 in the institutionalized and 20.7 in the community-dwelling population.

Table  2 shows the biological health and lived health questions considered for BHS and LHS, respectively.

Biological health and lived health scores

Irt assumptions, unidimensionality.

For both BHS and LHS the bifactor analyses supported the assumption of a strong general factor, with all questions loading highly on the general factor. However, questions from the mobility domain of LHS and questions from the communication domain and learning and application of knowledge and development of tasks domain of LHS loaded higher on their respective group factors than on the general factor. We decided to proceed with unidimensional BHS and unidimensional LHS, since these domains are contributing to biological health and lived health, respectively. We checked our decision by estimating the GRMs both with and without mobility for BHS and communication and learning and application of knowledge and development of tasks for LHS and analyzed the correlation between the item thresholds for the two models each. The results showed that our decision did not affect the results.

Local independency

While the examination of the residual correlations of biological health questions indicated violation of local independency in five groups of questions, the results for lived health questions revealed violation in six. Table  2 shows the local dependent questions as well as the questions considered in the final models.

Monotonicity

The monotonicity IRT assumption was satisfied by most of the biological health and lived health questions, with the exception of the questions: ‘With what level of difficulty would you say are you able to carry out activities related to menstrual care?’ and ‘With what level of difficulty would you say are you able to drive vehicles?’.

Differential item functioning

Table  3 presents the biological health and lived health questions included in the BHS and LHS respectively and their parameter estimates (discrimination and threshold parameters) for the final GRM models. While for BHS 6 questions showed DIF for study population and 11 questions for age groups, for LHS 7 questions showed DIF for study population, and 4 for age groups. All questions of the BHS and of the LHS were free of DIF for gender and number of health conditions.

Biological health scale and lived health scale

The most discriminating biological health question was ‘initiate and maintain intimate or sexual relations’ in the community-dwelling old age group (with a discrimination of 4.97). This means that this question differentiates well between people with high and lower difficulties in biological health in the old age group. The least discriminating question was ‘walk or move outside the home’ (with a discrimination of 0.62). For LHS, the most discriminating question was ‘carry out housework’ (with a discrimination of 4.25); the least discriminating was ‘speak intelligibly or utter coherent phrases’ in the community-dwelling young-age group (with a discrimination of 0.91). While the question for which only those individuals in the worst biological health are expected to have median difficulties is ‘hold a gaze or pay attention when listening’ (with a threshold of 2.55 on the logit scale), the question for which individuals in the worst lived health are expected to have high difficulties is ‘speak intelligibly or utter coherent phrases’ in the community-dwelling young-age group (with a threshold of 3.80).

On a scale from 0 (best biological health) to 100 (worst biological health), the levels of biological health are higher for community-dwelling (mean = 31.07, standard deviation = 21.22, range = [0; 98.96]) than for institutionalized population (mean = 48.86, standard deviation = 23.54, range = [0; 100]). When technical assistance, personal assistance or both was received, the difference between community-dwelling (mean = 31.94, standard deviation = 20.72, range = [0; 100]) and institutionalized populations (mean = 36.75, standard deviation = 22.69, range = [2.09; 93.22]) was smaller. The biological health score and lived health score are not comparable since they were calculated based on two separate sets of questions.

For both study populations the Pearson correlation between biological health and lived health was high: 0.79 for community-dwelling population and 0.85 for institutionalized population.

Conditional permutation importance of biological health and lived health scores

For both community-dwelling and institutionalized populations the association between SRGH and lived health scores (community dwelling: r S  = 0.33, institutionalized: r S  = 0.36) was higher than the association between SRGH and biological health scores (community dwelling: r S  = 0.23, institutionalized: r S  = 0.30). The relation between SRGH and biological health scores and lived health scores is displayed in Figure  1 .

Box-plot showing the distribution of biological health scores and lived health scores in each of the five SRGH response options (1 = very good, 2 = good, 3 = fair, 4 = bad, 5 = very bad).

The resulting importance measures of the two predictors (biological health score and lived health score) of SRGH are displayed in Figure  2 . For both samples, the lived health score showed the higher variable importance and therefore was a better predictor of SRGH than the biological health score.

Conditional permutation importance of biological health and lived health scores as predictors of SRGH by study population. The higher the value, the better the prediction of SRGH.

Comparing the predictive value for SRGH of biological health and lived health in a psychometric space is the first step towards a true understanding of what people are thinking about when rating their general health. Our study showed that people base their evaluation of their health, not on their biological state, but on their lived experience of their health. This is an important result because it implies that any kind of intervention that targets population health should address, not merely the intrinsic capacity of a person, but also his or her environment.

We are not aware of studies reporting on the comparison of predictive power of biological health and lived health on SRGH. Yet, our finding is similar to, and confirms the Smith et al. [ 29 ] conclusion that ‘sickness is a social role in addition to biological state’ and that SRGH ‘is not a continuum of biological states’. As Jylhä [ 30 ] suggested, the response to SRGH is influenced not only by ‘earlier health experiences, present health conditions’, but also by the health-related environment.

Bifactor analyses of biological health questions and lived health questions supported the construction of BHS and LHS, in terms of the contribution of questions to a single common dimension. The presence of an underlying factor that links domains of functioning commonly used to operationalize biological health and lived health helped us to quantify both biological and lived health as a single number, which facilitated comparability between people’s abilities from the two study populations. Our results with respect to BHS and LHS are also concordant with other findings [ 31 ].

The GRM IRT modelling was used to assess the levels of biological health and lived health. The primary advantage of using an IRT model is that it allows for an estimation of biological health and lived health independent of the set of test questions administrated [ 32 ]. For BHS, this makes it possible for us to consider questions that addressed domains of functioning that were not addressed by lived health questions.

The different gradients captured in the developed BHS and LHS - study population and age - support the validity of both scales. However, there is a large number of lived health questions showing DIF. One possible explanation is that institutionalized people receive constant support from hospital personal. This is not the case in the community-dwelling population. In fact more than half of the community-dwelling population did not benefit from personal help. For the age groups, the DIF could be explained by the use of a cut-off of 65 years, which was available in both populations and was in line with others studies that showed that SRGH is worse after an age of 65 years in the Spanish population [ 33 ].

For both study populations, the Spearman correlation analysis showed that there is a stronger association between lived health and SRGH than between biological health and SRGH. Since correlation analysis is not a full proof of the strength of biological health and lived health to cause the answer to the SRGH, the regression analysis was used. The causal chain results from the correlation analysis: biological health - > lived health - > SRGH. This implies that linear regression with SRGH as a dependent variable and biological health and lived health as independent variables would have a coefficient zero for biological health, i.e. conditional on lived health, biological health is not contributing anything to predict SRGH. The results of qualitative studies showed that some people will disagree that biological health is unimportant to SRGH, therefore we used the optimal solution of overcoming the structural relation between the variables, namely Random Forest regression and the variable importance measures. Certainly, the causal chain indicates that both biological health and lived health are important factors to consider when people rate their health. However, using the Random Forest regression informs us that it is enough to measure lived health for predicting SRGH.

Strengths and limitations

The most important strength of this study was its large nationally representative Spanish sample. Yet, it is significant that this sample is only representative of persons with limitations in functioning and not the general population. This is because the design of the 2008 EDAD used a representative Spanish sample as starting point but only obtained more detailed information about lived health from the subpopulation with limitations in biological health. Thus, our results are not generalizable to the entire Spanish population. There were additional limitations. First, more aspects of the environment that affect the experience of health in everyday life should be considered in addition to personal support and technical aids. Secondly, an artificial cut-off was set, in the sense that only what was considered larger than or equal to moderate difficulty could be rated as ‘moderate’, ‘severe’ or ‘cannot carry out the activity’. We had to assume that people answering ‘no difficulty’ were those who either had no or little difficulty, and in any event did not have a severe enough problem to rate it as moderate. We also had to collapse the response options ‘moderate’ and ‘severe’ difficulty because of the skewed distribution towards complete limitation of the response options.

Our study showed that people base their evaluation of health on their lived health experience rather than their experience of biological health. This result needs to be confirmed and supported by further studies before conclusions can be drawn and practical implications proposed to improve health policy. However, since SRGH can predict the use of health services [ 34 ], our study result points to the need on the part of health service personnel and decision makers to consider lived health when they develop and implement health promotion programs or select study outcomes. People with health problems are handed over to health professionals, and this creates an important responsibility. The decisions of health professions should take into account the fact that their patients may be less concerned to know medical facts and more interested in how their health affects everything that they do in their lives. Further research is necessary to determine whether lived health rather that SRGH could be considered when health professionals track health changes over time and for health cross-population comparability.

Abbreviations

• Self-reported general health

Biological health scale

Lived health scale

• Graded Response Model

Item Response Theory

Survey on disabilities, independence and dependence situations.

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Bostan, C., Oberhauser, C., Stucki, G. et al. Biological health or lived health: which predicts self-reported general health better?. BMC Public Health 14 , 189 (2014). https://doi.org/10.1186/1471-2458-14-189

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Understanding the Biopsychosocial Model of Health and Wellness

A holistic approach to well-being

Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

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• The Three Aspects of the Biopsychosocial Model

How the Biopsychosocial Model Impacts Mental Health

• Criticism of the Model

How Healthcare Professionals Use the Biopsychosocial Model

How clients and patients can use the biopsychosocial model.

The biopsychosocial model is an approach to understanding mental and physical health through a multi-systems lens, understanding the influence of biology, psychology, and social environment. Dr. George Engel and Dr. John Romano developed this model in the 1970s, but the concept of this has existed in medicine for centuries.

A biopsychosocial approach to healthcare understands that these systems overlap and interact to impact each individual’s well-being and risk for illness, and understanding these systems can lead to more effective treatment. It also recognizes the importance of patient self-awareness , relationships with providers in the healthcare system, and individual life context.

Dr. Akeem Marsh, MD , physician and author of Not Just Bad Kids , described the biopsychosocial model as “at its core, centering around social determinants of mental health in connection with the ‘standard’ biomedical and psychological models. One of the more common ways in which it is represented when using the model is through the four ‘Ps’ of case formulation: predisposing, precipitating, perpetuating, and protective factors.”

Learn more about how providers can use the biopsychosocial model to offer holistic care and how clients and patients can benefit from this approach.

What Are the Three Aspects of the Biopsychosocial Model?

When understanding an individual’s physical and mental health through the biopsychosocial model, we consider physiological factors such as genetics and illness pathology (biological); thoughts, emotions, and behavior (psychological); and socioeconomic components, social support, and culture (social). How do each of these components inform the model as a whole?

“Biology” refers to our genetics , physical health, and the functioning of our organ systems. Our physical well-being impacts our mental health for multiple reasons. First, our brain is an organ and can become unwell just like any other organ. Second, physical health conditions can wear on mental health. For example, chronic pain can lead to symptoms of depression.

Additionally, just like we can have genetic predisposition to a physical disability, mental health has genetic roots as well. According to Dr. Marsh, “Genetics are the most basic level by which mental health is influenced, and on some level has an impact for everyone.” In other words, “Whatever the phenotypical expression, genetics does play a role to some degree.” The expression is in turn influenced by the environment.

Psychological

Mental health is health, and one’s psychological well-being impacts both mental and physical health. Unhealthy and maladaptive moods, thoughts, and behaviors can all be symptoms of mental health conditions, and in turn can contribute to our overall health. Mental health and behavior can be cyclical; for example, an individual who self-isolates as a symptom of depression may experience increased depressive symptoms as a result of isolation.

Routine physical activity is known to promote positive mental wellness, while inadequate or excessive physical activity can contribute to different types of mental health struggles.

Addressing these symptoms is key in improving mental health.

Dr. Marsh shares the impact of external factors on health: “The expression [of genetics] is in turn influenced by environment.” Changes in one’s environment can impact mental health, both positively and negatively. In the previous example of depression and isolation , individuals who have appropriate social support experience fewer mental health issues compared to those without this support.

An individual who is struggling with their mental health might need social support and environmental changes just as much as they need therapy or medication intervention for their symptoms.

Traditionally, healthcare has focused primarily on the medical and biological side of the patient’s needs, and mental health care has focused on the psychological side. While it makes logical sense to address manifesting symptoms, a holistic approach to care that aims to address the social as well as the psychological and biological contributions to illness can be more health-promoting.

Sometimes, for instance, addressing an underlying social need or environmental stressor can improve mental health more effectively than other psychological or biological treatments. This may allow for less-invasive treatments and interventions, and it can improve the individual’s well-being in a way that non-holistic models overlook.

Criticism of the Biopsychosocial Model

Although many providers support a holistic approach to care and implement the biopsychosocial model in practice, like any model it has limitations. Dr. Marsh notes that there are concerns about its evidence backing: “Some people believe that [the biopsychosocial model] is not scientific, as in it has not quite met the ‘gold standard’ of being validated through multiple randomized trials, as it is a uniquely challenging study prospect.” How can researchers study controlled variables in a model that requires holistic care that takes individual needs into account?

At the same time, the model has many strengths and can benefit patients in the healthcare and mental health systems: “It has been researched extensively and shown positive results when applied in different ways,” Dr. Marsh said.

Mental health professionals who utilize the biopsychosocial model in practice include extensive medical history, family history, genetics, and social factors in assessments in addition to psychological information.

Additionally, they use this information to ensure that all of the client’s needs are met , as many medical issues can manifest with mental health symptoms. Therapy services to treat, for example, depression caused by an under-functioning thyroid is unlikely to be effective.

When adopted appropriately, health professionals conceptualize patients that they work with in a broad context that attempts to understand and see patients as a whole person—complex human being with nuance, so much more than just a cluster of symptoms or diagnosis.

This model lets providers see the whole person beyond their presenting symptoms.

While the biopsychosocial model has its place in the healthcare and mental healthcare systems, individuals might also implement tenants of this model in their own lives. This means being aware of how environmental factors impact their mental and physical health, as well as how their genetics and medical history in turn influence behaviors, thoughts, and emotions.

It can help individuals better understand themselves as complex, whole beings as well. “I believe that [the biopsychosocial model] could enhance their self-awareness and understanding of themselves, along with broadening their personal sense of what issues or challenges may be going on with them," says Dr. Marsh.

Engel GL. The need for a new medical model: a challenge for biomedicine .  Science . 1977;196(4286):129-136. doi:10.1126/science.847460

Soltani S, Kopala-Sibley DC, Noel M. The co-occurrence of pediatric chronic pain and depression: a narrative review and conceptualization of mutual maintenance .  The Clinical Journal of Pain . 2019;35(7):633-643. doi:10.1097/AJP.0000000000000723

Alsubaie MM, Stain HJ, Webster LAD, Wadman R. The role of sources of social support on depression and quality of life for university students .  International Journal of Adolescence and Youth . 2019;24(4):484-496. doi:10.1080/02673843.2019.1568887

By Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

Biobanking: New technique could revolutionize universal health

The ability to gather biological data can be vital in reacting to mass emergency health situations. Image:  Unsplash/National Cancer Institute

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Stay up to date:.

• Biobanking is the collection, processing and storing of biological samples and data for research.
• Mass data collection will be vital to quickly expand what we know currently in the fields of health and diseases.
• Experts claim that infrastructure must be supported to reach its potential, but ethical considerations are key.

Increasing the availability of high-quality biological samples through biobanks has the potential to advance global health research and speed up progress towards Sustainable Development Goals such as achieving universal health coverage, a UN science summit has heard.

Biobanking is the process by which samples of bodily fluid or tissue are collected, annotated, stored and redistributed for research to improve understanding of health and diseases .

The COVID-19 pandemic underlined the value of this gathering and processing of samples and related data , as scientists scrambled to develop effective vaccines and treatments.

“Biobanking is central in supporting SDG3 — good health and well-being — by supporting the discovery of new treatments for the great healthcare challenges,” said virologist Zisis Kozlakidis, one of the speakers at the online Science Summit, held during the United Nations General Assembly in New York.

In the last 100 years, more than 90 percent of crop varieties have disappeared from farmers’ fields, and all of the world’s 17 main fishing grounds are now being fished at or above their sustainable limits.

These trends have reduced diversity in our diets, which is directly linked to diseases or health risk factors, such as diabetes, obesity and malnutrition. One initiative which is bringing a renewed focus on biological diversity is the Tropical Forest Alliance .

This global public-private partnership is working on removing deforestation from four global commodity supply chains – palm oil, beef, soy, and pulp and paper.

The Alliance includes businesses, governments, civil society, indigenous people and communities, and international organizations.

Enquire to become a member or partner of the Forum and help stop deforestation linked to supply chains.

Developed in 2015 by the UN member states, the SDGs are “a shared blueprint” to attain, by 2030, a better and sustainable future for all. The 17 goals include ending poverty and hunger, achieving food security , improving nutrition and promoting sustainable agriculture , and ensuring healthy lives worldwide.

Kozlakidis, who is head of the laboratory services and biobank group at the International Agency for Research on Cancer (IARC), in Lyon, France, explained that research in medicine is based on the analysis of samples and — because associations in many diseases are often weak — these samples are needed in large quantities.

“The implication is clear: if more, well-characterised, high-quality samples are available through biobanks, the faster research will advance and impact upon the faster delivery of precision healthcare today as part of SDG3,” Kozlakidis added.

At the summit meeting on 22 September, Kozlakidis spoke about how data collected as part of routine clinical healthcare can be re-used for research, to improve health services in an increasingly digital age. “We have seen that the application of artificial intelligence has brought a new era of possibilities and promise, but it requires operating within large-scale, high-quality data [as found in some biobanks].”

He added that the model of digital health implemented in high-income countries would need to be adjusted for resource-restricted settings.

Kurt Zatloukal, a professor of pathology at the Medical University of Graz, Austria, told the meeting: “Biobanks host human samples like tumors that are removed by surgery, [and] blood that is taken during diagnostics, and these biological materials contain very detailed information on human diseases. This insight into human diseases lays the foundation for the development of new diagnostics and new drugs.”

The data generated through biosamples is a key resource for the digital transformation of health systems, he suggested.

World revenue for biobanking will surpass $53 billion in 2027, according to Zatloukal, who underlined one of the key challenges facing biobanking: the drug industry is required to provide funding, yet patients remain reluctant to make their samples available to drug companies.

Have you read?

Biodivercities: how infrastructure could transform the urban relationship with nature, we can't meet the sdgs without improving farmers' incomes. here's why, why are some places more biodiverse.

“[To] tackle this problem, a model [has been] developed called Expert Centers ,” Zatloukal told the summit. In this concept, he said, sending or selling bio-samples to industry directly by biobanks is avoided as it involves joint funding and contributions from public and private companies, with the data and knowledge shared between both.

“This model of transforming biological raw material into knowledge and data [can] also be used to enable international collaboration,” he said.

Fredrick Chite Asirwa, executive director and chief executive of the International Cancer Institute in Kenya, said more also needed to be done to tackle the challenges facing biobanking in Africa, including increasing awareness among healthcare professionals, policymakers and patients, and promoting the necessary infrastructure and networks needed to support biobanks.

“Most [important] is the ethical and legal implications of setting up biobanks, so that the processes that we develop are actually very responsive to the questions that are being asked currently within our systems,” he said.

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National Research Council (US) Committee on New and Emerging Models in Biomedical and Behavioral Research. Biomedical Models and Resources: Current Needs and Future Opportunities. Washington (DC): National Academies Press (US); 1998.

Biomedical Models and Resources: Current Needs and Future Opportunities.

• Hardcopy Version at National Academies Press

2 Biomedical Model Definition

Biomedical models can be of many types—from animal models of human diseases to animal, in vitro, or modelling systems for studying any aspect of human biology or disease. A detailed discussion of various types of models appeared in a National Research Council study, Models for Biomedical Research (NRC 1985), and is appended to this report.

A biomedical model is a surrogate for a human being, or a human biologic system, that can be used to understand normal and abnormal function from gene to phenotype and to provide a basis for preventive or therapeutic intervention in human diseases. For example, characterization of mouse models of various dwarfing syndromes, cloning of mutated genes, and parallel comparative genetic mapping and cloning of genes for similar human syndromes have led to an understanding of various human dwarfing conditions and have suggested therapies based on biologic knowledge, rather than shotgun testing. Mouse models with targeted mutations in the cystic fibrosis gene are providing a means for testing gene therapy delivered by aerosol into the lungs (Dorin and others 1996). The use of nonhuman primates that are genomically similar is beginning to shed light on complex human diseases. Squid giant axons are important model systems in neurobiologic research because their size allows a variety of manipulations not possible with vertebrate axons and because there are 40 years of data on the anatomy, physiology, biophysics, and biochemistry of those neurons. Clams, sea urchins, and fishes are models in developmental biology (for example, for study of transcriptional regulation during early cell differentiation) because they have high fecundity, short generation times, and transparent eggs that develop externally. Those are but a few examples among thousands that illustrate the breadth and utility of comparative models in biomedicine.

A model need not be an exact replica of a human condition or disease. For example, mice with mutations in the homologue of the human Duchenne-Becker muscular dystrophy gene are less severely affected than human patients and can regenerate degenerating muscle (Anderson and others 1988); they have been used successfully to test muscle implantation therapy for this debilitating disease (Ragot and others 1993). Many targeted-mutation (so-called knockout) mice exhibit unexpected phenotype, revealing previously unidentified roles for known genes (Homanics and others 1995 Shastry 1994). Finally, to the extent that biologic processes in living organisms are predictable, computer modelling might be able to predict the outcome of perturbing a metabolic pathway or treating a metabolic disease; this can lead to hypothesis-driven research with an animal model.

This report tends to emphasize genetic models because the dramatic success of the Human Genome Initiative has created a strong bias in biomedical research toward research on functional genomics. The preponderance of survey and workshop participants were scientists who were using genetic animal models. This emphasis is not intended to downplay the value of nongenetic model systems. The information that we gathered from researchers who were using nongenetic systems strongly suggests that many of the same factors influence their success or failure.

The committee recognized the importance of in vitro models, but did not cover them in this report for several reasons. First, in vitro models, including cell culture, bacteria, viruses, and yeasts. are universally used by the scientific community, including those using animal models. In vitro models provide important perspectives on the continuum of biologic processes that ultimately must be investigated at the organismal level. Furthermore, in vitro systems provide a wealth of material for in vivo applications, including vectors, constructs, expression libraries, monoclonal antibodies, infectious agents (including genetically modified agents), and so on. Finally, in vitro models are used by scientists across all NIH institutes, and this committee focused on recommendations that would enhance NCRR's rich tradition of animal model development, maintenance, and support.

• Cite this Page National Research Council (US) Committee on New and Emerging Models in Biomedical and Behavioral Research. Biomedical Models and Resources: Current Needs and Future Opportunities. Washington (DC): National Academies Press (US); 1998. 2, Biomedical Model Definition.
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What Is Biohacking? 8 Ways to Biohack Yourself for Better Health

By Kissairis Munoz

August 9, 2019

From earning enough miles for a trip around the world to getting free goods at the grocery store, these days it seems like you can hack nearly anything to get the most bang for your buck. If only we could hack our own bodies, right?

Figure out just how they tick so that we can feel our best and have our bodies performing optimally all the time. What a treat that would be.

Except … it already exists. Welcome to the world of biohacking.

What Is Biohacking?

Biohacking is the process of making changes to your lifestyle in order to “hack” your body’s biology and feel your best.

By biohacking yourself, you can actually transform your body so you feel more energized, more productive and, overall, like the best possible version of yourself.

It doesn’t have to involve being a mad scientist and running crazy experiments with your body. Instead, it means using various hacks to see what works best for you (which could be very different from what works for Susan down the street!) and using it to live your best life.

Now, some people will tell you that all sorts of gadgets and measurements are necessary to biohack yourself, but there’s something to be said for the good old-fashioned way — making small changes to your lifestyle, giving your body time to adjust and then seeing how you feel.

You stick with the things that work for you, and ditch the ones that don’t. After all, when it comes to how your body feels, you’re the expert!

History of Biohacking

“Biohacking” is a broad term that refers to a number of different things. Historically, the term was mentioned in a 1988 article in the Washington Post discussing biotechnology being brought to the masses in the form of “fiddling with the genetic code of a living organism.” 

More recently, experts like Ben Greenfield and Dave Asprey (the founder of Bulletproof) have developed an art when it comes to biohacking. By sharing their experiences, “hacks” and products, they hope to help followers manipulate nutrition, fitness and lifestyle to improve their health.

Types of Biohacking

Typically, biohacking falls into three categories: nutrigenomics , do-it-yourself biology and grinder biohacking. Here’s an explanation of these biohacking meanings:

• Nutrigenomics : This is described as the study of nutritionally manipulating the activity of your body. Nutrigenomics is also related to other sub-categories in biohacking like sleep manipulation, exercise, attention hacking, adjusting environmental triggers (like sound and light) and stress management. 
• This type of biohacking is really just building on the concept that our bodies are ever-changing and using these discoveries to live better. Food, activity and various stimuli alter your body’s function, and nutrigenomics involves learning how these interactions work.
• Do-it-yourself biology ( DIYBio ) : DIYBio is a biohacking subculture of people who conduct biological experiments and study life sciences outside of conventional means. It’s a movement that started in the early 2000s.
• Many “teachers” in this crusade are formal educators or scientific researchers who want to show the average Joe how to conduct experiments. While it’s a fascinating movement, this subset of biohacking is focused more on studying and testing unproven science and is often criticized for having no official oversight.
• Grinder biohacking:  This is a subset of DIYBio that fixates on technology implants or chemical manipulation of the body. Grinder attempts to push the limits of technology and the human body to their limits, practicing body modification to improve their “hardware.”
• These are typically very risky techniques that aren’t recommended. 

Biohacking vs. Biotechnology

Biotechnology uses biological processes or applications for industrial or other purposes. It involves living systems and organisms to develop or modify products and serves as a broader term for this kind of technological advancement.

It’s not uncommon for advancements in biotechnology research to inspire biohackers when it comes to inventing or using new biohacking technology. However, holistic biohacking that involves a biohacking diet or lifestyle change does not require or interact with biotechnology.

8 Ways to Biohack Yourself Today

What is biohacking good for in  your life, though? Here are multiple ways to biohack yourself:

1. Try an elimination diet

If you struggle with food allergies , have trouble digesting foods, experience skin issues like eczema and acne, or find yourself constantly fatigued, it’s probably time to biohack yourself with an elimination diet .

An elimination diet may sound scary, but it’s really just a short-term eating plan to figure out if the foods you consume play a role in whatever health issues you’re experiencing. Research shows that an elimination diet is an effective way to recognize triggering foods so they can be avoided for those dealing with a food allergy.

Here’s how it works: For three to four weeks, you remove foods that are known allergens, giving any inflammation time to go down and offering you a clean slate. Gluten, soy, dairy, peanuts and corn are all foods to cut out during this time.

Then, slowly, you’ll re-introduce the banned foods, paying attention to how you feel and how your body responds physically. If you suspect a food you’ve added back into your diet is an irritant, you’ll remove it again and see if symptoms clear up.

An elimination diet is one of the best biohacks you can do for yourself. Some people don’t understand how good they can truly feel until they remove some of the worst food offenders from their diets.  

Want to spend a little money to figure out exactly what you’re reacting badly to? Many naturopaths, integrative physicians and even some biohacking fitness centers offer an option to take a blood or urine test to pinpoint food allergens or sensitivities.

This might be a great idea for you if an elimination diet doesn’t seem to reveal any clear perpetrators.

2. Kick sugar to the curb

Giving addictive sugar the boot is one of the best things you can do for your overall health. It can be a pretty tough biohack but one of the most rewarding.

Now, this doesn’t mean you have to eliminate naturally occurring sugars, like the ones you find in fruits and dairy. Added sugars are the ones you want to worry about.

You’ll find those in products like soft drinks, processed foods and sweets. They’re also in foods like flavored yogurt, condiments (check those barbecue sauce and ketchup labels!) and energy drinks.

What makes sugar so bad for your body?

Studies show that it increases your risk of type 2 diabetes, leads to mood swings, increases inflammation in the body and lowers energy ­— and that’s the abbreviated list! (Read more about the benefits of a sugar-free diet .)

How do you reduce your sugar habit? Learn how to measure sugar, look for it in all its forms on labels (hint: anything ending in “ose” and natural sweeteners like honey, molasses and fruit juice still count) and limit processed foods.

3. Change when you eat

Did you know that by simply changing when you eat, you can biohack your body? Intermittent fasting is gaining popularity as a method of losing weight and normalizing insulin sensitivity, which can help prevent chronic diseases like diabetes.

It also regulates ghrelin levels, more commonly known as the hunger hormone, which tells your brain when you’re hungry, and leptin , which sends signals to the brain when you’re full and should stop eating.

The cool thing about fasting is that there is more than one way to do it. Some people opt for alternate-day fasting , where on fasting days, you limit your calories to 25 percent of your normal intake and then eat your usual amount of calories on non-fasting days.

There’s also  time-restricted eating , where you only eat during a certain window during the day (if you eat dinner early and tend to have a late breakfast, you already do this!) and a more spiritual approach, the Daniel fast . Though intermittent fasting can take some time to get used to, depending on your health goals, it may be a good biohacking option.

4. Sleep more

Sleep is often missing from conversations about losing weight and improving your health and mood ­— and that’s a major mistake. If you don’t getting enough sleep each night (usually between seven to nine hours) and suffer from sleep deprivation , you’re putting yourself at risk for a host of health problems, including a higher risk for chronic disease, a weakened immune system, depression, trouble concentrating, irritability, an increased appetite and out-of-whack hormones.

In fact, research published in Nature and Science of Sleep indicates that sleep disruptions have substantial adverse short- and long-term health consequences.

There’s one step to biohacking sleep: Get more of it! Of course, I know it’s not always that simple.

These seven  natural sleep aids can help. Some of my favorite suggestions are sticking to a regular sleep schedule, even on weekends, to keep your circadian rhythms in check.

Keeping electronics out of bed is important, too. The lights from your smartphone tell your brain it’s time to wake up, not drift off to sleep.

If you use biohacking for insomnia, a DIY essential oils sleep aid just might do the trick.

5. Eat fat — lots of it

Looking for a diet where eating a lot of fat isn’t just encouraged, it’s required? The keto diet might be for you!

While the keto diet is experiencing some serious popularity right now, it’s not a fad diet. On the keto diet, you try to get your body to ketosis , a metabolic state where the body uses mostly ketones, not carbohydrates, for energy.

This happens when fat, not glucose (carbohydrates), provide most of body’s calories. (It can also be induced by multiple-day fasting, but that’s not a long-term option for most people.)

On a keto diet, you seriously restrict carbs and sugar and instead eat keto-friendly foods like healthy fats (coconut oil, ghee, nuts, etc.), non-starchy veggies (goodbye, potatoes) and foods that are high in protein but have no or low carbs, like grass-fed beef, wild-caught fish and eggs.

Studies show that the keto diet is very effective at promoting weight loss, especially if you are very overweight. It can reduce heart disease markers like high cholesterol and could even fight brain disease.

In fact, the keto diet was originally used as a way to manage seizures in people with epilepsy. If you already eat relatively well but want to challenge yourself even further, biohacking your diet and going keto could be what you need.

6. Zone out with meditation

What we feed our minds is just as important as what we feed our bodies. Meditation is the ultimate brain hack.

Studies have proved that the benefits of meditation are huge: from reducing pain and increasing sleep quality to lowering inflammation and boosting productivity. If you suffer from stress or anxiety, meditation can also be a really effective way of naturally dealing with symptoms.

Establishing a daily meditation practice is one of the best things you can do for your mental and physical health.

If you’re concerned that you can’t stop your brain from buzzing long enough to meditate, don’t worry. Guided meditation  can help you get into the habit.

There are also dozens of smartphone apps you can use. Some will alert you at the same time each day or have specific meditations for different purposes, like starting the day with a clear head or helping you unwind.

Healing prayer is another option that might speak to you.

7. Kick off your shoes

How often do you walk barefoot in the grass or feel the sand crunch between your toes? If the answer is “not enough,” you should definitely consider grounding as your next biohack.

Grounding, also known as earthing , is a bit of a biohacking secret. It means allowing your feet to connect with the surface below them and the powerful energy that brings.

When we spend time barefoot on the earth, our feet act as electrical currents, allowing the natural electrical charges that the earth produces to flow through us.

Research published in Alternative Therapies in Health and Medicine suggests that grounding has the potential to act as a “simple, natural and accessible clinical strategy against the global epidemic of noncommunicable, degenerative, inflammatory-related diseases.” Grounding can improve your sleep, reduce inflammation and encourage you to enjoy nature more and get your dose of vitamin D ­— plus, it’s free!

Try it by taking a short walk sans shoes to the mailbox, strolling on the beach or even barbecuing barefoot. As the weather gets colder, minimalist shoes can help keep your feet in closer contact with the earth.

Active people often enjoy biohacks like “rewilding,” similar to the thought process behind earthing. Many biohacking experts teach that we should fight against our natural “domestication” and, instead, spend more time outside, eat less processed foods, drink better water, be exposed to sunlight and learn to love the outdoors.

We were made to thrive using these methods, so it makes sense to do your yoga routine in the backyard tomorrow — where you not only benefit from the exercise, but also from just being outside under the sun.

8. Get up, stand up

Most of us spend our days going from sitting in our cars, to sitting at a desk, to sitting in the car some more. Rinse and repeat, and we spend an extraordinary amount of our lives seated.

All that sitting  harms our health and might even be as dangerous as smoking.

There’s an easy fix to that: Stand more . You don’t need to invest in a standing desk (although it’s helpful!). Instead, it’s how often we stand, not how long we stand for, that matters.

You can biohack your way to better health with various exercise hacks , too — simply by getting up and talking to colleagues instead of sending an email, taking the stairs instead of the elevator, standing up and pacing during long phone calls, or even setting a reminder on your phone for every 60–90 minutes to take a quick lap around the office.

Other Biohacking Techniques

More cutting-edge biohacking principles include things like biohacking nootropics (“smart” drugs), neurofeedback, heart rate variability training and inversion therapy.

Nootropics are cognitive-enhancing drugs and supplements. Some are relatively healthy, safe and well-investigated (turmeric and vitamin D supplements, for example), while others which are often considered dangerous or available on with a prescription, like amphetamine and eugeroics.

The simple definition for neurofeedback is taking advantage of the plasticity of your brain by retraining it how to respond to various emotions. This typically involves EEG monitoring and then playing “games” that give you positive and negative feedback based on your desired result.

This process is claimed by many to increase creativity and even IQ.

Heart rate variability training involves using biohacking technology to sense when your heartbeat changes to reflect stress — you go from a varied amount of time between each beat to a fixed rhythm when you’re under duress of some kind.

Typical technology used for this would then warn you and walk you through what to listen to and how to breathe to avoid giving into the stress.

Some biohackers also like to practice inversion therapy, the complex process of hanging upside down. The simple function of forcing blood to your brain supposedly strengthens capillaries within the brain and can increase mental performance.

Proponents of this technique also claim it changes blood pressure regulation when done on a regular basis.

There are also ways to maximize workouts using biohacking. Some of these are very straightforward, like tracking your exact workout times, specific exercises and results to develop a schedule and a routine that is exactly right for your body or practicing breathing exercises as part of your regular workout.

Other workout biohacks are a little more complex — and potentially expensive. For example, biohacker  Ben Greenfield says that lifting weights underwater in the cold is one of his favorite biohacking secrets.

The concept of these types of routines is to use very exact methods to achieve maximum results, but they should be done with caution, particularly because biohacked workouts can be tricky and potentially unsafe if they are done incorrectly (or designed without reliable scientific results to support them).

Does It Work?

When you are working to eat, move and think in a way that positively impacts your body and the way you feel, then biohacking definitely works. It can help you feel better and even reduce your risk of disease.

Biohacking weight loss is even possible when you work to nourish your body with healthy foods that reduce inflammation, get enough rest, and stand up and move your body throughout the day.

That said, grinder biohacking or DIY biohacking may not work or even be safe, especially when it’s not done by a trained professional. There’s a range of biohacking products and technology that may work in the short term but over time can cause adverse side effects, infections and inflammatory reactions.

Does implanting a sound-transmitting magnet into your ear really serve as built-in headphones? Or do brain-computer interfaces that are implanted underneath the skull enable telepathy and circumvent memory loss?

For one thing, there isn’t enough research to determine whether or not these biohacking projects are effective. On top of that, this obviously goes way beyond boosting your health with diet and barefoot walks on the grass.

Biohacking your body may work, to a certain extent, depending on how you define biohacking and the extremity of your approach.

Blood Testing and Biohacking

If you’re interested in biohacking to improve your health, you may find it helpful to have blood work done to measure your body’s nutrient counts and blood components. Biohackers believe that blood testing gives them a sense of what their bodies are doing.

When you continue to blood test and you see small changes in your blood over time, after making changes to your diet or lifestyle, you know that what you’re doing is working. Some biohackers recommend getting blood tests every year, while others do it more frequently.

Blood testing is part of the biohacking guide because it serves as a proactive and preventative measure. When you notice a negative change, you shift your diet and lifestyle right away to make yourself healthier.

Is Biohacking Safe?

Biohacking can be really fun. Figuring out what your body prefers and how to get it feeling its best can even feel invigorating, particularly if you’ve been struggling with health concerns and are finally getting answers.

However, it’s important to remember that we’re more than just the number of calories we eat or burn, and it is possible to take biohacking too far.

A biohacking movement is growing in popularity, especially in Silicon Valley, where tech execs are tracking what they eat, ketone levels, body composition and more daily. They also fast for days at a time, increasing their risk of critical mineral deficiencies and infection — and likely creating an obsession and anxiety around the food ( orthorexia ) they’re eating.

While some medical professionals and scientists practice standard biohacking and even get involved in DIYBio studies and using biohacking implants, many scientists and doctors are skeptical of these practices.

The ones that fall more in line with ancient nutrition principles are sometimes scoffed at because of the mistaken idea that nutrition doesn’t have as much impact on your body as medicines or medical therapies might. Of course, we know that to be a false assumption.

However, many biohacking techniques that go “off the beaten path” are untested and can cost a lot of money to achieve, just two of the reasons why mainstream science and medicine may be skeptical of them.

While it’s exciting to see how people may be able to enhance or maximize their physical potential through natural means, there are still a lot of unknowns when it comes to the concept of biohacking, particularly when it comes to pushing your body to unknown limits or using chemical and technological enhancements to do things your body may not have been designed to do.

There’s nothing wrong with wanting to biohack yourself to be at your best, but the concern is related to the obsessive behavior around hardcore biohacking that’s practiced by biohacking grinders. It can really quickly lead to unhealthy territory or fuel an eating disorder.

Instead, it’s healthy and safe to take a holistic approach to biohacking your brain and body. Grab a journal and jot down how certain foods make you feel or whether you find yourself reaching for certain meals when you’re feeling down.

If you find that eating in a certain window of time makes you a superstar at work, stick to that schedule. Remember that there’s no one biohacking diet or biohacking product that works for everyone.

It’s a journey, not a science!

Precautions

As mentioned, there are different levels of biohacking out there. If you plan to go beyond a holistic biohacking definition that involves listening to your mind and body to make positive and effective changes, you should do so with caution.

Any time you plan to take biohacking supplements or use biohacking technology, speak to your health care professional first.

Final Thoughts

• What is biohacking? Biohacking is all about making lifestyle changes to optimize the way your body functions.
• Whether it’s bulletproof biohacking, starting a biohacking diet or inserting biohacking magnets into your body — there are a number of biohacking definitions, with some much more extreme than others.
• The truth is that you don’t need fancy gadgets to biohack yourself. Instead, it’s about finding natural ways to improve how you feel.
• Biohacks include strategies like trying an elimination diet, standing up throughout the day more, experimenting with intermittent fasting and getting more sleep.
• Though a more extreme form of biohacking is gaining popularity in Silicon Valley, using natural biohacking supplements and botanical biohacking approaches is a safer and possibly more effective choice.

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• Biofeedback

Biofeedback is a type of mind-body technique you use to control some of your body's functions, such as your heart rate, breathing patterns and muscle responses. During biofeedback, you're connected to electrical pads that help you get information about your body.

You may not realize it, but when you have pain or are under stress, your body changes. Your heart rate may increase, you may breathe faster, and your muscles tighten. Biofeedback helps you make slight changes in your body, such as relaxing muscles, to help relieve pain or reduce tension. You may be able to decrease your heart rate and breathing, which can make you feel better. Biofeedback can give you the skills to practice new ways to control your body. This can improve a health problem or help make daily activities easier.

Types of biofeedback

Your health care provider might use different kinds of biofeedback depending on your health problems and goals. Biofeedback types include:

• Breathing. During breathing biofeedback, bands are placed around your stomach and chest. Sensors on the bands check your breathing rate and patterns. You can control your breathing and feel better.
• Brain waves. During this type of biofeedback, an electroencephalograph (EEG) uses scalp pads to monitor your brain waves. There are certain brain waves that show different mental states, such as relaxation, wakefulness and sleep. With biofeedback training, you can see a change in the brain waves that improve your health.
• Heart rate. In this type of biofeedback, pads are placed on your chest, lower trunk or wrists. These pads are connected to an electrocardiogram (ECG) that measures your heart rate and how your heart rate changes. A sensor also can be placed on your finger to measure your heart rate. When you are relaxed, your heart rate may decrease.
• Muscle activity. A machine called an electromyograph (EMG) uses sensors to measure muscle tightening. This helps make you aware of muscle tension so you can take steps to control it.
• Sweat gland activity. Pads attached to the fingers, palm or wrist measure the activity of the sweat glands. The amount of perspiration on your skin warns you of nervousness.
• Temperature. Pads attached to your fingers or feet measure blood flow to your skin. Because your temperature often drops when you're under stress, a low reading can prompt you to begin relaxation methods. As you become more relaxed, your fingers and toes may become warmer.

Biofeedback machines

You can receive biofeedback training in physical therapy clinics, medical centers and hospitals. A growing number of biofeedback machines and programs are being marketed for home use, including:

Interactive computer programs or mobile devices. Some types of biofeedback machines measure physical changes in your body. Changes in your heart rate and skin are measured with pads attached to your fingers or your ear. The measuring pads plug into your computer.

Using computer pictures and cues, the machines then help you control nervousness by helping you:

• Manage your breathing.
• Relax your muscles.
• Think positive things about your power to deal with stress.

Studies show that these types of machines might help in dealing with stress and make you calmer.

Another type of biofeedback treatment involves wearing a headband that tracks your brain activity while you meditate. It uses sounds to let you know when your mind is calm and when it's active. This may help you learn to control your stress. Every time you do this, the information is stored on your computer or mobile device so you can track your progress over time.

• Wearable devices. One type involves wearing a measuring pad on your waist that monitors your breathing patterns using a downloadable app. The app can let you know if you're tense and give you breathing activities to restore calm.

The Food and Drug Administration (FDA) has approved a biofeedback machine, Resperate, for decreasing stress and lowering blood pressure. Resperate is a portable electronic machine that helps you have slow, deep breathing.

The FDA doesn't control many biofeedback machines made for home use. Before trying biofeedback therapy at home, talk about the different machines you can use with your health care team to find the best fit.

Be aware that some items might be falsely sold as biofeedback machines. Also, some people who teach biofeedback may not be certified or have enough training to help you.

Why it's done

Biofeedback, sometimes called biofeedback training, helps many physical and mental health problems, including:

• Nervousness or stress.
• Attention-deficit/hyperactivity disorder (ADHD).
• Side effects from drugs to treat cancer.
• Long-lasting pain.
• Constipation.
• Loss of bowel control, also known as fecal incontinence.
• Fibromyalgia.
• High blood pressure.
• Irritable bowel syndrome.
• Raynaud's disease.
• Ringing in the ears, also called tinnitus.
• Temporomandibular joint disorder (TMJ).
• Urinary incontinence and trouble passing urine.
• Depression.

Biofeedback appeals to people for a variety of reasons:

• There's no surgery involved.
• It might lower or end the need for medicines.
• It might make medicines work better.
• It might help when medicines can't be used, such as in pregnancy.
• It helps people feel more in control of their health.

Biofeedback is generally safe, but it might not be right for everyone. Biofeedback machines might not work on people with some medical problems, such as heartbeat issues or some skin diseases. Be sure to talk with your health care provider first.

How you prepare

It's not hard to start biofeedback.

To find a person who teaches biofeedback, ask your health care provider to recommend someone who has experience treating your problem. Many biofeedback experts are licensed in another area of health care, such as psychology, nursing or physical therapy.

State laws regulating biofeedback teaching vary. Some biofeedback experts choose to become certified to show their extra training and experience in the practice.

Before starting treatment, consider asking the biofeedback expert a few questions, such as:

• Are you licensed, certified or registered?
• What is your training and experience?
• Do you have experience teaching biofeedback for my problem?
• How many biofeedback treatments do you think I'll need?
• What's the cost and is it covered by my health insurance?
• Can you give me a list of references?

What you can expect

During the treatment.

During biofeedback, a therapist connects electrical pads or sensors to different parts of your body. These pads might be used to:

• Monitor your brain waves.
• Check the temperature of your skin.
• Measure muscle tightness.
• Monitor your heart rate.
• Monitor your breathing rate and patterns.

The pads send information to a nearby screen. The therapist uses that information and makes suggestions to help you control your body's responses. For example, if the pads sense tight muscles that may be causing headaches, you then learn how to relax those muscles.

A typical biofeedback treatment lasts 30 to 60 minutes. How many treatments you have and how long they last depend on your health problem and how quickly you learn to control your body's responses. The goal of biofeedback is to learn to use these methods at home on your own without a machine or sensors.

Insurance companies may not pay for biofeedback.

If biofeedback works for you, it might help your health problem or decrease how much medicine you take. In time, you can practice the biofeedback methods you learn on your own. Don't stop the medical treatment for your problem without talking to your health care provider.

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Biofeedback care at Mayo Clinic

• Narayanan SP, et al. A practical guide to biofeedback therapy for pelvic floor disorders. Current Gastroenterology Reports. 2019; doi: 10.1007/s11894-019-0688-3.
• Czornik M, et al. Psychophysiological treatment of chronic tinnitus: A review. Clinical Psychology & Psychotherapy. 2022; doi:10.1002/cpp.2708.
• Ovadia-Blechman Z, et al. Reducing test anxiety by device-guided breathing: A pilot study. Frontiers in Psychology. 2022; doi:10.3389/fpsyg.2022.678098.
• Biofeedback. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 13, 2022.
• Rakel D, et al., eds. Headache. In: Integrative Medicine. 5th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Dec. 13, 2022.
• Dinces EA. Treatment of tinnitus. https:www.uptodate.com/contents/search. Accessed Feb. 14, 2023.
• Standards for performing biofeedback. The Association for Applied Psychophysiology and Biofeedback. https://aapb.org/Standards_for_Performing_Biofeedback. Accessed Feb. 14, 2023.
• Ami TR. Allscripts EPSi. Mayo Clinic. Accessed Nov. 23, 2022.
• De la Barra Ortiz HA, et al. Efficacy of biofeedback in rehabilitation of musculoskeletal disorders: A systematic review. Advances in Rehabilitation. 2022; doi:10.5114/areh.2022.113241.
• Chiang CH, et al. Therapeutic efficacy of biofeedback pelvic floor muscle exercise in women with dysfunctional voiding. Scientific Reports. 2021; doi:10.1038/s41598-021-93283-9.
• Pizzoli SFM, et al. A meta-analysis on heart rate variability biofeedback and depressive symptoms. Scientific Reports. 2021; doi:10.1038/s41598-021-86149-7.
• Kopańska M, et al. Development of a brain wave model based on the quantitative analysis of EEG and EEG biofeedback therapy in patients with panic attacks during the COVID-19 pandemic. Scientific Reports. 2022; doi:10.1038/s41598-022-19068-w.
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Environmental Changes Are Fueling Human, Animal and Plant Diseases, Study Finds

Biodiversity loss, global warming, pollution and the spread of invasive species are making infectious diseases more dangerous to organisms around the world.

By Emily Anthes

Several large-scale, human-driven changes to the planet — including climate change, the loss of biodiversity and the spread of invasive species — are making infectious diseases more dangerous to people, animals and plants, according to a new study.

Scientists have documented these effects before in more targeted studies that have focused on specific diseases and ecosystems. For instance, they have found that a warming climate may be helping malaria expand in Africa and that a decline in wildlife diversity may be boosting Lyme disease cases in North America.

But the new research, a meta-analysis of nearly 1,000 previous studies, suggests that these patterns are relatively consistent around the globe and across the tree of life.

“It’s a big step forward in the science,” said Colin Carlson, a biologist at Georgetown University, who was not an author of the new analysis. “This paper is one of the strongest pieces of evidence that I think has been published that shows how important it is health systems start getting ready to exist in a world with climate change, with biodiversity loss.”

In what is likely to come as a more surprising finding, the researchers also found that urbanization decreased the risk of infectious disease.

The new analysis, which was published in Nature on Wednesday, focused on five “global change drivers” that are altering ecosystems across the planet: biodiversity change, climate change, chemical pollution, the introduction of nonnative species and habitat loss or change.

The researchers compiled data from scientific papers that examined how at least one of these factors affected various infectious-disease outcomes, such as severity or prevalence. The final data set included nearly 3,000 observations on disease risks for humans, animals and plants on every continent except for Antarctica.

The researchers found that, across the board, four of the five trends they studied — biodiversity change, the introduction of new species, climate change and chemical pollution — tended to increase disease risk.

“It means that we’re likely picking up general biological patterns,” said Jason Rohr, an infectious disease ecologist at the University of Notre Dame and senior author of the study. “It suggests that there are similar sorts of mechanisms and processes that are likely occurring in plants, animals and humans.”

The loss of biodiversity played an especially large role in driving up disease risk, the researchers found. Many scientists have posited that biodiversity can protect against disease through a phenomenon known as the dilution effect.

The theory holds that parasites and pathogens, which rely on having abundant hosts in order to survive, will evolve to favor species that are common, rather than those that are rare, Dr. Rohr said. And as biodiversity declines, rare species tend to disappear first. “That means that the species that remain are the competent ones, the ones that are really good at transmitting disease,” he said.

Lyme disease is one oft-cited example. White-footed mice, which are the primary reservoir for the disease, have become more dominant on the landscape, as other rarer mammals have disappeared, Dr. Rohr said. That shift may partly explain why Lyme disease rates have risen in the United States. (The extent to which the dilution effect contributes to Lyme disease risk has been the subject of debate, and other factors, including climate change, are likely to be at play as well.)

Other environmental changes could amplify disease risks in a wide variety of ways. For instance, introduced species can bring new pathogens with them, and chemical pollution can stress organisms’ immune systems. Climate change can alter animal movements and habitats, bringing new species into contact and allowing them to swap pathogens .

Notably, the fifth global environmental change that the researchers studied — habitat loss or change — appeared to reduce disease risk. At first glance, the findings might appear to be at odds with previous studies, which have shown that deforestation can increase the risk of diseases ranging from malaria to Ebola. But the overall trend toward reduced risk was driven by one specific type of habitat change: increasing urbanization.

The reason may be that urban areas often have better sanitation and public health infrastructure than rural ones — or simply because there are fewer plants and animals to serve as disease hosts in urban areas. The lack of plant and animal life is “not a good thing,” Dr. Carlson said. “And it also doesn’t mean that the animals that are in the cities are healthier.”

And the new study does not negate the idea that forest loss can fuel disease; instead, deforestation increases risk in some circumstances and reduces it in others, Dr. Rohr said.

Indeed, although this kind of meta-analysis is valuable for revealing broad patterns, it can obscure some of the nuances and exceptions that are important for managing specific diseases and ecosystems, Dr. Carlson noted.

Moreover, most of the studies included in the analysis examined just a single global change drive. But, in the real world, organisms are contending with many of these stressors simultaneously. “The next step is to better understand the connections among them,” Dr. Rohr said.

Emily Anthes is a science reporter, writing primarily about animal health and science. She also covered the coronavirus pandemic. More about Emily Anthes

Explore the Animal Kingdom

A selection of quirky, intriguing and surprising discoveries about animal life..

Indigenous rangers in Australia’s Western Desert got a rare close-up with the northern marsupial mole , which is tiny, light-colored and blind, and almost never comes to the surface.

For the first time, scientists observed an orangutan, a primate, in the wild treating a wound  with a plant that has medicinal properties.

A new study resets the timing for the emergence of bioluminescence back to millions  of years earlier than previously thought.

Scientists are making computer models to better understand how cicadas  emerge collectively after more than a decade underground .

New research questions the long-held theory that reintroduction of Yellowstone’s wolves caused a trophic cascade , spawning renewal of vegetation and spurring biodiversity.

To protect Australia’s iconic animals, scientists are experimenting with vaccine implants , probiotics, tree-planting drones and solar-powered tracking tags.

Mount Bio major heading to Albany College of Pharmacy, Health Sciences

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Dozens of Mount scholars filled Aquinas Hall on Wednesday, May 1 and showcased a semester’s worth of hard work and research at the Honors Research Symposium/iROC Student Poster Session. One of those students was Biology major Mackenzie Zupko of Montgomery, N.Y., shown her discussing one of her latest research projects.

After she graduates from Mount Saint Mary College on Saturday, May 18, Biology major Mackenzie Zupko of Montgomery, N.Y. will embark on her next academic journey at Albany College of Pharmacy and Health Sciences, working on a Master’s degree in Clinical Laboratory Science.

“I’ve always wanted to work in the medical field, and do research in the lab,” said Zupko. “Becoming a Clinical Laboratory Scientist will allow me to do both. I’m hoping to work in a transplant lab, where I would ensure organs that are being transplanted into patients will be compatible. The Mount helped me find my interest in lab work, especially during my SURE programs and classroom experiences.”  

SURE is the acronym for the college’s popular Summer Undergraduate Research Experience, which pairs students with faculty mentors for original research projects. For example, Zupko, fellow student Alina Mendelowski of Walden, N.Y., and Associate Biology Professor James Moran jointly worked on original research titled “Evaluating the Immune and Inflammatory Responses in Mice Following Exposure to the Artificial Oxygen Carrier Oxyvita.”

Oxyvita is a blood substitute that, when perfected, can be manufactured as a liquid and is also the first working blood substitute in powder form in the world. Thanks to Moran’s ongoing collaboration with OXYVITA, Inc. investigating the immune safety of the synthetic blood substitute, many Mount Summer Undergraduate Research Experience (SURE) projects have focused on testing Oxyvita over the course of more than a decade.

Zupko credited Moran with much of her academic success. He served as Zupko’s mentor, professor, and advisor throughout her time at the Mount, and their connection goes back even further than that, she added.

“I have worked with him since 2018 when I was in high school doing my Science Research Program,” Zukpo noted. “Since then we have done three SURE summers, a few semesters of independent study, and many conferences together. I am incredibly thankful for his guidance and mentorship in all aspects of my academic career.”

Earlier this year, Zupko received the Frank G. Brooks Award for Excellence in Student Research at the Beta Beta Beta (Tri-Beta) NE-1 District Convention at Hofstra University for her, Mendelowski’s, and Moran’s Oxyvita research. Less than a week later, Zupko and Mendelowski received a second-place award for their Oxyvita poster presentation in the category of Physiology, Behavior and Toxicology at the Annual Undergraduate Research Symposium at William Patterson University in Wayne, N.J.

Even more impressive is that Zupko kept up her studies while tending to an unexpected medical issue during her sophomore year at the Mount. She was diagnosed with Thoracic Outlet Syndrome, which occurs when certain nerves and blood vessels are compressed. Symptoms can include pain and numbness in the neck and shoulders, and unfortunately for Zupko, the remedy involved a major surgery.

“I was in and out of the hospital,” she explained. “All of my professors were incredibly accommodating and the Office of Disability Services helped me get back on my feet academically. I’m so grateful that the Mount has services and professors who are so understanding of students’ struggles.”

With her undergraduate work at the Mount in the rearview, Zupko has some advice for incoming Mount students: Get involved.

“Joining the American Chemical Society Student Affiliates was one of the best things I could do during my freshman year,” Zupko said. “I became close with my professors, got to plan some exciting events, and met other Natural Science students…Having each other as a support system can make all the difference.”

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University of Wisconsin–Madison’s N+1 Institute and GE HealthCare Collaborate for Faster Biohealth Innovation and Valuable Real-World Education for Students

Editorial team.

May 5, 2024

The University of Wisconsin School of Computer, Data & Information Sciences (CDIS) at UW–Madison and GE HealthCare, a company with a rich Wisconsin history, today announced GE HealthCare as the founding member of the N+1 Institute. This announcement comes in advance of the  official launch event  on May 6, 2024. The collaboration will explore artificial intelligence (AI) and edge computing as a means of improving precision and flexibility in patient monitoring technology.

Part of the Department of Computer Sciences within the School of CDIS, the N+1 Institute’s mission is to create unique pathways for  industry-university collaboration . In addition to speeding up development and adoption of innovative technology, the industry membership model also provides students with valuable hands-on learning experiences. 

The collaboration comes on the heels of a huge win for the state’s biohealth industry. In October, the White House formally designated Wisconsin as a Regional Tech Hub “ promot[ing] innovation in personalized medicine .” Both UW–Madison and GE HealthCare serve as  Tech Hub consortium members , alongside 18 other public and private organizations throughout the state. This collaboration between the N+1 Institute and GE HealthCare, which will pursue edge-based solutions to meet a range of patient needs, is one way that the state-wide push for innovative biohealth research comes to life. 

“The collaboration between N+1 and GE HealthCare couldn’t come at a better time,” said David Ertl, Executive Director of the N+1 Institute at UW–Madison. “With Wisconsin’s thriving biohealth industry and UW–Madison’s incredible wealth of resources and expertise, we’re uniquely positioned to develop solutions that improve healthcare outcomes in the state and beyond.” 

Edge computing, one of N+1’s three core research areas, is a computing model that distributes data processing and storage at the “edge” of a network rather than relying on a central server. This improves speed, optimizes bandwidth, and increases reliability — crucial factors in patient monitoring. With their combined efforts, GE HealthCare and the N+1 Institute set their sights on edge technology that will save time, guesswork, and even help save lives. 

“Alongside the UW–Madison N+1 Institute, we’re pursuing a future in which edge computing technology in patient monitoring can support clinicians in providing real-time, critical patient care,” stated GE HealthCare’s Roshy Francis, Chief Technology Officer for Patient Care Solutions. “In combination with advanced cloud technologies, edge computing has the potential to create a more connected, efficient, and intelligent digital ecosystem for the healthcare industry. We believe it can help address healthcare industry challenges and opportunities, as well as support timely decision making for more precise, personalized patient care.” 

For doctors, real-time health monitoring means faster intervention when patient health begins to decline.   Yet it’s not just about industry outcomes. With the work being conducted at one of the country’s leading research universities, leaders from both N+1 and GE HealthCare are eager to involve another key group: students. 

As a founding member of the N+1 Institute, GE HealthCare plans to work closely with the UW-Madison team, mentor students during capstone and research projects, guide and leverage applied post-graduate research, and collaborate on course materials. The company will also provide patient monitoring technology, like Portrait™ Mobile, a wireless and wearable continuous monitoring solution that provides a real-time personalized view of the patient, to support coursework and research projects. For students, the arrangement offers a valuable real-world education. For the state, the collaboration will prepare a trained workforce capable of supporting the Biohealth Tech Hub that Wisconsin legislators, University leaders, and industry members worked so hard to establish.  

To learn more about GE HealthCare’s monitoring solutions, visit  https://www.gehealthcare.com/products/patient-monitoring . 

The Editorial Team at Healthcare Business Today is made up of skilled healthcare writers and experts, led by our managing editor, Daniel Casciato, who has over 25 years of experience in healthcare writing. Since 1998, we have produced compelling and informative content for numerous publications, establishing ourselves as a trusted resource for health and wellness information. We offer readers access to fresh health, medicine, science, and technology developments and the latest in patient news, emphasizing how these developments affect our lives.

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