What is Integrative Health?

But some alternative therapies can be useful in chronic conditions where conventional medicine has reached its limits, and in instances where behavioral health plays a significant role. 

According to the Mayo Clinic, patients with cancer, chronic pain, chronic fatigue, and fibromyalgia can better manage their symptoms and improve their quality of life through integrative medicine practices such as animal-assisted therapy, acupuncture, aromatherapy, massage therapy, music therapy, and meditation.

Critically, complementary medicine refers to the partnership of some alternative therapies with conventional treatments, and not the replacement of the latter with the former. And integrative health goes a step further: according to the National Center for Complementary and Integrative Health (NCCIH), integrative health aims for well-coordinated care among different providers and institutions by bringing conventional and complementary approaches together to care for the whole person, rather than a single organ system or isolated condition.

In a 1998 issue of the New England Journal of Medicine (NEJM), Dr. Marcia Angell and Dr. Jerome Kassirer argued that “There cannot be two kinds of medicine—conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work.” 

While the reasoning behind those statements still rings true, the medical community’s thinking on integrative health has evolved in the last 24 years. That evolution is mirrored in consumer practices: a 2012 national survey found that more than 30 percent of American adults use healthcare approaches outside conventional medical care. 

Integrative health seeks to bring together the best of both medical worlds in a safe, effective, and complementary manner that considers the whole person, including the interconnected biological, behavioral, social, and environmental domains. 

Alternative treatment still comes with risk, and there is further risk in equating all alternative treatments with scientifically proven ones. Contemporary alternative medicine includes a sizable portion of quackery, ignorance, and outright deceit. For example, during the Covid-19 pandemic, unscrupulous entities hawked colloidal metals as antiviral treatments. Also, for over a decade, otherwise normal consumers forked over money to ingest little bits of jellyfish under the assumption that it would improve their memory. 

But entities like the NCCIH are attempting to filter alternative therapies down to the ones which are truly effective and complimentary, while still providing authoritative sources and leaving room for consumer choice.

The NCCIH classifies complementary approaches by their primary therapeutic input: nutritional, psychological, physical, or a combination of psychological and physical. But in almost every form of complementary treatment, there will be some overlap between categories.  

Nutritional approaches include treatments through the consumption of herbs, vitamins, minerals, and probiotics. These forms of complementary therapy are heavily marketed and readily available to consumers. They’re also by far the most common approach, with 17.7 percent of American adults using some form of nutritional complementary therapy. Of the nutritional supplements, fish oil is the most commonly consumed. 

But according to the NCCIH, most of the large and credible studies done on dietary supplements have found them to not be effective in the way they were marketed; potential remains, but so do concerns around safety and interactions with other medicines. 

Physical, psychological, and combination physical-psychological approaches include acupuncture, chiropractic and osteopathic medicine, massage, meditation, and yoga. The 2012 survey found meditation, yoga, and chiropractic medicine to be the most commonly used complementary therapies in these categories. Yoga has continued to grow in popularity, with 9.5 percent of American adults practicing yoga in 2012 and 14.3 percent in 2017. Meditation has seen an even bigger increase, from 4.1 percent to 14.2 percent. 

These practices have origins outside of Western medicine, but that doesn’t make them unscientific: organizations like the Mayo Clinic and Johns Hopkins both publicize the benefits of complementary therapies like meditation and yoga. Currently, the NCCIH is funding studies on the use of chiropractic medicine, mindfulness, meditation, and hypnotherapy in helping veterans with pain management. They’re also funding studies into the use of yoga, tai chi, and massage therapy in symptom relief for cancer patients. And early reports suggest that complementary therapies can help promote healthy behaviors, like smoking cessation, too.

The last few decades have seen an increasing acceptance of complementary therapies and integrative health. Part of that is a result of more rigorous scientific inquiry. But it’s also due to a growing awareness of the inherent biases of Western medicine: historically, Western medicine has been dominated by white males, and unfortunately so has its research. That research, and that medicine, aren’t necessarily as effective as it could be when applied to female bodies and bodies of color. That’s given rise to significant health disparities. 

To support the goal of improving women’s and minority health and eliminating health disparities, the NCCIH’s strategic plan includes funding research with diverse populations and promoting a more diverse scientific workforce. Continued research, combined with more consumer education, can change the landscape of what’s possible in integrative health. 

The rise of integrative medicine can also be seen as a growing open-mindedness in the medical community: there’s much to be learned from alternatives. Chinese medicine and indigenous medicine may have once been dismissed out of hand solely due to their origins; now, the hope is that if elements of those practices are dismissed, it’s after a careful examination of scientific fact. 

Over time, with more research and more data to compare, integrative health can better achieve its mission of effectively treating the whole person, no matter what gender, race, or ethnicity that person may be, and no matter where an effective treatment originated. 

To learn more about the state of integrative health today, and where it’s going, check out some of the resources below.

• Academic Collaborative for Integrative Health (ACIH): The ACIH builds partnerships, educates, collaborates, and advocates for whole person, collaborative, team-based, patient/person-centered care.
• National Center for Complementary and Integrative Health (NCCIH): Part of the National Institutes of Health, the NCCIH funds research and education around complementary and integrative health. Its mission is to determine, through rigorous scientific investigation, the fundamental science, usefulness, and safety of complementary and integrative health approaches and their roles in improving health and healthcare.
• World Health Organization 2019 Report on Complementary Medicine: This WHO report examines the use of alternative and complementary medicine across 179 member states over the past two decades.

Matt Zbrog

Writer

Matt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about trends within the healthcare workforce, with a particular focus on the power of interdisciplinary teams. He’s also covered the crises faced by healthcare professionals working at assisted living and long-term care facilities, both in light of the Covid-19 pandemic and the demographic shift brought on by the aging of the Baby Boomers. His work has included detailed interviews and consultations with leaders and subject matter experts from the American Nurses Association (ASCA), the American College of Health Care Administrators (ACHCA), and the American Speech-Language Hearing Association (ASHA).