title: Defining Health in the Era of Value-Based Care: The Six Cs of Health and Healthcare.
abstract: BACKGROUND
  While healthcare expenditure continues to increase overall health outcomes in the United States continue to be submarginal. The changes we make in our healthcare system need to be informed by a comprehensive and actionable definition of health that can unite patients, healthcare professionals, and policymakers.
  
  
  METHODS
  A literature review across multiple disciplines was conducted to assess a broad range of factors associated with health and well-being and based on this literature review a novel definition of health was developed.
  
  
  RESULTS
  Development of a definition of health as the ability to dynamically recognize and resolve dissonance in one's physical, mental, social and spiritual worlds via cooperation with social and spiritual connections, the medical community and with the natural world in a way that fosters and promotes harmony, resilience, and relief from suffering. This definition is then expanded into six domains (connection, communication, creativity, cooperation, cost-consciousness, and computerization) which are applicable to individuals, society and the healthcare system and which form the basis for actionable guidelines to promote measurable and sustained change on a public health scale.
  
  
  CONCLUSIONS
  Healthcare in the United States is changing and in order to move forward in an evidence-based and compassionate way, we need to understand what we mean by 'health' and how that definition can be operational at individual, societal, and public policy levels.
authors.affiliation: Boise Veterans Administration Medical Center, University of Washington Department of Psychiatry and Behavioral Sciences.
authors.forename: Mark
authors.initials: M
authors.lastname: Warren
keywords: health definition; health expenditure; health outcomes; health policy; value-based care