The Whole Well-Being Model: A Layered Framework for Thriving People, Systems, and Planet

Abstract

The Whole Well-Being Model offers a layered framework for understanding and supporting health across multiple levels, from individual experience to systems and the environment. As terms like whole health, whole person health, and integrative health gain traction, their overlapping use can create confusion. This model brings clarity by organizing existing domains, from integrative health to planetary health, into a coherent structure. It organizes these domains in a way that clarifies their connections and highlights their distinct contributions. It is rooted in the recognition that well-being does not happen in isolation and requires attention to both personal and systemic factors. The model was developed conceptually to help leaders, practitioners, and educators align strategies with a broader vision of human and planetary thriving. While not yet tested through formal feedback or empirical study, it is designed as a practical tool to inform design, collaboration, and innovation. This article introduces the model, explores its structure, and considers real-world applications. By linking individual needs with broader systems and environmental contexts, the Whole Well-Being Model supports more integrated and intentional approaches to advancing health.

Background

Health care today is increasingly recognizing that true health extends beyond the treatment of disease, and is impacted by broader aspects including social, environmental and systemic conditions.^1-3 Terms like “whole health,” “whole person health,” and “integrative health” have gained traction reflecting this understanding.^1,4,5 Yet the language and frameworks can often feel overlapping, inconsistently applied or fragmented. Without a coherent way to organize these ideas, opportunities to design better systems, deliver more meaningful care, and support thriving individuals and communities can be lost.

This paper introduces the Whole Well-Being Model, a layered framework that connects individual experience with systemic and environmental factors to help practitioners and organizations work with greater clarity and impact. Drawing on concepts from integrative to planetary health, the model organizes these domains into a nested progression that reveals their relationships and points of action. It builds on Drake’s (2021) idea of nested health domains which centers on the continuum from public to planetary health, ⁶ and expands that framing by further delineating the inner layers and clarifying relationships not previously defined in published models. It identifies integrative health, whole person health, and whole health as distinct but connected areas, and offers a practical framework to guide aligned action across all levels.

At its core, the model is based on a simple truth: well-being does not happen in isolation. It is influenced by personal choices, care systems, community environments, global interdependencies, and the state of the planet itself. Each layer matters. Yet many of the most pressing questions facing health care today around tools, systems, equity, and design sit in the early layers, where clarity has been most needed.

By offering a way to see both the parts and the whole, the Whole Well-Being Model may provide a useful foundation for more thoughtful design, more strategic collaboration, and more powerful action toward true thriving at every level of scale.

Why Well-Being Needs a Better Map

Across the healthcare landscape and in everyday conversation, the term well-being appears with increasing frequency. ⁷ But in most contexts, it remains either loosely defined or applied inconsistently. For one organization, well-being might mean reducing burnout among staff. For another, it might mean supporting patient lifestyle change, offering community programming, or investing in green space.

None of these interpretations are wrong. But without a shared framework, efforts become fragmented, often pursued in parallel but rarely aligned. This creates disconnected efforts that are all aimed at the same goal but lack the coherence and synergy that true systems-level impact requires.

To move beyond this fragmentation, a framework that makes room for multiple truths is needed. One that connects the deeply personal and the broadly systemic. One that does not collapse well-being into a single metric or intervention but instead offers a structure for seeing how the pieces relate and where our work fits within the whole.

This model does not attempt to simplify complexity or impose uniformity. Instead, it offers a layered, integrated view: a way to zoom in and out, to understand what is happening within a person’s lived experience, and how that experience is shaped by systems, communities, policies, and environments.

Defining Well-Being

To discuss well-being in a meaningful way, it is important to start with a clear definition. Well-being is a multidimensional concept that includes physical, emotional, social and environmental aspects. ⁸ Jarden and Roche describe it as an evolving term that often includes life satisfaction, positive function and a sense of flourishing. ⁷ Building on this, the Whole Well-Being Model defines well-being as:

“The experience of living with connection, purpose, and capacity – as defined by each person, in relationship to their community, environment, and life circumstances.”

This definition does several things that traditional clinical or behavioral health definitions often miss. It centers experience, recognizes personal definition, emphasizes relational context, and acknowledges internal/external capacity.

The challenge of defining well-being has a long history in the academic literature. Foundational work by Ed Diener and colleagues ⁹ shaped the field of subjective well-being by showing that happiness and life satisfaction can be systematically defined and measured, mostly at the individual level. VanderWeele has expanded on this by framing well-being as human flourishing, emphasizing its multidimensional nature. ¹⁰ While this work is invaluable, most of the discussion focuses on individuals, with some attention to community well-being but less at a more comprehensive level. This model builds on that foundation by extending the lens of well-being to broader levels.

Well-being is more than physical health, the absence of disease, or even happiness. It is about whether life feels workable, meaningful, and supported. It is shaped by cultural identity, access to care, opportunities for belonging, structural inequity, environmental security, and more.

By defining well-being this way, a door is opened to more inclusive, more honest conversations. And space is created for strategies that honor not only what is going on in a person’s body, but what is happening in their community and their world.

Clarifying the Path to the Whole Well-Being Model: Integrative Health, Whole Person Health, and Whole Health

The first three layers of the Whole Well-Being Model share a common philosophical foundation: an emphasis on treating the whole person, aligning care with personal values and purpose, and integrating a broad range of tools and approaches. Yet, each reflects a distinct level of action:

• • Integrative Health has historically centered on expanding the clinical toolbox beyond conventional medicine, but it has also always incorporated a whole-person perspective, even before that language became more widespread. By expanding the scope of care to include evidence-based complementary approaches, it helps bridge the gap between biomedical treatment and personal experience.

• • Whole Person Health focuses on the lived, multidimensional experience of individuals. It addresses not just physical symptoms but also emotional, social, spiritual, and environmental dimensions. It reflects an understanding that well-being arises from the interplay of many life factors, and that meaningful care requires supporting the full context of a person’s life. The National Center for Complementary and Integrative Health (NCCIH) describes Whole Person Health as restoring health across interconnected domains, rather than treating disease in isolation. ⁵ The Duke Health & Well-Being Wheel of Health and the VA’s Circle of Health are two examples of structured approaches that reflect core concepts of whole person health.^11,12

• • Whole Health builds on that vision by calling focused attention to what matters most to each person, their purpose, and goals, and calls for designing systems and structures that support those priorities. The U.S. Department of Veterans Affairs (VA) has operationalized this model through the Whole Health System framework, which emphasizes team-based care centered on individual purpose and well-being. This model has become foundational in national efforts to reimagine care through a whole health lens.^12,13

While these terms are sometimes used interchangeably, understanding their distinctions clarifies how the unique role each layer plays, while viewing them within the context of the whole provides greater perspective and coherence.

Key Insight: Each approach shares a commitment to whole-person care but emphasizes distinct levels of action from expanding clinical tools, to supporting lived experience, to reshaping systems for lasting well-being.

The Whole Well-Being Model: A Layered Framework

Well-being is shaped by more than one factor, one system, or one choice. It lives in the intersections of personal care, social structures, environments, and planetary realities. The Whole Well-Being Model offers a structured way to see those intersections, organized as seven nested layers, each contributing to, and dependent on, the others (Figure 1).

Figure 1.

The Whole Well-Being Model

Think of this as a series of concentric circles or zoom levels: starting with the tools used to support health, and expanding outward through systems, communities, ecosystems, and the planet itself. Each layer contributes to, and depends on, the others. None are sufficient on their own.

While disciplines like public health, global health, One Health, and planetary health may not always use the term well-being to describe their work, the systems they influence are essential to supporting it. This model does not assume all fields must adopt the same terminology. Rather, it offers well-being as a unifying lens, one that helps connect individual lived experience with structural, environmental, and planetary realities. By viewing these layers through a shared frame, efforts can be better aligned across silos and understand how different levels of action shape what it means to thrive.

Integrative health serves as the model’s starting point because it offers a broader, more complete, and inclusive approach to health and well-being than the conventional biomedical model. This breadth is essential, because as this model moves outward through the other dimensions of well-being, it becomes clear that lasting impact requires a holistic view; one that avoids limiting our understanding or our solutions. Beginning with integrative health reflects that commitment to seeing the full picture from the start.

Layer 1: Integrative Health—“The Toolbox”

This is the level of strategies and approaches, the tools used to support people in pursuing health and well-being. In conventional healthcare, the toolbox often includes diagnostics, medications, and procedures. Integrative health broadens that view. It includes evidence-based complementary approaches and lifestyle interventions that recognize the complex nature of healing. ⁴

Examples:

• • Health coaching that aligns with personal goals and readiness for change.

• • Root-cause assessments, such as functional medicine evaluations.

• • Incorporation of mind-body practices such as meditation, yoga therapy or breathwork.

• • Lifestyle interventions such as sleep hygiene practices.

Key Insight:

When offered with openness and partnership, integrative tools create pathways for personal agency and deeper engagement in health and well-being.

Layer 2: Whole Person Health—“The House”

This layer reflects the lived experience of the individual, their body, mind, relationships, culture, trauma, history, and hopes. It’s not about checklists of symptoms, but about the integrated experience of being human. ¹⁴

Examples:

• • A patient with diabetes whose sense of purpose influences health behaviors more than any treatment plan.

• • A veteran working through moral injury that impacts their physical, emotional, and social well-being.

• • A parent whose chronic stress, poor sleep, and financial strain create a cascade of symptoms.

This is the level where compassion and curiosity matter most. Where healing often begins not with a prescription, but with being seen and heard.

Key Insight:

Whole Person Health reminds us that health is not just treating problems; it is about supporting people in the full context of their lives. Understanding the “house” requires attention to both internal and external influences.

One example of a whole person model is the Duke Health & Well-Being Wheel of Health, which offers a structured way to visualize the interconnected dimensions of well-being. ¹¹ (Figure 2). The model places “You” at the center, surrounded by Mindful Awareness and a set of key domains of health, held within the broader context of Community. It reflects an integrative philosophy that supports whole person care by addressing both internal and external influences on well-being.

Figure 2.

Duke Health & Well-Being Wheel of Health

Layer 3: Whole Health—“The Neighborhood”

If Whole Person Health is the house, Whole Health is the neighborhood – the systems, policies, cultures, and teams that surround and support the individual.^1,13,15

This layer focuses on how environments are intentionally designed to align with what matters most to each person – their goals, values, and sense of purpose. Whole Health is not just about access to care; it is about creating systems that actively promote well-being, resilience, and thriving.

This layer includes:

• • Care environments and team structures.

• • Payment and access models.

• • Organizational values, inclusion, and equity practices.

This broader shift toward designing care around purpose, resilience, and thriving is also reflected in the 2023 National Academy of Sciences report, Achieving Whole Health: A New Approach for Veterans and the Nation. ¹ They define Whole Health as “physical, behavioral, spiritual, and socioeconomic well-being as defined by individuals, families, and communities,” supported by team-based care aligned with a person’s purpose. ¹ The VA echoes this with the ethos of “what matters to you,” not just “what’s the matter with you.” ¹⁶

Examples:

• • A clinic redesigns care teams to integrate behavioral health, coaching, and community health workers.

• • An employer embeds purpose-driven well-being into workplace structures.

• • A health system shifts performance metrics to reflect relationship-centered outcomes.

Key Insight:

Whole Health is about design. Are our systems enabling the outcomes that they say they care about? Or are they quietly undermining them?

Layer 4: Public Health—“The Town”

Public health is the level of shared conditions. It is about the infrastructure, prevention strategies, and community environments that shape health before a person ever enters a clinic. As Turnock describes, it is “an organized community effort to address the public interest in health by applying scientific and technical knowledge to prevent disease and promote health.” ¹⁷

This includes:

• • Social determinants of health.

• • Housing, transportation, food access.

• • Environmental exposures and clean air and water.

• • Community trauma and structural inequities.

Examples:

• • A public health department partners with schools to offer nutrition education and trauma-informed care.

• • A city redesigns neighborhoods to reduce heat islands and improve green space access.

• • Policy leaders prioritize upstream interventions instead of reactive crisis response.

Key Insight:

Public health reminds us: your health is not only about your choices. It is also about the conditions you live in, which are, in turn, shaped by systems and power.

Layer 5: Global Health—“The Network”

Global Health is the network that connects people, ideas, and conditions across the world, extending beyond the local focus of public health.

This layer reflects the reality that no community’s health exists in isolation and draws from established global health frameworks developed by academic institutions and public health organizations.^18,19 People, goods, diseases, ideas, and policies move rapidly across borders, shaping conditions far beyond their point of origin. Global Health focuses on the shared vulnerabilities and interdependencies that define our modern world, highlighting the need for cross-border collaboration, equity, and collective action.

This includes:

• • Global efforts to prevent and respond to infectious disease outbreaks.

• • International work to promote maternal and child health.

• • Vaccine distribution and access initiatives.

• • Addressing disparities in healthcare infrastructure and resources across nations.

Examples:

• • International collaborations to improve vaccine equity in under-resourced regions.

• • Global surveillance systems for emerging infectious diseases.

• • Cross-border partnerships to strengthen healthcare systems and build resilience against climate impacts.

Key Insight:

Global Health reminds us that no town, city, or nation is an island. Health flows across borders, and so must our solutions.

Layer 6: One Health—“The Ecosystem”

One Health is a concept shaped by institutions such as the CDC and WHO that reflects the understanding that human, animal, and environmental health are interdependent.^20,21 It is where land use, food systems, and disease ecology intersect.

Examples:

• • Collaborative disease surveillance between animal and human health agencies.

• • Sustainable agriculture initiatives that reduce pesticide and antibiotic resistance.

• • Addressing zoonotic disease risks at the wildlife-livestock-human interface.

Key Insight:

Human beings are not separate from the ecosystems we live in. Supporting well-being means seeing ourselves within the living systems we depend on.

Layer 7: Planetary Health—“the Planet”

Planetary Health is about preserving the systems that make life possible: climate stability, biodiversity, clean water, food security, and air quality.^3,6

It is not abstract. Planetary health directly affects human well-being: climate change drives stress and displacement, environmental degradation worsens chronic disease, and biodiversity loss threatens nutrition, medicine, and resilience.

Examples:

• • Health systems reducing carbon emissions and waste.

• • Community-based resilience planning for climate change.

• • Mental health support for climate grief and anxiety.

Key Insight:

Planetary health is the outer boundary of the model, but perhaps the most urgent. ²² To protect human well-being, the planet itself must be protected.

Applying the Whole Well-Being Model in Practice

The Whole Well-Being Model can be used as a practical guide to align actions, programs, and system designs across multiple levels of influence. It offers a way to see both the immediate opportunities for impact and the larger structures that shape outcomes over time.

Strategic Planning and Program Design

When developing or evaluating initiatives, leaders and teams can use the model to reflect:

• • Which layer(s) the program addresses

• • Where alignment across layers can be strengthened

• • How individual, systemic, and environmental factors are being integrated

Communication and Engagement

The model provides a clear framework for communicating. It can help:

• • Align teams around a shared goals and outcomes.

• • Convey how specific efforts support broader vision of well-being.

• • Strengthen language around the multidimensional nature of care and system redesign.

Training and Leadership Development

In education and leadership development, the Whole Well-Being Model can be used to:

• • Teach systems thinking in a tangible, layered way.

• • Help individuals see their specific roles within a broader landscape.

• • Encourage leadership that recognizes the nested, interconnected realities of health and well-being.

The model offers a flexible, non-prescriptive lens for strategy and communication. It invites users to see both the parts and the whole, and to align efforts in ways that create deeper, more sustainable impact across individuals, communities, and the planet.

Limitations and Opportunities

As a conceptual model, the Whole Well-Being Model is primarily intended to guide thinking, strategy, and design. While informed by diverse disciplines, its use in specific settings has not been tested and may require adaptation. Developed by the author as a conceptual framework, it has not yet undergone collaborative design or formal feedback. Grounded in applied experience, it is meant to spark further dialogue, adaptation, and research to support more aligned approaches to health and well-being. An implementation or assessment guide could enhance its use. Future work could explore how the model might be used in health systems redesign, care transformation, or strategic planning.

One important opportunity is to develop meaningful ways to measure well-being across the layers of the model. While there is robust research on measuring individual-level subjective well-being and flourishing, much of this does not extend well to community, systems, or planetary levels. Recent frameworks such as the Robert Wood Johnson Foundation’s work on healthy communities and the Institute for Healthcare Improvement’s population health measures point to possible directions. Continued work on practical, multi-level metrics will be essential to understand whether strategies and systems designed with this model are moving the needle on well-being at every level.

Conclusion

The national call for whole health transformation, reflected in Achieving Whole Health: A New Approach for Veterans and the Nation, reinforces the urgency of moving beyond fragmented care to systems that center purpose, resilience, and thriving. ¹ The Whole Well-Being Model offers one way to frame that work, one that links individuals, systems, and ecosystems in service of true well-being.

Health is not only clinical; it is relational, environmental, and systemic. Well-being is not a side initiative; it is the central reason for the work. Systems must be designed for human thriving in mind, while also paying attention to its place in the larger whole.

The Whole Well-Being Model offers a way to bring coherence to complexity. Not by oversimplifying, but by helping us see the full picture: the inner life of individuals, the outer design of systems, and the interconnected world that holds us all. By framing well-being as layered, nested and interconnected, the model provides a conceptual foundation toward a more sustainable and human-centered approach to health. This model is offered as a starting point to guide more integrated and meaningful action.

ORCID iD

Teresa Keever https://orcid.org/0009-0008-9444-3801