In my first column, I introduced myself, and also introduced the concept of "integrative" medicine, in which the patient is central, and all therapeutic modalities are considered, as patient and care-giver work in partnership towards the goal of healing.

Now I'd like to explain the title I have used for this column: "global health".

Global health, like so many names these days, is a play on words, with several different layers of meaning. The first and most obvious meaning is that any consideration of health has to address it as a broad and sweeping phenomenon, involving any and all aspects of our lives. Health, as the World Health Organization stated in 1946, is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." We are hopelessly narrow in our thinking if we define health as merely physical, or define it as the lack of outward manifestation of disease. In fact, we are missing the point entirely if we consider people unhealthy if they suffer from a physical infirmity, but have balanced emotions, strong minds and deep spiritual roots. Health is a wonderful thing, but it is not simple.

The second meaning of "global health" is that any and all processes and procedures can contribute to – or subtract from – health. For example, is an exercise program for seniors less or more important to maintaining bone strength than a herbal remedy designed to do the same, or than calcium/magnesium supplements, or than a patented drug obtained on prescription? Well, the honest answer to that question is that any or all might help, depending on the circumstances. In our part of the world, for most of the last half century, we have almost overwhelmingly chosen something like the last remedy; but now we're reconsidering all the others again, and many more besides them, and discovering that our range of choices was both narrow, and in many respects ill-considered.

Consider another example. Is the "health care system" (really a disease care system) more important for your health than an adequate supply of fresh, uncontaminated food? (Historically, it's clearly the latter; I refer readers to the work of Welsh epidemiologist Thomas McKeown, who laid out the greater importance of abundant food and other non-medical factors in maintaining health, way back in 1976, in a slim volume entitled "The Role of Medicine: Dream, Mirage or Nemesis?").

Everything in our lives has an influence on our health, and the restriction of options to drugs and surgery is not only foolish, it's illogical and unscientific.

The third meaning of the title "global health" is that the health of the Planet is a real and all-pervasive presence in our lives – and has a constant, reciprocal connection to our own health, in profound ways.

If there is one aspect of human existence that has slipped below our radar until recent decades, it is this: the intimate inter-relationship between the health of the Planet and the health of us humans. For most of humankind's existence on earth, we have been able to ignore this unavoidable biological fact. We have almost always been able to delude ourselves into believing that we were separate from Nature, that we controlled Nature, that we were smarter than Mother Nature.

How wrong we have been! Until recently, the only voices speaking about our inextricable connection to the web of life were visionaries scattered throughout this culture, persons with a profound intuitive sense of this unavoidable truth. Even First Nations, in the past, did not often consciously address this issue – they lived it on a day-to-day basis, it is true, but when pressures to disturb the natural balance came along (e.g. an intense desire for beaver hats in Europe's capitals in the 1700s and 1800s), they could be as blind to the long-term effects of environmental destruction as any ignorant colonist (in a few decades native hunters nearly wiped out the beaver in much of Canada).

Interest and concern for the "environment", defined as the natural "ecosystem" around us, has a history of only about 50 years in total. Prior to that, the word meant primarily the human or "built" part of what surrounds us – public health officials for the most part still think of "environment" that way. But such thinking, in the light of an enormous and growing weight of scientific knowledge, is fatally flawed.

Our health always has depended on a whole range of influences, responded to a vast range of treatments and interventions, and been linked to the health of the planet and all its creatures. "Global health" is more than a catchy title. It's reality.

Dr Bell is a very busy physician in the heart of the Okanagan Valley, BC.

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