Determinants

Humaginarium operationalizes the force of self-determination.

Humaginarium addresses the problem of health incompetence, and we do it in a new way.

Not by telling folks how to avoid, prevent and control chronic illness, but letting them figure it out by themselves.

Not by imparting sterile medical information, but empowering them to make choices and decisions that satisfy underlying needs.

Not by picking apart symptoms and treatments, but nudging folks to understand and deal with causes.

Those causes are called determinants of health. According to Humaginarium, the determinants of health fall into four categories:

  • Physical
  • Psychological
  • Social
  • Environmental

Physical determinants are tangible properties of the body. Physiology, biochemistry, the tissues that give it shape and weight, the growth and decay manifest in them. Physical determinants can be seen under a microscope, on an x-ray and CT scan, in a DNA sequence. They’re as tiny as molecules swarming the mitochondria, as large as 25 feet of neatly folded intestines hosting trillions of symbiotic bacteria.

Psychological determinants are properties of the mind — conscious and subconscious, voluntary and reflexive, rational and emotional, learned and instinctive. Psychological determinants can’t be seen, yet they can be felt and measured. They’re as fleeting as appetite and rooted as depression. As a professional focus of mind-body medicine, and having biochemical agency, they are psychic fluff that both augurs and stymies disease.

Social determinants of health are properties of lifestyle. Extrinsic, situational, interpersonal rather than organic and evolved, they manifest in customs, culture, class and community as behavioral norms, relationships and traditions that organize and regulate the tribe. Social determinants of health include wealth and poverty, education, race, religion, vocation, zip code and lately ideology. Sex and violence are also big among them.

Environmental determinants of health are both naturally occurring and built — in biosphere and atmosphere, urban sprawls and outback. The water we drink, the air we breathe, the weather that rains on our parade, the ground we frack, the mountains we strip and decapitate, the rivers we pollute, the trees we incinerate. Environmental determinants are palpable yet easy to ignore. They not only cause sickness, but also extinction!

There we have it, four determinants of health by category. There’s a fifth one I haven’t mentioned, the secret sauce of Humaginarium: it’s the determinant of self.

As in, self-determination. An individual’s firm intention to achieve a desired end. Self-determination theory explains out how it works and what it means; conation gives it linguistic pedigree; motivation, grit and ambition haul it into common parlance.

Self-determination is what a person exercises to assert cause, rather than be wrangled by the causes of others. Self-determination can be positive as with Laurence of Arabia, or negative as with Billy Budd. Either way, it is the single most potent counterweight to the other determinants of health that I listed. And of course, it is largely ignored by healthcare and biomedicine as we know them.

As players in Humaginarium develop their own firm intention to prevent, avoid and control the chronic illnesses they meet in our fantasies, it shall happen, they will win, both in game and real life.

But as long as they lack the gumption and inspiration and wherewithal to stand up and fight, it will not happen. I believe that as surely as I believe the sun also rises.

That Humaginarium has found a way to operationalize self determinants at scale, quickly and easily, simply means that the days of the other determinants of health may be numbered. They have ruled and tortured folks with chronic illness enough. Shut the back door. Game on!

From The Little Engine That Could