OPERATIONALIZATION OF THE INTEGRAL MODEL OF HEALTH IN THE HUMAN-ENVIRONMENT ECOSYSTEM: CRITERIA, VALIDATION, AND DIGITAL BOUNDARIES

The underlying integral model defines health as a dynamic state of integral human existence in interaction with the environment. This study aims to develop a conceptually coherent architecture for operationalizing this definition and a program for its subsequent empirical validation. A conceptual integrative synthesis was conducted across biopsychosocial, salutogenic, functional, capability-based, socio-ecological, humanities-based, public policy, and digital ethics approaches. The unit of analysis is the human-environment system, with the person as the primary agent in assessment and decision-making. Six interrelated criteria were developed: integrity and coherent interaction among dimensions; adaptability; maintenance and restoration of individual balance; functional capacity and agency; viability, self-realization, and generativity; and distributed responsibility. For each criterion, constructs, candidate indicators, data sources, levels of assessment, and risks of misinterpretation were identified. An operational chain linking definition, criterion, construct, indicator, data, assessment, decision, and feedback, together with a six-stage validation program, is proposed. Within this architecture, the healthcare professional acts as a clinical expert, interpreter, partner in shared decision-making, coordinator, and guarantor of safety, without holding exclusive authority over the definition of health. Economic productivity is regarded as an important, but not exhaustive, manifestation of human capacity. The framework establishes requirements for future digital and AI solutions while preserving human judgment.