The term "health" can mean different things to different people. Yet current medical frameworks largely fail to consider individual perspectives on what constitutes health.

“Health is not just about being cured of an illness or staying alive,” explains Professor Gerold Stucki, who also serves as Director of Swiss Paraplegic Research in Nottwil. Rather, he explains, health is also about “functional capacity,” which may involve “the extent to which you can manage your day-to-day life independently and engage in activities that greatly affect your wellbeing, like participating in social life or working.”  

A new framework

In 2001, the World Health Organisation (WHO) introduced the International Classification of Functioning, Disability and Health (ICF). The new framework for defining and measuring disability focuses on how people live with their health conditions, and how these conditions affect their functioning in daily life.

While the concept of functional capacity has gained traction in rehabilitation medicine, both in clinical practice and benchmarking, it has yet to be fully integrated into the broader healthcare system. “We need a new understanding of health - and therefore a paradigm shift,” Stucki insists.

The University of Lucerne leads the way

Stucki and his colleague, Professor Sara Rubinelli, underscore the University of Lucerne's pivotal role in developing methodologies to apply the WHO's ICF classification in various healthcare settings through projects like "Smarter Health Care" and initiatives such as the "Life Ruler," aimed at standardizing functional capacity data collection globally by 2030.

The professors also emphasize the importance of societal and political shifts to support the new perspective. Through the Lucerne Initiative for Functioning, Health, and Wellbeing (LIFE), the University of Lucerne aims to advance a novel understanding of health as functioning within society and to incorporate this perspective into healthcare systems, research, education and practice. Rubinelli describes the guiding principle behind the initiative as “enabling people to live their lives independently and according to their needs."

As the population ages and chronic illnesses increase, Stucki and Rubinelli's call for a holistic approach to health becomes increasingly urgent. Rubinelli concludes, "We need a shift from a disease-centred to a person-centred approach," underscoring the profound humanistic and societal benefits of embracing functional capacity as a core healthcare metric.

This article is based on an in-depth interview  (German only) with professors Gerold Stucki and Sara Rubinelli published in the latest issue of the University Magazine «cogito».