The 'lifeworld' of health and disease and the design of public health interventions

The consequences of the COVID-19 pandemic are still working through health systems worldwide, and further reflections about the nature of health and disease, and about how to design and implement effective public health interventions are much needed. For numerous diseases and conditions, as well as for COVID-19, our knowledge base is rich. We know a lot about the biology of the disease, and we have plenty of statistics that relate health to socio-economic factors. In this paper, we argue that we need to add a third dimension to this knowledge base, namely a thorough description of the lifeworld of health and disease, in terms of the mixed biosocial mechanisms that operate in it. We present the concepts of lifeworld and of mixed mechanisms, and then illustrate how they can be operationalised and measured through mixed methodologies that combine qualitative and quantitative approaches. Finally, we explain the complementarity of our approach with the biological and statistical dimensions of health and disease for the design of public health interventions.