Centering social wellbeing in health systems

By Sara Barada and Elsy Dumit

Written in collaboration with World Governments Summit, this paper explores how health systems can place societal wellbeing at their core amid rising chronic disease, shifting patient roles, and rapid technological change. It proposes a three-dimensional framework—sociocultural, behavioral, and technological—to guide governments in designing health systems that are inclusive, preventive, and human-centered.

1. From care delivery to wellbeing architecture: Health outcomes are shaped as much by culture, behavior, and environment as by clinical services, requiring systems that extend beyond hospitals.
2. People as partners in health: Enabling healthy behaviors through supportive environments, incentives, and shared ownership is critical to tackling chronic disease sustainably.
3. Technology with a human core: Digital and AI solutions must expand access and equity while reinforcing trust, empathy, and meaningful human connection in care.

The rise in chronic diseases, the shifting role of patients, artificial
intelligence (AI), digital health and the growing role of patients in
disease self-management, are having significant consequences for
the evolution of health systems. Their disruptive potential requires
governments to be deliberate about how they will design health
systems to continue driving societal wellbeing and livability while
remaining grounded in the needs of the populations they serve. To
do so, they will need to factor in three key dimensions that serve as a
framework for identifying and responding to the needs of beneficiaries.

First, the sociocultural dimension recognizes that healthcare is not
a biomedical transaction between doctors and patients, but an
encounter shaped by deeply held community values, traditions, and
beliefs about how care is sought and received. The next generation
of health systems must acknowledge this and evolve beyond onesize-
fits-all solutions toward tailored, responsive models that honor
community preferences. By embedding these preferences into health
system design, societies can improve engagement and place trust
in the health system while incorporating communities’ preferences
into system design, thereby empowering them. The challenge lies
in how community preferences can be responsibly balanced with
technocratic and evidence-based approaches to health system design.

Second, the individual and behavioral dimension emphasizes
that health systems must align with the lifestyles, life stages, and
agency of patients. While only a fraction of health outcomes stems
directly from clinical care, the majority are driven by the choices that
people make every day. As a result, individuals should be seen as
active partners in health rather than passive recipients of services.
This requires not only creating enabling environments that address
the wider determinants of health but also designing incentives
that encourage and sustain healthier behaviors over time.

The technological dimension requires innovation to strengthen and not substitute the human experience of care. Technologies such as AI and
augmented reality (AR) can help achieve efficiency and value. However, they must be inclusive and equitable by supporting those who may otherwise be left behind instead of furthering health inequity. Most importantly, technology should not displace the human connection at
the heart of healthcare. Healthcare journeys encompass moments of great vulnerability (such as illness and end-of-life care) as well as joy
(for example, maternal and newborn care), and technology must be sensitive to these experiences, enhancing trust, empathy, and the human touch, rather than eroding these important qualities.

By embedding sociocultural understanding, creating conducive environments for individuals to choose healthy behaviors, and humanizing technology to advance access, health systems can move past being encumbered by context and, instead, thrive on the strengths of embracing diverse lenses through which to understand the needs of the health system.

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