Section 1: Definition of Terms and Professional Considerations
Common language and terms can provide a critical baseline for cross-disciplinary communication for health professionals within a One Health System. Although not exhaustive, the list in Table 1.1 outlines key terms required for discussions of One Health strategies.
In This Resource:
Considerations for contacting human health care professionals
It is beyond the scope of these guidelines to outline all the professions veterinary teams may encounter in a One Health system; however, consider these key clarifications:
- In addition to MD/DO, advanced practice providers such as nurse practitioners (NP), certified nurse midwives (CNM), physician assistants/physician associates (PA), and advanced practice pharmacists complete advanced training and provide advanced practice roles, performing functions that include diagnosing, managing, prescribing, and treating health conditions and injuries. The scope and degree of autonomy varies by profession and, in some cases, by state.
- Nursing, social work, physical therapy, occupational therapy, speech therapy, and others exist as unique disciplines grounded in their own professional practice and bodies of knowledge.
- Veterinary teams may need to engage with professionals in a variety of these roles. Consider these examples:
- Advanced practice providers, working in primary care settings, may be the point of contact for zoonotic disease exposure.
- Nurses may interface with the veterinary team regarding support for a pet while the pet’s human family member is undergoing medical treatment, or more broadly with population or public health concerns.
- Physical or occupational therapists may provide insights into a veterinary client’s abilities and challenges if pets need care that requires certain levels of mobility or fine motor skills.
- Social workers may be a resource for situations where the family needs help with access to food, shelter, and/or mental health support.
- Animal behaviorists and human mental health care professionals may collaborate on family-behavioral support.
TABLE 1.1 Definition of Terms
| Term | Definition | Application & Use in Guidelines |
|---|---|---|
| Companion animals/pets | Nonhuman members of the family | In these guidelines, “pets” is used as a general term to include dogs and cats living in companionship with humans in a family context, including service and support animals. Although many other companion animals live within human families, a discussion of other species is beyond the scope of these guidelines. |
| Doctor | A health care professional with a doctorate degree (i.e., MD/DO, DVM/VMD, DNP, PhD, PharmD, DPT, etc.). | |
| Family | Refers to the bonded family unit that includes humans, regardless of biological or legal relationships, and companion animals. A family may include one individual person and their pet(s) or multiple people in a home with their pet(s). | While other domesticated and free-living animals are included in the One Health model, a discussion of these relationships is outside the scope of these guidelines. |
| Family-centered care | A comprehensive and coordinated approach to health care that focuses on the entire family as defined above. | By viewing pet caregivers and pets as existing in an interconnected system, comprehensive, coordinated care strives to address the patient’s health needs within the context of the family and environment. |
| Health care provider or health care professional | An expansive term that refers to the many professions that provide health care to humans and animals. | When specificity is required, these guidelines use “human health care professional” or “veterinary health care professional.” |
| Health care silos | In health care, this term describes “the physical and non-physical boundaries arising between divisional units of a health system. They often evolve from complex governance structures and disparate financing models.” 1 | While not inherently destructive, silos may impede communication and collaboration and result in inefficiency and poorer outcomes for those seeking health care. 2 |
| Health Insurance Portability and Accountability Act (HIPAA) | HIPAA limits human health care providers from disclosing protected information, with a few exceptions, to anyone other than the patient and the patient’s authorized representatives without their consent. Certain states also have laws that require that information regarding veterinary care be protected from disclosure. | While veterinary health care professionals are advised to get written permission from a client to speak with their human health care providers, in most cases written consent is required for a human health care provider to discuss patient health information. HIPAA allows for communication between providers in certain situations (e.g., communicable disease reporting to a public health agency.) 3 Public health agencies can provide a useful bridge for collaborating across sectors when data sharing is a concern. |
| Human-animal bond | “The human-animal bond is a mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors considered essential to the health and wellbeing of both. This bond is beneficial to the mental, physical, and social health of people and animals.” 4 | Abundant literature documents that humans and animals share a special, mutually beneficial relationship 5,6,7,8,9,10 When the bond is challenged by illness, 11 violence , 12 or lack of resources, 13 it can have negative impacts for both people and animals. |
| Human health care team | A group of physicians, registered nurses, advanced practice providers (e.g., nurse practitioners, physician assistants/physician associates) and numerous other types of licensed and unlicensed health care professionals. | |
| Interprofessional collaboration or collaborative care | Members of two or more professions that work together toward a shared goal or outcome. 14 Sharing care for patients and clients between different health care professionals across different institutions and organizations. | Interprofessional Collaboration or Collaborative Care outlines 4 core competency areas for successful interprofessional collaboration:
|
| One Health | As defined by the United Nations’ One Health High Level Expert Panel, “…an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent.” 16 | While acknowledging that One Health encompasses a much broader approach, these guidelines focus specifically on One Health as it relates to human and companion animal interactions and connections. |
| One Health system | A One Health family-centered system is a team-based approach to animal and human health care that includes the participation of veterinarians, veterinary technicians and assistants, physicians, nurses, social workers, policymakers, and others helping to provide comprehensive and personalized services. | For the purposes of these guidelines, the term “One Health system” will encompass “One Health family-centered system,” “One Health family-centered clinical practice,” and “One Health family-centered health care.” |
| Patient | The individual(s) receiving care (e.g., veterinary patient, human patient). | |
| Physician | A health care provider with an MD, DO, or equivalent international degree. | Preferred term for these medical professionals. |
| Physician Assistant/Physician Associate | An advanced practice provider who works as a member of the human health care team. | The PA professional organizations at the national and state level are advocating to change their title from Physician Assistant to Physician Associate (PA), with Oregon passing a law with the title change in July 2024. Given the changing nomenclature, these guidelines will use the abbreviation PA or Physician Assistant/Physician Associate. |
| Social determinants of health (SDOH) | “The non-medical factors that influence health outcomes. They are the conditions in which people are born, work, live, and age, and the wider set of forces and systems shaping the condition of daily life.” 17 | SDOH are grouped into 5 key domains: (1) economic stability; (2) education access and quality; (3) health care access and quality; (4) neighborhood and built environment; and (5) social and community context. 18 |
| Veterinarian | A health care provider with a DVM, VMD, or equivalent international degree. | |
| Veterinary health care team | The group of professionals within a veterinary practice responsible for establishing and maintaining the veterinary-client-patient relationship (VCPR) with pet caregivers and their animals for ongoing care. | This team typically includes veterinarians, veterinary technicians, veterinary assistants, client service representatives, practice managers, and support staff. Depending on the type of practice, this team may also include board-certified veterinary specialists and veterinary technician specialists. |
The AAHA One Health Guidelines are generously supported by Merck Animal Health.
Citations
- Peiris D, Feyer AM, Barnard J, et al. Overcoming silos in health care systems through meso-level organisations – a case study of health reforms in New South Wales, Australia. Lancet Reg Health West Pac 2024;44:101013.
- Peiris D, Feyer AM, Barnard J, et al. Overcoming silos in health care systems through meso-level organisations – a case study of health reforms in New South Wales, Australia. Lancet Reg Health West Pac 2024;44:101013.
- US Department of Health and Human Services. HIPAA for Professionals. 2021. Available at: https://www.hhs.gov/hipaa/for-professionals/index.html. Accessed July 11, 2024.
- Human Animal Bond Research Institute. About HABRI. habri.org. N.d. Available at: https://habri.org/about/. Accessed November 5, 2024
- Brooks HL, Rushton K, Lovell K, et al. The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence. BMC Psychiatry 2018;18(1):31.
- Barker SB, Wolen AR. The benefits of human-companion animal interaction: a review. J Vet Med Educ 2008;35(4):487–95.
- Martins CF, Soares JP, Cortinhas A, et al. Pet’s influence on humans’ daily physical activity and mental health: a meta-analysis. Front Public Health 2023;11:1196199.
- Wemelsfelder F, Mullan S. Applying ethological and health indicators to practical animal welfare assessment. Rev Sci Tech 2014;33(1):111–20.
- Friedmann E, Son H. The human-companion animal bond: how humans benefit. Vet Clin North Am Small Anim Pract 2009;39(2):293–326.
- Sobo EJ, Eng B, Kassity-Krich N. Canine visitation (pet) therapy: pilot data on decreases in child pain perception. J Holist Nurs 2006;24(1):51–7.
- Spitznagel MB, Hillier A, Gober M, et al. Treatment complexity and caregiver burden are linked in owners of dogs with allergic/atopic dermatitis. Vet Dermatol 2021;32(2):192-e50.
- Mota-Rojas D, Monsalve S, Lezama-García K, et al. Animal abuse as an indicator of domestic violence: One Health, One Welfare Approach. Animals 2022;12(8):977.
- LaVallee E, Mueller MK, McCobb E. A systematic review of the literature addressing veterinary care for underserved communities. J Appl Anim Welf Sci 2017;20(4):381–94.
- Brooks HL, Rushton K, Lovell K, et al. The power of support from companion animals for people living with mental health problems: a systematic review and narrative synthesis of the evidence. BMC Psychiatry 2018;18(1):31.
- Interprofessional Education Collaborative. IPEC Core Competencies for Interprofessional Collaborative Practice: Version 3. 2023. Washington, DC: Interprofessional Education Collaborative.
- World Health Organization. One Health High Level Expert Panel Annual Report 2021. March 31, 2022. Available at: https://www.who.int/publications/m/item/one-health-high-level-expert-panel-annual-report-2021. Accessed January 16, 2025.
- World Health Organization. Social determinants of health. 2024. World Health Organization. Available at: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1. Accessed June 28, 2024.
- Office of Disease Prevention and Health Promotion. Social determinants of health. Healthy People 2030. U.S. Department of Health and Human Services. N.d. Available at: https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health. Accessed May 8, 2024.