From Living Systems to Precision Health: The Allostatic Viability Principle as a Framework for Responsible Health Systems

Precision health is often presented as the expansion of measurement, prediction and personalization: more biomarkers, more omics layers, more digital traces and more artificial intelligence. Yet data density does not by itself produce orientation, responsibility or better care. This Perspective introduces the Allostatic Viability Principle (AVP) as a systems framework for responsible precision health. Drawing on the biological logic of allostasis and the systems concept of viability, the AVP argues that health systems remain responsible not by freezing static parameters, but by preserving their capacity for regulated openness, feedback-sensitive adjustment and accountable correction. The framework is operationalized through four interdependent system functions: boundary, exchange, feedback and correctability. It further distinguishes population-based biomarker norms from individual trajectories and patient-defined health objectives. The biological analogy is used as a conceptual lens: it does not provide a blueprint for institutional design, but helps to identify when precision health systems remain responsive, and when they become closed, noisy or uncorrectable. The Perspective integrates systems theory, epigenetic and microbiome regulation, precision nutrition, allostatic load, salutogenesis, evolutionary developmental biology, digital health and AI governance. The paper argues that precision health becomes responsible only when biomarkers, AI outputs and patient-reported outcomes are embedded in correctable, goal-concordant and institutionally accountable learning systems.