Document Type : Review Article

Authors

1 The George Institute for Global Health, Imperial College London, London, UK

2 Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia

3 The George Institute for Global Health, New Delhi, India

4 The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland

5 Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India

Abstract

Background 
While support for the idea of fostering healthy societies is longstanding, there is a gap in the literature on what they are, how to beget them, and how experience might inform future efforts. This paper explores developments since Alma Ata (1978) to understand how a range of related concepts and fields inform approaches to Healthy Societies and to develop a model to help conceptualize future research and policy initiatives.

Methods 
Drawing on 68 purposively selected documents, including political declarations, commission and agency reports, peer-reviewed papers and guidance notes, we undertook qualitative thematic analysis. Three independent researchers compiled and categorised themes describing the domains of a potential Healthy Societies approach.

Results 
The literature provides numerous frameworks. Some of these frameworks promote alternative endpoints to development, eschewing short-term economic growth in favour of health, equity, well-being and sustainability. They also identify values, such as gender equality, collaboration, human rights and empowerment that provide the pathways to, or underpin, such endpoints. We categorize the literature into four ‘components’: people; places; products; and planet. People refers to social positions, interactions and networks creating well-being. Places are physical environments – built and natural – and the interests and policies shaping them. Products are commodities and commercial practices impacting population health. Planet places human health in the context of the ‘Anthropocene.’ These components interact in complex ways across global, regional, country and community levels as outlined in our heuristic.

Conclusion 
The literature includes little critical reflection on why greater progress has not been made, or on the need to organise and resist the systems which perpetuate ill-health.

Keywords