The Roots of Health Creation

Health creation as a concept brings together the wisdom gained from clinical and community leaders who have been working over decades to address inequality and support people to change their and their communities’ lives. In particular, it draws on the work of:

• Aaron Antonovsky, an American sociologist who talked about helping people to manage and reduce chronic stress (and the impact this has on health). He put forward a theory called ‘a sense of coherence’ which said that people could stave off the worst effects of stress if their lives are comprehensible, manageable and meaningful¹
• Viktor Frankl, a psychiatrist who sought to understand why some people had survived the German concentration camps during the Second World War, concluding – by quoting Nietzsche – “He who has a why to live for can bear with almost any how”- i.e. the importance of a life with meaning²
• Sir Harry Burns, the former Chief Medical Officer for Scotland, who spoke often about his experiences of working at Glasgow Royal Infirmary as a surgeon, observing that his working-class patients healed more slowly than others. Absorbing the work of others, such as Frankl and Antonovsky, he thought that some of what he saw was down to a lack of resilience, meaning and purpose in men’s lives when the shipyards of Glasgow closed³
• The Young Foundation, in 2008, studied how neighbourliness strengthens community resilience. They found the strongest communities are those in which residents are able to influence decisions affecting them and their neighbourhoods, where there is regular contact between neighbours and where residents gain the confidence to exercise control over their circumstances⁴

It is this work that led Health Creation Alliance to articulate the 3Cs of health creation – Control, Contact and Confidence – and to test them further with people with lived-experience.

In essence, the Health Creation Framework is a new way of conceptualising and drawing together a range of theories and approaches that have long been expressed in the health world by different names.