Most countries are struggling to meet the growing demand for care.

The Creating Health Collaborative believes that at the heart of this struggle is our inability to define health as more than just ‘the absence of disease’, a definition derived from the bio-medical model.

When people and communities are asked what makes them feel healthy their answers encompass things like safety, physical functioning, financial security, emotional security, nourishing relationships, control over one’s life, and a sense of meaning.

Embracing these broader definitions of health – which we call ‘health beyond the lens of health care’ – may make it possible to create it and, in turn, reduce the demand for care.

We are a group of entrepreneurs and intrapreneurs working individually to understand and create health beyond the lens of health care. We share our work and struggles, and collectively work out the principles for this work, as well as the key questions we need to answer next.

This is the report of our July 2015 meeting, entitled ‘Creating Health: Refining The Principles To Catalyze Practice’. The members of the meeting are listed in Appendix 1, the timetable of the meeting is in Appendix 2, and abstracts describing the work of the members are in Appendix 3. By listening to the members share their work and struggles we not only identified new principles (over and above those gleaned from our July 2014 meeting and in producing our eBook) but also clarified existing ones.

The refined principles are:

1. Embrace An Inclusive Definition Of Community
2. Acknowledge Power Imbalances
3. Share Power
4. Let The Community Define What Matters
5. Measure What Matters
6. Operate At Individual And Community Levels
7. Embrace Complexity
8. Acknowledge That No One Can Do It Alone
9. Accept That It’s Going To Take Time
10. Build The Right Team
11. Search For Sustainability

Our aim is to catalyze practice. The principles are a list of things to bear in mind when trying to create health beyond the lens of health care. They are not a set of instructions and there is nothing to read into their order. We are aware that the principles share common ground with good processes for community change and systems change. Given that 70% of our health is derived from our social circumstances and the environment, this is not a coincidence. How the principles have evolved is in Appendix 4.

The five key questions seemingly common to all were:

1. How do we reconceive and describe health as something plural, culture-specific, and not professionally-provided?
2. How does a community see itself as one, including acknowledging shared interests and showing equal respect to all?
3. How do we manage the tension between the health care system’s approach to health and residents’ understanding of their health?
4. How do we reconcile the differences between reductionist and holistic approaches to measurement in health?
5. And, given the ‘local’ nature of this work, what does ‘scale’ mean?

Our hope is that the refined principles can be leveraged to help more people try to create health beyond the lens of health care. But, as Ollie Smith, a member of the Executive of the Collaborative, shares in his commentary, “we must do better than just producing a list of principles”.

While we hope you enjoy the report what we really hope is that you start trying to do this kind of work. There is no road map; we have to learn by trying. So just start – and if we can help, let us know.