International Journal of Health Policy and Management

International Journal of Health Policy and Management

What Is Not Conceptualized Is Not Measured: Towards Healthier Societies; Comment on “How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks”

Document Type : Commentary

Author
Erica Di Ruggiero
Social and Behavioural Health Sciences Division, Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
10.34172/ijhpm.9184
Abstract
Global geopolitical conflicts, pandemics, the climate crisis or rising inequities within and between countries alongside other intersecting crises all impede the pursuit of healthier societies. This commentary highlights gaps in how framing and measurement approaches reflect narrower biomedical conceptualizations of health. These gaps also relate to whether and how power is analysed, and how interventions that contribute to the (re)building of healthier societies are designed, implemented and evaluated. Dominant measurement approaches in health that prioritize individual measurement of problems and solutions at the expense of whole-of-society intersectoral interventions, and their governance are among some of the reasons. More holistic and explicit measurement equity and well-being (as opposed of disease) are required. Theory-informed research that interrogates values, social norms and ideologies, power asymmetries and that centres the study of complex context-sensitive policy and program interventions should inform future inquiries.
Keywords
Equity
Measurement
Intersectoral Interventions
Power
Governance
Healthier Societies
  1. Nambiar D, Bestman A, Srivastava S, Marten R, Yangchen S, Buse K. How to build healthy societies: a thematic analysis of relevant conceptual frameworks. Int J Health Policy Manag. 2023;12:7451. doi:34172/ijhpm.2023.7451
  2. Whitehead M. Waving or drowning? A view of health equity from Europe. Aust N Z J Public Health. 2012;36(6):523. doi:1111/j.1753-6405.2012.00947.x
  3. Morin E, Kern AB. Homeland Earth: A Manifesto for the New Millenium. Advances in Systems Theory, Complexity, and the Human Sciences. Cresskill, N.J: Hampton Press; 1999.
  4. Foucault M. The History of Sexuality. 1: An Introduction. New York: Vintage Books; 1990.
  5. Trowbridge J, Tan JY, Hussain S, Ruggiero ED. Examining the contextual factors influencing intersectoral action for the SDGs: insights from Canadian federal policy leaders. Int J Health Policy Manag. 2024;13:8108. doi:34172/ijhpm.8108
  6. Working Group for Monitoring Action on the Social Determinants of Health. Towards a global monitoring system for implementing the Rio Political Declaration on Social Determinants of Health: developing a core set of indicators for government action on the social determinants of health to improve health equity. Int J Equity Health. 2018;17(1):136. doi:1186/s12939-018-0836-7
  7. Buse K, Hawkes S. Health in the sustainable development goals: ready for a paradigm shift?. Global Health. 2015;11:13. doi:1186/s12992-015-0098-8
  8. Reynolds MM, Galea S. Advancing the Study of Power: Opportunities and Priorities for Understanding Population Health Inequities. Am J Public Health. 2025;115(6):883-889. doi:10.2105/AJPH.2025.308015
  9. Trowbridge J, Tan JY, Hussain S, Osman AEB, Di Ruggiero E. Examining Intersectoral Action as an Approach to Implementing Multistakeholder Collaborations to Achieve the Sustainable Development Goals. Int J Public Health. 2022;67:1604351. doi:3389/ijph.2022.1604351)
  10. Mondal S, Van Belle S, Maioni A. Learning from intersectoral action beyond health: a meta-narrative review. Health Policy Plan. 2021;36(4):552-571. doi:1093/heapol/czaa163
  11. Friel S, Townsend B, Fisher M, Harris P, Freeman T, Baum F. Power and the people's health. Soc Sci Med. 2021;282:114173. doi:1016/j.socscimed.2021.114173
  12. Abimbola S, Pai M. Will global health survive its decolonisation?. Lancet. 2020;396(10263):1627-1628. doi:10.1016/S0140-6736(20)32417-X
  13. Krugman DW. Global health and the elite capture of decolonization: On reformism and the possibilities of alternate paths. PLOS Glob Public Health. 2023;3(6):e0002103. doi:1371/journal.pgph.0002103
  14. Shoveller J, Viehbeck S, Di Ruggiero E, Greyson D, Thomson K., Knight R. A critical examination of representations of context within research on population health interventions. Crit Public Health. 2015;26(5):487-500. doi:1080/09581596.2015.1117577
  15. Petticrew M, Knai C, Thomas J, et al. Implications of a complexity perspective for systematic reviews and guideline development in health decision making. BMJ Glob Health. 2019;4(Suppl 1):e000899. doi:1136/bmjgh-2018-000899
International Journal of Health Policy and Management
Volume 15, Issue 1
2026
Pages 1-4

  • Received Date 26 April 2025
  • Revised Date 01 May 2026
  • Accepted Date 10 May 2026
  • First Published Date 23 May 2026
  • Published Date 01 December 2026