Theory and Policy Innovation for Health: where has the creativity and fun gone?

Recently, I attended one of those weekly research seminars. The presenter was a newly appointed research professor with many competitive grants and international consultancies under his belt. In explaining what had taken him to such leading stature in his field, he proudly announced that he ‘. . . never let research be clouded by theory.’ I had to think of one of Kurt Lewin’s famous maxims, ‘If you want to understand something, try changing it.’ Indeed, action before understanding sometimes is a promising approach to innovation. Yet, the same Lewin also said something about the practicality of theory. As editors of this journal, we are sometimes torn between excellent manuscripts describing a problem, and possibly less brilliant pieces that speculate why something is a problem and how solutions could be sought. The scientific procedures of describing a problem analytically have crystallized into a fabulously powerful toolbox, with the Randomised Controlled Trial emerging as (what some would believe) the ‘Swiss Army Knife’ of empirical understanding. However, approaches towards theorizing and validly speculating about causal, final, normative and other relations often still rely on creativity, lateral thinking and applying wisdoms from alternative disciplines to the health field. Such approaches are less strictly codified, and harder to appraise for us as editors of a journal at the cutting edge of health understanding. The science of innovation in fact finds humour in creativity, one of the greatest assets for change (Land and Jarman, 1993). In this issue of the journal, we are proud to present some of the fabulous creativity and lateral thinking that will take the health promotion field forward, colourfully and sometimes with great wit clouded by theory. In her book ‘Policy Innovation for Health’, the Chair of our Editorial Board presents, as always, some challenging thoughts (Kickbusch, 2008). She describes how historically the four domains of health (personal; public; medical; and the health market) have been competing for power over health. Medical health currently seems dominant. At the same time, ‘health’ has escaped from what was historically a contained arena owned by well-defined proprietors. The discourse now has expanded into many other spheres in the last decades. Health is now socially pervasive and penetrates virtually all spheres of public, private and corporate life at any local level. This compelling starting point leads to dramatic new insights. While most of us are still considering our options as a result of the reinvigorated debate around social determinants of health, Kickbusch leads her co-authors beyond these ‘classical’—as she calls them—determinants into a domain where globalization, networked governance and partnerships may work for and against human health. Indeed, the book challenges us all to radically rethink the approaches, structures and geo-political options that are required to deal with health in a changed and ever-changing world. The very practical case that is given is that of obesity as the emblematic disease of the twenty-first century, compared to cholera as the symbol of the nineteenth. With the wisdom of hindsight Thomas McKeown could—applying Sherlock Holmes’ maxim When we have eliminated the impossible, whatever remains, however improbable, must be the truth—start to argue Health Promotion International, Vol. 26 No. 1 doi:10.1093/heapro/dar001 # The Author (2011). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com