Bridging the distance between lifestyle and determinants of health approaches: The Circle of Health as a synthesis tool

Abstract

The rhetoric of crisis in the Canadian Health Care System has created an environment in which the central tenants of health promotion are divided into opposing camps of individual lifestyle practices versus a systems approach to health. A number of frameworks have attempted to bridge together the many components of health promotion theory, but in their design they have continued to reflect the divide between lifestyle and determinants of health perspectives. However, an innovative, collaborative, community-based workshop process has resulted in the development of a framework, called the Circle of Health, that successfully synthesises core elements of both perspectives on theory and practice. This paper situates the development of the Circle of Health in Canada's current healthcare environment and in Canada's dynamic history with health promotion theory and praxis. The authors describe the development and validation of the Circle of Health. The authors conclude with the proposition that the Circle of Health has the potential to serve as a culturally appropriate tool for bridging the distance between lifestyle and systems approaches to emerging healthcare challenges in Canada and internationally.