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Abstract：
BACKGROUND: As the Sustainable Development Goals deadline of 2030 draws near, greater attention is being given to health beyond the health sector, in other words, to the creation of healthy societies. However, action and reform in this area has not kept pace, in part due to a focus on narrower interventions and the lack of upstream action on health inequity. With an aim to guide action and political engagement for reform, we conducted a thematic analysis of concepts seeking to arrive at healthy societies.
METHODS: This paper drew on a qualitative thematic analysis of a purposive sample of 68 documents including political declarations, reports, peer reviewed literature and guidance published since 1974. Three independent reviewers extracted data to identify, discuss and critique public policy levers and \'enablers\' of healthy societies, the \"how.\"
RESULTS: The first lever concerned regulatory and fiscal measures. The second was intersectoral action. The final lever a shift in the global consensus around what signifies societal transformation and outcomes. The three enablers covered political leadership and accountability, popular mobilization and the generation and use of knowledge.
CONCLUSIONS: Documents focused largely on technical rather than political solutions. Even as the importance of political leadership was recognized, analysis of power was limited. Rights-based approaches were generally neglected as was assessing what worked or did not work to pull the levers or invest in the enablers. Frameworks typically failed to acknowledge or challenge prevailing ideologies, and did not seek to identify ways to hold or governments or corporations accountable for failures. Finally, ideas and approaches seem to recur again over the decades, without adding further nuance or analysis. This suggests a need for more upstream, critical and radical approaches to achieve healthy societies.
METHODS: This paper drew on a qualitative thematic analysis of a purposive sample of 68 documents including political declarations, reports, peer reviewed literature and guidance published since 1974. Three independent reviewers extracted data to identify, discuss and critique public policy levers and \'enablers\' of healthy societies, the \"how.\"
RESULTS: The first lever concerned regulatory and fiscal measures. The second was intersectoral action. The final lever a shift in the global consensus around what signifies societal transformation and outcomes. The three enablers covered political leadership and accountability, popular mobilization and the generation and use of knowledge.
CONCLUSIONS: Documents focused largely on technical rather than political solutions. Even as the importance of political leadership was recognized, analysis of power was limited. Rights-based approaches were generally neglected as was assessing what worked or did not work to pull the levers or invest in the enablers. Frameworks typically failed to acknowledge or challenge prevailing ideologies, and did not seek to identify ways to hold or governments or corporations accountable for failures. Finally, ideas and approaches seem to recur again over the decades, without adding further nuance or analysis. This suggests a need for more upstream, critical and radical approaches to achieve healthy societies.
摘要：
背景：随着2030年可持续发展目标的最后期限临近，除了卫生部门之外，人们对健康给予了更多的关注，换句话说,建立健康的社会。然而,这方面的行动和改革没有跟上，部分原因是侧重于范围较窄的干预措施和缺乏针对健康不平等的上游行动。旨在指导改革的行动和政治参与，我们对寻求实现健康社会的概念进行了主题分析。
方法：本文对包括政治宣言在内的68个文件的目的性样本进行了定性主题分析，reports,自1974年以来出版的同行评审文献和指南。三名独立审稿人提取数据进行识别，讨论和批评健康社会的公共政策杠杆和“推动者”，“如何。\"
结果：第一个杠杆涉及监管和财政措施。第二个是部门间行动。最后一个杠杆是全球共识的转变，围绕什么意味着社会转型和结果。这三个推动者涵盖了政治领导和问责制，大众动员和知识的产生和使用。
结论：文件主要集中在技术而非政治解决方案上。尽管人们认识到政治领导的重要性，对权力的分析是有限的。基于权利的方法通常被忽略，因为评估什么起作用或不起作用来拉动杠杆或投资于推动者。框架通常不能承认或挑战流行的意识形态，也没有试图找出让政府或公司对失败负责的方法。最后,在过去的几十年里，想法和方法似乎再次出现，没有添加进一步的细微差别或分析。这表明需要更多的上游，实现健康社会的关键和激进方法。
方法：本文对包括政治宣言在内的68个文件的目的性样本进行了定性主题分析，reports,自1974年以来出版的同行评审文献和指南。三名独立审稿人提取数据进行识别，讨论和批评健康社会的公共政策杠杆和“推动者”，“如何。\"
结果：第一个杠杆涉及监管和财政措施。第二个是部门间行动。最后一个杠杆是全球共识的转变，围绕什么意味着社会转型和结果。这三个推动者涵盖了政治领导和问责制，大众动员和知识的产生和使用。
结论：文件主要集中在技术而非政治解决方案上。尽管人们认识到政治领导的重要性，对权力的分析是有限的。基于权利的方法通常被忽略，因为评估什么起作用或不起作用来拉动杠杆或投资于推动者。框架通常不能承认或挑战流行的意识形态，也没有试图找出让政府或公司对失败负责的方法。最后,在过去的几十年里，想法和方法似乎再次出现，没有添加进一步的细微差别或分析。这表明需要更多的上游，实现健康社会的关键和激进方法。
