Developing a health equality imagination: Critical reflection, public health practice and transformational learning

Critically reflecting on current public hospital practice opens the space to explore public health practitioners’ responses to the realities of growing national and international health inequalities research. This rapidly growing body of research is currently driving social policy across the globe but is it having any impact on direct practice interventions in health and welfare systems? Critical reflection aids professionals to discover the differences between espoused beliefs and knowledge and actual practice, to explore the multiple reasons why actions have been taken and the consequences and power of these actions. Based in these reflections this paper discusses the challenges and opportunities health inequalities research presents for educators and practitioners in relation to improving health and well-being. The development of a “practitioner health equality imagination” is proposed in order that all practitioners advance a transformational response in their daily practice. For educators developing a “practitioner health equality imagination” requires knowledge about transformational learning and the addition of detailed health inequality knowledge to the now well- developed knowledge of other forms of discrimination and injustice. For practitioners it requires the ability to deliberately promote a social model of health that reflects upon and addresses issues of power, access, the interplay between the individual, the professional and health and welfare systems at the point of service delivery. For the multi-disciplinary team it requires the creative ability to use their imaginations to reflect upon how life could be different for the individual, family and community if we address the micro level detail of current social barriers to good health and well-being. For professional groups it requires the ability to develop and implement policy that drives new approaches to practice.