Pathways to health, illness and well-being: From the perspective of power and control

This article introduces the special issue entitled 'Power, Control and Heal th'. The five articles in this issue, using qualitative observation and the ory-building, deconstruct individualistic explanations of the roles of powe r, empowerment, control, self-efficacy, etc. in producing health and well-b eing outcomes, and reconstruct models and pathways to population health and well-being that are profoundly anchored in the social, economic and politi cal dimensions of human life which create, structure, and reinforce power a nd powerlessness at individual and collective levels. The theory developed here contributes to the understanding of how population health and well-bei ng are intimately related to and are consequences of power and powerlessnes s. This is the first published collection addressing the etiology of popula tion health from the perspective of power and powerlessness; as such it not only advances knowledge about the determinants of population health, but p rovides a more scientific basis for interventions aimed at 'empowering' mar ginalized persons and classes of persons. The topics dealt with include a d econstruction of self-efficacy theory and the 'socialization' of that conce pt, a model concerned with work and work stress for pathways to health and illness emphasizing class and gender, reflections on the meaning of empower ment in the prevention of unsafe sex practices, a study of empowerment and recovery in the context of changes in a community mental health system, and a systemic model based on the lifecourse perspective for child wellness an d resilience centred around power and control. Those articles are followed by a commentary which stresses the need to 'depsychologize' community psych ology, noting that even the articles in this special issue retain notable v estiges of reductionism to the individual level. This introduction describe s the evolution of the public health field into the 'population health fiel d' and the pertinence of a focus on power for understanding pathways to hea lth, illness and well-being. Copyright (C) 2001 John Wiley & Sons, Ltd.