This is part 1 of a two part session deliver for a Common Awards (Theology, Ministry and Mission, University of Durham) course on health and the Church. The first part focuses on a theological perspective and the second part focuses on public health perspectives

1. Are social determinants of
health a theological issue?
Health, Flourishing and the Common Good
Jim McManus
2nd November 2022
Jim.mcmanus@hertfordshire.gov.uk mcmanusj@Roehampton.ac.uk

2. The problem of defining terms: “Health” as a
major cultural preoccupation
“health” as a major current concern
◦ What is Health
◦ WHO Definition of Flourishing
◦ Functional Health – Satisfactory adjustment to lived reality
Even the definitions become problematic
Is it or is it not the same as Flourishing?
An issue which spans disciplines
Rise of medical humanities
Rise of theological contributions
dialoguing the contribution of theology and science

3. Research on Faith and Health : Public
Health Discourse
◦ Rise of public health discourse
on Faith and social
determinants
◦ Attempting to place religion as
a social determinant of health
in same way housing,
education and employment
work
◦ (Idler, 2014)

4. Background
Explore theological and biblical discourses on health and human flourishing in social and
scientific context
Work through the lens of Catholic Social Teaching
Strong Biblical and Early Church Themes on Social Theology and Health

5. So what does the science tell us?
Inequalities in Life Expectancy have a social gradiant
Inequalities in Health outcomes (early disability, life limiting illness)
too
Social, economic and racial patterning
Covid is a perfect example of these
◦ Vaccine Inequalities – BAME populations half the uptake of White in
some areas
◦ Health and the access to health are essentials for human living
BUT – is this a theological issue?

6. A word
about the
lens
Deliberately NOT looking in the obvious places
- Liberation Theology, Dorothy Day, Social
Gospel
Why on earth would you do that?
A hermeneutic of suspicion applied from some
commentators to anything that isn’t manifestly
patristic, scriptural or magisterial – narrowly
defined
needs intersectional lens, just for starters ,
otherwise we risk just incarnating the social
gradient into theological discourse

7. What about theological principles?
Privatised religion in a connected World
DISCOURSE 1
It is my OBLIGATION to attend Church
come what may
I will not Mask
I will never take the vaccine
My access to sacraments and
sanctification
DISCOURSE 2
The Common Good
Solidarity
Scientifically – epidemiology shows we are not
Islands
Theologically- what principles when Bioethics
seems focused on individuals?

8. Dominant
Theological
Discourses on
Health
the social and public
dimensions often missing, but
need to hold the value from
tradition too – how can you
affirm “good health” is good
and people can flourish with
long term conditions - HIV
1. “Suffering” has value and is not redundant
2. Formal Sacramental “Healing” – Reconciliation as much as
Sacrament of the Sick
3. Self-Care (Temple of Holy Spirit)
4. Popular Piety/ Prayer for Healing/Rites/Healing Ministry
5. Flourishing more than absence of disease – Living and Thriving
with HIV as an example (Orthodox theology, Vincent, Yetunde)
6. Vocation to Health Care

9. Example: Vocation to Health
Care in the Charter for Health
Care Workers (1995)
T H E TAI ZE I CO N O F M E RCY – T HE G O O D SA MARITAN
Conceptualised as Individual response to
calling of Christ
Individual participation in Ministry of Christ
Individual Response to Individual Suffering
(Pontifical Council, 1995)

10. Patristric readings of Scripture
God is active in human history
Covenant relationship
God – Humankind - Creation
Community – social elements, justice
Anawim -- "the widows, orphans and
aliens”
Challenge of the prophets when Israel fails
in its obligations
The example of Jesus – reign of God,
healing
“Health is Social, Teleological (aligned to
our creatureliness ) and structural, not just
individual” [Pennington, 2015]

11. John Paul II – Ecology of Human
Flourishing and Human Health
Centesimus Annus 1991
Contended that the term “ecology” had become almost
exclusively applied to the natural environment in debates
about conservation.
“not only has God given the earth to humanity, who must use
it with respect for the original good purpose for which it was
given to them, but humanity too is God’s gift to
humankind.”[ii]
a balanced view of ecology begins with a correct
understanding of the ecology of the human person.

12. Benedict XVI developed this
•Idea of Integral Development: development of each person and the
whole person - scientific and theological hooks here
•Concentration on adequate anthropology
•The role of truth (social capital?)
•The Social and the individual in dynamic tension are needed for Integral
Development
•Ecological – Social – Personal development for flourishing important
•Access to the means to flourish – Access as a theological principle
Thought Experiment: Read this while thinking about access to Covid
Vaccines

13. Social dimension of Mission
in Health(care) in revised Charter
Those involved in health care policy…have a
responsibility not only to their specific fields, but
also towards society and the sick.
It is up to them, in particular, to defend and promote
the common good, performing the duty of justice,
according to the principles of solidarity and
subsidiarity, in developing…policies aimed at the
authentic development of peoples
(Pontifical Council, 2016; Para 7.)

14. Developing a Theological Perspective on
Determinants of Health using Catholic Social
Teaching
SOCIAL TEACHING CORE PRINCIPLES
1. The Dignity of the Human
Person
2. The Common Good
3. Solidarity
4. Subsidiarity
5. Social/Structural Sin
6. Preferential option to the Poor
7. Care for Creation
SOCIAL DETERMINANTS OF HEALTH
1. Poorly Articulated?
2. Good Health as common good
3. Lack of explicit narrative
4. “Social Capital “crucial for good health
5. Inequity in access, inequality in outcomes
6. Focus on most marginalised
7. Ecology as a fundamental public health
challenge

15. The person
“Mission, Vocation and Profession are integrated in
the person of the healthcare worker”
New Charter for Healthcare Workers

16. Background
Explore theological and biblical discourses on health and human flourishing in social and
scientific context
Work through the lens of Catholic Social Teaching
Strong Biblical and Early Church Themes on Social Theology and Health

17. Some Conclusions
It's a
theological
issue because
determinants of
health affect in
multiple ways
how fully we
live,flourish and
die.
Theological Perspectives on Flourishing chime with scientific
perspectives : Integral Development (Person, Environment, Society)
Life in Right Relationship and Balance
Societal and individual levels are equally important (eg suffering and
social justice)
Social as important corrective to the individual-only focus
Grounding in Scripture and Patristic readings
Significant unfolding corpus in the Tradition
A theological anthropology of health: persons in relationship ;
ecology of human flourishing

18. Faith and Health Research

19. Research on Faith and Health
◦ Cross-disciplinary
◦ Focuses very much on individual aspects
◦ Link between health and faith outcomes strong and
take various directions
◦ Biopsychosocial model
◦ Salutogenic impact of faith based interventions for
those of faith
◦ Salutogenic impact of discussing issues of ultimate
meaning for those not necessarily of faith
◦ (Koenig, 2012;)

20. Theology of
Human
Flourishing –
social,
teleological and
structural not
just the individual
(Pennington, 2015)
Shalom - wholeness results in wellbeing
Ashre– wise living / wisdom / orientation to
God
Barak - Blessedness and Happiness
Tamim – (complete, wholeness with God) the
means to achieve God directed wholeness

21. Thank You
“Christ commanded us to Heal and to
make disciples? Why has the
institutional Church separated the two?”
Flourishing and wellbeing is a mission
issue ?
Still feels a bit “dead white men” – could
do with a greater intersectional lens
If it affects our ability to be fully human,
it’s a theological issue