Public Health, Health Promotion and the Problem of Positivism

INTRODUCTION: Even though in public health and health promotion (HP) the most fundamental concepts refer to philosophical notions like equality, equity, fairness, justice or well-being, the practice of empirical research in HP is dominated by quantitative and standardized measures (seen widely on Health Literacy studies). Most of the quantitative empirical research has hardly any contact to these notions above referred. Public health and HP concepts shared by the WHO, UNESCO, UNHCR (asf. charters and declarations) deserve to be better explored. DEVELOPMENT: It is argued that there are several reasons that reproduce the domination of numbers in the field of public health and HP, rather than the insightful and transformative thoughts of theoretical developments. One reason is the power from medicine and similar disciplines that use their statistical and evidence-based methods as standard rules of evaluation. A second reason is the promise of public health and HP to make things better. A third reason is that in public health-related study programs very little attention is given to philosophy or sociological insights, although these are basic foundations of public health and HP. Explore some problems and shortages of a positivistic understanding of public health and HP, i.e. the scientific practice that overwhelms the reality by its methods and sees only what can be seen through the lens of the used methods, is needed to reflect on sustainability of human action. DISCUSSION: Public health and HP both refer immanently to - although contested - concepts and theories of democracy, freedom and justice. These concepts and theories are resistant against a pure mathematization and cannot be operationalized fully by quantitative numbers. There is a normative surplus in the subject of public health and HP that needs to be addressed differently. Finally, the relationship between empirical research and theory building in public health and HP is a quest yet to be firmly rooted.