Co-Creation of Public Values: Citizenship, Social Justice, and Well-Being

Introduction

How do we create communities where people feel valued and add value to others? How can the public sector, citizens and stakeholders work together to support citizenship, social justice and well-being? There is an urgent need for political consensus, collaboration and co-creation across the whole of government, and the whole of society, to achieve sustainable development and create well-being for all, leaving no one behind (United Cities and Local Governments [UN], 2015; World Health Organization [WHO], 2019a). Equity, health, and well-being are crucial determinants of sustainable societies, and for which collaboration and inclusive participation is imperative (European Commision [EU], nd; Kickbush 2012; Marmot, 2014; Marmot et al., 2020; OECD, 2020; WHO, 2019a,b). The importance of well-being is highlighted in the UNs SDG#3; ´Ensure healthy lives and promote wellbeing for all at all ages´. Although, moderate progress has been made to reach SDG#3 goals, the SDG goal #10 on reducing inequity requires attention to achieve social justice.

High levels of inequality create social gaps in health and well-being, and harms society in many ways. It hampers social cohesion and can reduce a sense of citizenship, resulting in lost opportunities for many aligned with increased crime and social vulnerability affecting the whole population (International Institute for Democracy and Electoral Assistance, 2013; Marmot, 2014; Wilkinson & Pickett, 2009). Moreover, it reduces social trust in general, and especially in public and democratic institutions (International Institute for Democracy and Electoral Assistance, 2013; OECD, 2020; WHO, 2019b). The need to belong and the dependency to other people is universal and a basic part of being human (Baumeister & Leary, 1995). According to Prilletensky (2020), many of the above-mentioned problems origins in what he describes as an ‘Me-culture’ formed by societal fragmentation and neoliberal tendencies in the society. However, a ‘We-culture’ of inclusiveness, belonging, compassion and reciprocal support is required to support wellbeing for all, and, as the SDG’s urges; to leaving no one behind.

The WHO Health Equity Status Report (WHO, 2019a) captures the impact of policies on inequities in health and well-being over the last 10 to 15 years. This report have identified five critical factors and assigned to each a percentage reflecting its contribution to the overall burden of health inequity: Income security and social protection (35%); living conditions (29%); social and human capital (19%); access to and quality of health care (10%); and employment and working conditions (7%). Addressing these factors is above all a political choice, and where opinions and political will-formation are informed by democratic participation (WHO, 2019b; Marmot et al., 2020). These factors are also connected to measures beyond available public services. Acknowledging the significance of social support, public services cannot simply ‘deliver’ friendships and caring social networks to citizens as a service. The public sector also has limited measures available for creating good living environments and meaningful work for all that ensures economic safety, as these values are highly dependent on stakeholders outside of the public sector. Creating public value that addresses the abovementioned factors thus relies on collaboration and co-creation across the whole of society, crosswise sectors, at multiple levels.

In general, the responsibility for participatory processes to create public value falls to the public sector, with a particular responsibility on administrations and political leaders. However, participatory processes can also be invited by companies, non-governmental organizations and social entrepreneurs, who might enable numerous entry points and openings to endorse more participatory and empowering processes, even in settings in which there are no participatory traditions (WHO, 2019b). Contrary to making progress towards social justice and well-being for all, political parties and political views are becoming more polarized, people are getting more disengaged, and those affected by low levels of well-being tend to be excluded from democratic processes (International Institute for Democracy and Electoral Assistance, 2013; OECD, 2020; WHO, 2019a,b). In parallel, social inequities in health and well-being are accelerated by neoliberal societal tendencies, and where late stage neoliberalism has contributed to alienate people from ‘the collective’ (Gergen, 2009; Pūras, 2020). Such societal tendencies are leading to pressing public health problems, crime, polarization and marginalization, and are threatening human rights and sustainable development across the globe (Pūras, 2020; WHO, 2019a,b; Wilkinson & Pickett, 2009).