Conceptualization of occupation across the health continuum: A critical occupational perspective

Introduction: The view that engagement in “occupation” is health promoting has been asserted by Wilcock (2005, 2007) and Yerxa (1998) as a foundational principle of occupational therapy and occupational science. However, this perspective does not acknowledge the numerous occupations that are fundamentally harmful or risky to one’s health or to the health of society. Kantartzis and Molineux (2011) argue that the current conceptualization of occupation has become associated with “Western society’s construction of a ‘healthy’ daily life” (p. 62). To date, a comprehensive understanding of how occupation is conceptualized within the occupation-based literature across the health continuum, that is, from health to illness, has not been articulated. Objectives: The objective of this study is to describe and critique how occupation is conceptualized across the health continuum within the occupation-based literature. Methods: The methodological framework outlined by Arksey and O’Malley (2005) will serve as the basis for a scoping review of the occupation-based literature that discusses occupation across the health continuum. A critical occupational perspective, the view that occupation is a site for the social re/production of knowledge understood from within political and social structures (Njelesani, 2012, p. 58), will be used to synthesize the data into themes related to the conceptualizations of occupation. Results: The findings will provide an understanding of what has been the preferred way to “situate” occupation in relation to health by occupational scholars. The assumptions underlying this current conceptualization will be discussed. A framework will be proposed as a way of articulating the complex relationship of occupation and health to broaden an appreciation of human occupation as a site of knowledge production. Conclusions: Viewing occupation as predominantly health-promoting is argued as problematic, as it leads to an incomplete understanding of human occupation and reproduces assumptions related to occupation and health. A refinement of the conceptualization of occupation will provide a more nuanced understanding of the potential risks and benefits to individual and societal health and wellbeing, as influenced by occupational engagement and choice