Meaningful occupation as a fundamental principle of health and citizenship

Introduction : Occupational therapists are concerned with fostering abilities and opportunities towards meaningful participation. This aim is conceived in health terms, but implies that health is connected to enacting citizenship, since participation goals are social, transactional and depend on interaction and reciprocal exchange. Objectives: To present a critical discussion of the significance of occupation for health and transformative citizenship. Approach Restriction in participation is also a restriction of citizenship. Practice-based vignettes will serve as examples of how dis-citizenship is generated through marginalisation with negative impacts on health outcomes. Secondly, we will frame exercising citizenship as social participation. This approach of participatory citizenship brings forth the potential of social transformation both individually and collectively based on new collective understandings and mutual recognition. Practice implications Approaching citizenship and health as interrelated and embodied rather than abstract, takes into account the ways in which social and cultural backgrounds as well as material circumstances affect people's lives as citizens. Health conditions are generated or maintained by social conditions such as poverty and limited access to resources and affected by cultural factors such as difference. The implication of critical occupation-based practise is that it offers a possibility to question and challenge these limitations and create particular spaces of action where in everyday life people negotiate rights and possibilities, belonging and participation. Conclusion Citizenship as an occupational practice of participation has valuable potential as the basis for the understanding of processes of participation and health as for the promotion of social transformation and more inclusive communitie