Spirituality a recognised dimension of health in the field of health promotion and public health (Scriven, 2010). Good health and wellbeing includes spiritual health and wellbeing. The determinants of health and what should be done to address them to improve health is an important agenda globally. Interestingly however, although spirituality is important to health and wellbeing it does not appear in key models of determinants of health, such as the classic layer diagram of Dahlgren and Whitehead (1993). Nor does spirituality get included in influential frames for discourse. For example, the narrative/metaphor of the river and upstream versus downstream action on health which is central to so much of the language of intervention to improve health (Talley, 2010). The absence of spirituality in the discourses of health determinants and health improvement thus seems a significant omission. The work presented here therefore represents the beginning of a journey of exploration by the author to reflect on and address this conundrum. The early steps of thinking are described, including examination of models of health and wellbeing, and ways in which spirituality could be made integral to, if not central to, considering the origins of health, wellbeing and illness
