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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2011 Jul 1;102(4):244–248. doi: 10.1007/BF03404041

Twenty-five Years After the Ottawa Charter: The Critical Role of Health Promotion for Public Health

Louise Potvin 12,22,✉, Catherine M Jones 12,22
PMCID: PMC6973872  PMID: 21913576

Abstract

After a quarter of a century, the Ottawa Charter for Health Promotion, often recognized as a foundational document of health promotion, continues to be relevant for public health. Inspired by the WHO Constitution, the Alma Ata Declaration, and the Lalonde Report, the Ottawa Charter endorses a positive definition of health, situates health as a product of daily life, proposes core values and principles for public health action, and outlines three strategies and five action areas reaching beyond the boundaries of the health care sector. The Charter established a radical agenda for public health, specifically to expressly convey the values public health pursues, thereby increasing the potential for the reflexivity of the field and opportunities to consider complementary values in actions that promote population health. In this paper, we examine how public health has integrated health promotion by exploring examples of changes in public health systems and practice at international and national levels of governance. Nevertheless, an important challenge remains for health promotion: better use of research to understand how the values, principles and processes of health promotion can help to achieve public health mandates. A three-pronged action plan is proposed.

Key words: Health promotion, public health, public health practice, research, World Health Organization

Footnotes

Acknowledgement: Louise Potvin is the holder of the CHSRF-CIHR Chaire approches communautaires et inégalités de santé (CHSRF-CIHR no. CP1-0526-05).

Conflict of Interest: None to declare.

References

  • 1.World Health Organization. Ottawa Charter for Health Promotion. Ottawa, ON: WHO; 1986. [Google Scholar]
  • 2.Kickbusch I. The contribution of the World Health Organization to a new public health and health promotion. Am J Public Health. 2003;93:383–88. doi: 10.2105/AJPH.93.3.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Hills M, McQueen DV. At issue: Two decades of the Ottawa Charter. Promotion & Education. 2007;14(suppl2):5. doi: 10.1177/10253823070140020101x. [DOI] [Google Scholar]
  • 4.Saan H. Ottawa 1986 revisited. Promotion & Education. 2007;14(suppl2):11. doi: 10.1177/10253823070140020501x. [DOI] [PubMed] [Google Scholar]
  • 5.Breslow L. From disease prevention to health promotion. JAMA. 1999;281:1030–33. doi: 10.1001/jama.281.11.1030. [DOI] [PubMed] [Google Scholar]
  • 6.Fassin D. Comment faire de la santé publique avec des mots. Une rhétorique à l’oeuvre. Rupture, revue transdisciplinaire en santé. 2000;7:58–78. [Google Scholar]
  • 7.World Health Organization. The Bangkok Charter for Health Promotion in a Globalized World. 2005. [PubMed] [Google Scholar]
  • 8.De Leeuw E, Tang KC, Beaglehole R. Ottawa to Bangkok — Health promotion’s journey from principles to ‘glocal’ implementation. Health Promot Int. 2006;21(suppl1):1–4. doi: 10.1093/heapro/dal057. [DOI] [PubMed] [Google Scholar]
  • 9.World Health Organization. Declaration of Alma Ata. 1978. [Google Scholar]
  • 10.Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. Available at: https://doi.org/www.who.int (Accessed January 2011).
  • 11.Lalonde M. A New Perspective on the Health of Canadians. A Working Document. Ottawa: Ministry of Supply and Services Canada; 1974. [Google Scholar]
  • 12.Parrish RG. Measuring population health outcomes. Prev Chron Dis. 2010;7(4):A71. [PMC free article] [PubMed] [Google Scholar]
  • 13.Kickbusch I, et al. Health governance. The health society. In: McQueen DV, Kickbusch I, Potvin L, et al., editors. Health & Modernity: The Role of Theory in Health Promotion. New York, NY: Springer; 2007. pp. 144–61. [Google Scholar]
  • 14.Mann J. Health as a human right. BMJ. 1996;312:924–25. doi: 10.1136/bmj.312.7036.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Rootman I, Goodstadt M, Potvin L, Springett J, et al. A framework for health promotion evaluation. In: Rootman I, Goodstadt M, Hyndman B, et al., editors. Evaluation in Health Promotion: Principles and Perspectives. Copenhagen: World Health Organization; 2001. pp. 7–15. [Google Scholar]
  • 16.Fassin D. L’espace politique de la santé. Paris, France: Presses universitaires de France; 1996. [Google Scholar]
  • 17.Porter D. Health, Civilization and the State: A History of Public Health from Ancient to Modern Times. London, UK: Routledge; 1999. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Chapman S. Postmodernism and public health. Aust N Z J Public Health. 1998;22:403–5. doi: 10.1111/j.1467-842X.1998.tb01402.x. [DOI] [PubMed] [Google Scholar]
  • 19.Mansdotter A, Lindstrom L, Ohman A. Women, men and public health–how the choice of normative theory affects resource allocation. Health Policy. 2004;69:351–64. doi: 10.1016/j.healthpol.2004.01.002. [DOI] [PubMed] [Google Scholar]
  • 20.Balbo L, et al. Thinking health promotion sociologically. In: McQueen DV, Kickbusch I, Potvin L, et al., editors. Health & Modernity: The Role of Theory in Health Promotion. New York: Springer; 2007. pp. 129–43. [Google Scholar]
  • 21.Potvin L, McQueen DV, et al. Modernity, public health and health promotion. A reflexive discourse. In: McQueen DV, Kickbusch I, Potvin L, et al., editors. Health & Modernity: The Role of Theory in Health Promotion. New York: Springer; 2007. pp. 12–20. [Google Scholar]
  • 22.World Health Organization. World Health Assembly resolution WHA 51.12–Health promotion. 1998. [Google Scholar]
  • 23.Swedish National Committee for Public Health. Health on equal terms–national goals for public health. Scand J Public Health. 2001;57(suppl):1–68. [PubMed] [Google Scholar]
  • 24.Jusot F. Les interventions de réduction des inégalités sociales de santé en Europe. In: Potvin L, Moquet MM, Jones CM, editors. Réduire les inégalités sociales en santé. 2010. p. 88. [Google Scholar]
  • 25.Creating a Healthier Canada: Making Prevention a Priority - A Declaration on Prevention and Promotion from Canada’s Ministers of Health and Health Promotion/Healthy Living. Ottawa, 2010. Available at: https://doi.org/www.phac-aspc.gc.ca (Accessed April 2011).
  • 26.World Health OrganizationGovernment of Southern Australia. Adelaide statement on health in all policies. Moving towards a shared governance for health and well-being. 2010. [DOI] [PubMed] [Google Scholar]
  • 27.Saint-Pierre L, Jobin L, Druet C. FrL’évaluation d’impact sur la santé: un outil de lutte contre les inégalités. In: Potvin L, Moquet MM, Jones CM, editors. Réduire les inégalités sociales en santé. Paris: INPES; 2010. pp. 136–47. [Google Scholar]
  • 28.Puska P, Ståhl T. Health in All Policies—The Finnish initiative: Background, principles, and current issues. Annu Rev Public Health. 2010;31:315–28. doi: 10.1146/annurev.publhealth.012809.103658. [DOI] [PubMed] [Google Scholar]
  • 29.Poland B, Green L R I, editors. Settings for Health Promotion: Linking Theory and Practice. Thousand Oaks, CA: Sage; 2000. [Google Scholar]
  • 30.Dorris M. Health promoting settings: Future directions. Promotion & Education. 2006;13:2–4. doi: 10.1177/10253823060130010101. [DOI] [PubMed] [Google Scholar]
  • 31.De Leeuw E. Evidence for healthy cities: Reflections on practice, method and theory. Health Promot Int. 2009;24(suppl1):i9–i36. doi: 10.1093/heapro/dap052. [DOI] [PubMed] [Google Scholar]
  • 32.St Leger L, Kolbe L, Lee A, McCall D, Young I. School health promotion–Achievements, challenges and priorities. In: McQueen DV, Jones CM, editors. Global Perspectives on Health Promotion Effectiveness. New York: Springer; 2007. pp. 107–24. [Google Scholar]
  • 33.UNICEF. The baby friendly hospital initiative. 2011. [Google Scholar]
  • 34.Pelikan J, Krajic K, Dietscher C. The health promoting hospital (HPH): Concept and development. Patient Educ Couns. 2001;45:239–43. doi: 10.1016/S0738-3991(01)00187-2. [DOI] [PubMed] [Google Scholar]
  • 35.Potvin L, Gendron S, Bilodeau A, Chabot P. Integrating social science theory into public health practice. Am J Public Health. 2005;95:591–95. doi: 10.2105/AJPH.2004.048017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Organisation mondiale de la Santé. Combler le fossé en une génération: instaurer l’équité en santé en agissant sur les déterminants sociaux de la santé. Genève: Organisation Mondiale de la Santé, Commission des Déterminants sociaux de la Santé; 2008. [Google Scholar]
  • 37.Frohlich KL, Mykhalovskiy E, Miller F, Daniel M. Advancing the population health agenda: Encouraging the integration of social theory into population health research and practice. Can J Public Health. 2004;95:392–95. doi: 10.1007/BF03405154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Kickbusch I. Health promotion–not a tree but a rhizome. In: O’Neill M, Pederson A, Dupéré S, Rootman I, editors. Health Promotion in Canada: Critical Perspectives. Toronto, ON: Canadian Scholars’ Press; 2006. [Google Scholar]
  • 39.Scriven A, Speller V. Global issues and challenges beyond Ottawa: The way forward. Promotion & Education. 2007;14(4):194–98. doi: 10.1177/10253823070140040201. [DOI] [PubMed] [Google Scholar]
  • 40.Catford J. Implementing the Nairobi call to Action: Africa’s opportunity to light the way. Health Promot Int. 2010;25:1–4. doi: 10.1093/heapro/daq018. [DOI] [PubMed] [Google Scholar]

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