Health promotion

The main determinants of health are people's cultural, social, economic and environmental living conditions, and the social and personal behaviours that are strongly influenced by these conditions. Health promotion aims to empower people to control their own health by gaining control over the underlying factors that influence health.

Health promotion as a process is concerned with positive health and well-being; it adopts a holistic concept of health that relates to lifestyles and living conditions. It seeks to strengthen individual skills and capabilities and the capacity of communities themselves to act collectively to tackle the factors that affect their health.

In 1986 the first International Conference on Health Promotion was held in Ottawa, Canada. A key milestone for the health promotion movement emerged from this conference with the adoption of the Ottawa Charter for Health Promotion. The charter builds on the progress made at Alma-Ata and calls for action in achieving the global strategy ‘Health for All’ by the year 2000 and beyond. It also formally recognises that health services should incorporate health promotion concepts such as community development, empowerment and advocacy.

An increasing amount of research places social factors including poverty at the root of the growing inequalities in health. However, in many low income countries there is a lack of resources and capacity to move from a disease focus in order to tackle these underlying determinants of health. They are also increasingly facing the same challenges from chronic diseases that developed countries face.

Effective health promotion is carried out by addressing individual risk factors for specific health outcomes (e.g. poor nutrition, physical inactivity, substance abuse) together with addressing the underlying societal determinants (e.g. poverty, inequality and socioeconomic-related factors). Health promotion interventions include actions to improve health by changing health damaging behaviours, such as substance abuse and unsafe sex, as well as facilitating screening, education, environmental health and clean sanitation, and other aspects of healthy public policy.