Health promotion principles and practice: Addressing complex public health issues using the Ottawa Charter

Abstract

We live in a world where we are faced with a myriad of health issues including communicable and non-communicable diseases such as SARS, HIV/AIDS, over- and under-nutrition, heart disease, occupational injuries and drug and alcohol misuse. Addressing our most pressing concerns is a complex task and requires action on a number of levels from prevention through to treatment. This chapter introduces readers to the discipline of health promotion, which is preventive in focus. The World Health Organization defines health promotion as ‘the process of enabling people to increase control over their health and its determinants, and thereby improve their health. It is a core function of public health and contributes to the work of tackling communicable and non-communicable diseases and other threats to health’ (World Health Organization, 2005, p. 25). This definition encompasses two important aspects. First, it is based on the World Health Organization’s holistic, positive definition of health and, second, it necessitates an understanding of health that goes beyond the physical and/ or psychological body to an understanding that there are many factors that influence one’s ability to be healthy (see chapters 1 and 5). Using the opening case study of tobacco use, readers will explore how Australia has attempted to curb the uptake of tobacco smoking and to encourage those who already smoke to quit. This has been undertaken by implementing public health interventions that target both individuals’ smoking behaviours and altering the social and economic conditions surrounding tobacco use. The Ottawa Charter for Health Promotion (‘Ottawa Charter’) will be used to frame the discussion. The Ottawa Charter is the guiding framework that health promotion practitioners use to address the multiple determinants of health through multi-sectoral and multi-level approaches. It includes five action areas: building healthy public policy, creating supportive environments, strengthening community action, developing individual skills, and reorienting health services. Each of the action areas is explored in the rest of the chapter. Addressing the multiple determinants of health is not easy an easy task. It requires input from all sectors of society. To successfully and sustainably promote health, governments, communities, and organisations need to appreciate the long-term effort required to address complex health issues rather than depending solely on non-integrated policy change and behaviour change as is the current trend.