Health promotion

The first International Conference on Health Promotion took place in Ottawa, Canada in 1986. The conference was a response to growing expectations for a new public health movement around the world. Out of this conference came the Ottawa Charter for Health Promotion, a framework for action to achieve 'Health For All by the Year 2000' and beyond.

The Ottawa Charter identifies three approaches for health promotion. These are:

• advocacy for health to create the essential conditions for health
• enabling people to take control of the determinants of health in order to achieve their fullest potential
• mediating between different interests in society in the pursuit of health (WHO 1986)

The Charter outlines five areas for health promotion action under the new public health:

• build healthy public policy
• create supportive environments
• strengthen community action
• develop personal skills
• reorient health services

The five action areas for health promotion

In the following section, there is an explanation of each of the five action areas taken directly from the Ottawa Charter (1986). Following each statement, there are some examples of what community health teams can do, and are doing, to improve health within each of the action areas.

Build healthy public policy

"Health promotion goes beyond health care. It puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health."

Community health teams can:

• assist the community to develop a community policy on alcohol availability
• support the formation of a local store committee and development of a healthy food policy
• observe whether the law that prohibits the selling of tobacco products to youth under 18 years of age is being followed and report to the council and local police if not

Create supportive environments

"Our societies are complex and interrelated. Health cannot be separated from other goals… the overall guiding principle for the world, nations, regions and communities alike is the need to encourage reciprocal maintenance - to take care of each other, our communities and our natural environment…".

Community health teams can:

• support activities that enable Aboriginal people to maintain their links to the land
• organise for improved occupational health and safety standards in the workplace and in public facilities
• support local income generating projects such as market gardens

Strengthen community action

"Health promotion works through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health. At the heart of this process is the empowerment of communities, their ownership and control of their own endeavours and destinies.

Community development draws on existing human and material resources in the community to enhance self-help and social support, and to develop flexible systems for strengthening public participation and direction of health matters. This requires full and continuous access to information, learning opportunities for health, as well as funding support."

Community health teams can:

• provide statistics to support the community's submission for alcohol reform to the NT Liquor Commission
• work with the women's centre to budget, plan, purchase and cook meals for school children and old people
• support the development of an action plan and funding submission for a dust suppression project

Develop personal skills

"Health promotion supports personal and social development through providing information, education for health and enhancing life skills. By so doing, it increases the options available to people to exercise more control over their own health and over their environments, and to make choices conducive to health. Enabling people to learn throughout life, to prepare themselves for all of its stages and to cope with chronic illness and injuries is essential…".

Community health teams can:

• support health team members to attend relevant professional development activities such as Aboriginal Cultural Awareness Program (ACAP) and public health skills training
• encourage responsible self-care by teaching mothers and carers to use the scales and Road To Health Chart, to enable them to monitor their babies' growth
• conduct store tours to educate people about healthy foods, thereby enabling them to make healthier food choices

Reorient health services

"The role of the health sector must move increasingly in a health promotion direction, beyond its responsibility for providing clinical and curative services. Health services need to embrace an expanded mandate which is sensitive and respects cultural needs. This mandate should support the needs of individuals and communities for a healthier life, and open channels between the health sector and broader social, political, economic and physical environmental components.

Reorienting health services also requires stronger attention to health research as well as changes in professional education and training. This must lead to a change of attitude and organisation of health services, which refocuses on the total needs of the individual as a whole person."

Community health teams can:

• base work plans on the Aboriginal Public Health Strategy and the Aboriginal Employment and Career Development Strategy
• offer a service where there is more balance between health promotion and treatment services
• include brief intervention processes in day to day work practices

The Jakarta Declaration on Health Promotion into the 21st Century

Participants, at the 4th International Conference on Health Promotion held in Jakarta in July 1997, confirmed the Ottawa Charter approaches and action areas.

To take Health Promotion into the 21st Century and meet the new challenges, the conference participants prioritised five 'new forms of action':

1. promote social responsibility for health
2. increase investments for health development
3. consolidate and expand partnerships for health
4. increase community capacity and empower the individual
5. secure an infrastructure for health promotion

For more information see WHO (1997) and the health promotion texts listed in the Bibliography

The health promoting way of working

There are a number of things that community health teams, support workers and public health staff can do to support a community and enable community action. These include:

• identify community priorities
• support local initiatives that make community residents more able to control and improve their situation
• find out what people know and what they think is important
• share information
• assist with skills development
• assist with research and information collection
• help to plan community action
• provide or help to locate resources if needed

		See 'Community Development' in the section 'Working with Communities'