The Ottawa Charter was first created in 1986 as a call for action to achieve “Health for All” by the year 2000 and beyond (World Health Organization, 1986). The key components of the Ottawa Charter are based off five areas of action to influence and provide guidance in achieving the goals and concepts of health promotion (Let’s Learn Public Health, 2017). Health promotion can be defined as the process of enabling people to increase control over, and to improve, their health (World Health Organization, 1986).
Upon its development, the Ottawa Charter endorsed a positive definition of health, situated health as a product of daily life, proposed core values and principles for public health action, and outlined three strategies and five action areas reaching beyond the boundaries of the healthcare sector (Potvin & Jones, 2011). The five action areas developed in the Ottawa Charter were: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services. The strategies to achieve these action areas are to advocate, mediate, and enable promotion of health (Let’s Learn Public Health, 2017). The significance of the Charter upholds the challenge of time because the changes it introduced were not only of practical importance but had rather strong philosophical implications on the way health is conceived. Important conditions and resources for health such as peace, shelter, education, a stable eco-system, social justice, and equity, among others, were listed as foundational requirements for improvement in health – improvement, which cannot be ensured by the health sector alone (Vinko et al., 2020).
Over the years, changes have been made globally to assist in growing health promotion, as well as putting the keys strategies of the Ottawa Charter in action to assist in worldwide health promotion developments. In the UK and Canada, laws and public health policy documents explicitly recognize health promotion as a core public health function. In Ontario, a specific Ministry of Health Promotion was created (Potvin & Jones, 2011). Other worldwide examples of the Ottawa Charter strategies implemented are new health policies and active participation in the food industry. For example, Australia and Europe have created tobacco, drug, and alcohol cessation programs (Vinko et al., 2020). The UN and the World Health Organization have recognized climate change in the sustainable development goals, which has resulted in countries working to adopt and implement the global agreement made in December 2019, which addresses adaptation, mitigation and capacity building (Vinko et al., 2020)
Three decades later, the world has drastically changed since the development of the Ottawa Charter. Stock (2023) explained how the COVID-19 pandemic demonstrated examples of where more attention is required to close the gaps in global disparities and health equity. The Ottawa Charter is still being utilized as a guideline on how to make improvements toward health promotion. For example, while quarantine restrictions protected groups of vulnerable populations from infection, it also resulted in women and children falling victim to increased violence. The COVID-19 pandemic also created a pandemic of domestic violence (Stock, 2023). Learnings from examples such as these suggest, solutions need to be developed on all levels with formal and informal community-based support networks (Stock, 2023). While quarantine policies were adequately put in place, it is self evident that the holistic approach was not taken when managing the “prevention paradox” (Stock, 2023) ergo, going against key actions of the Ottawa Charter.
Going forward, health promotion must find a way to use research to better understand how the values, principles and processes it advocates, result in an increased capacity for public health to fulfill its mandates (Potvin & Jones, 2011). Vinko et al. (2020) project challenges with new technologies and ethical dilemmas, social and economic dynamics, leadership and public health workforce, demographic changes due to population growth, and climate change. I believe that if proactive measures are not addressed utilizing the Ottawa Charter and health promotion as a priority, detrimental negative outcomes will be experienced due to the new modern challenges being faced.
Health promotion is value-laden and process-oriented; this however, is insufficient to legitimize its integration into a state mandate for public health. It needs to show outcomes. It must demonstrate that processes and promoting explicit values and principles into public health practices and programs do result in better health and/or is more equitable health distribution (Potvin & Jones, 2011). The significance of the Ottawa Charter lies in its longevity as a mouthpiece for the field of health promotion. It continues to confirm a vision, orient action, and underpin the values that comprise health promotion today (Potvin & Jones, 2011).
References
Let’s Learn Public Health. (2017, March 4). Introduction to Health Promotion and the Ottawa Charter [Video]. YouTube. https://youtu.be/G2quVLcJVBk
Potvin, L., & Jones, C. M. (2011). Twenty-five years after the Ottawa Charter: The Critical Role of Health Promotion for Public Health. Canadian Journal of Public Health, 102(4), 244–248. https://doi.org/10.1007/bf03404041
Stock, C. (2023). Editorial: Experts’ opinion in Public Health Education and promotion. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1211391
Vinko, M., Robnik, M., & Gabrijelčič Blenkuš, M. (2020, June 23). 30 years after the Ottawa Charter: Is it still relevant in the face of future challenges for health promotion?. EuroHealthNet Magazine. https://eurohealthnet-magazine.eu/30-years-after-the-ottawa-charter-is-it-still-relevant-in-the-face-of-future-challenges-for-health-promotion/
World Health Organization. (1986). Ottawa charter for health promotion, 1986 (No. WHO/EURO: 1986-4044-43803-61677). World Health Organization. Regional Office for Europe. https://www.canada.ca/content/dam/phac-aspc/documents/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion/charter.pdf
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