The Ottawa Charter- Almost 40 years old and still relevant today

In November 1986, health experts from around the world met in Ottawa, Ontario, Canada to discuss the need for changes in public health measures around the world (World Health Organization, 1986).   Building on the World Health Organizations previous work on Health for All, and the Declaration on Primary Care, the Ottawa Charter of Health Promotion was created, presenting a goal of Health for All by the year 2000. 

The charter focused on three prerequisites for improvements in health; Advocacy, Enabling and Mediating. It presents a practical framework towards action including; healthy public policies, supportive environments, community action and personal skills, while calling for a reorientation of health services towards the pursuit of health.

These tenants, and their framework for action are just as relevant today as they were 30 years ago.  Evidence emerging in the 21st century suggests that advocacy efforts are not only important, but fundamental in the field of health promotion, in order to support equity efforts (Gould, Fleming, & Parker, 2012).   Recent guidance in the area of strengthening health promotion efforts calls for more attention to enablers of health, suggesting that a whole-of-society approach is necessary to support health promotion efforts and improve public health capacity (Van den Broucke, 2021).   This suggests that the concept of enabling is still relevant today in the pursuit of health promotion.  While health promotion efforts continue to support the idea that partnerships and collaboration between different sectors such as public health and primary care, or public health and community churches leads to improved individual and population health outcomes (Brown et al., 2022; Martin-Misener, 2012).  This suggests that efforts to mediate which were highlighted in the 1986 charter continue to be relevant today.

The charter describes health promotion activities to include creating supporting environments and strengthening community action (World Health Organization, 1986).  These two actions are linked to reducing cultural bias (Butler et al., 2016).  This suggests that the actions would still be relevant for health promotion issues faced today.  The article also highlights the importance of healthy public policy, a strategy that can be applied to supporting indigenous health issues and promoting equity for vulnerable groups (Henderson, Montesanti, Crowshoe, & Leduc, 2018).

The Ottawa Charter may be almost 40 years old today, but its tenants, definitions and strategies are just as relevant today as they were in 1986.

References

Brown, N. R., Alick, C. L., Heaston, A. G., Monestime, S., & Powe, N. (2022). The Black Church and Public Health: A Key Partnership for Theory Driven COVID-19 Recovery Efforts. Journal of primary care & community health, 13, 21501319221097672. https://doi.org/10.1177/21501319221097672

Butler, M., McCreedy, E., Schwer, N., Burgess, D., Call, K., Przedworski, J., Rosser, S., Larson, S., Allen, M., Fu, S., & Kane, R. L. (2016). Improving Cultural Competence to Reduce Health Disparities. Agency for Healthcare Research and Quality (US).

Gould, T., Fleming, M. L., & Parker, E. (2012). Advocacy for health: revisiting the role of health promotion. Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals, 23(3), 165–170. https://doi.org/10.1071/he12165

Henderson, R., Montesanti, S., Crowshoe, L., & Leduc, C. (2018). Advancing Indigenous primary health care policy in Alberta, Canada. Health policy (Amsterdam, Netherlands), 122(6), 638–644. https://doi.org/10.1016/j.healthpol.2018.04.014

Martin-Misener, R., Valaitis, R., Wong, S. T., Macdonald, M., Meagher-Stewart, D., Kaczorowski, J., O-Mara, L., Savage, R. & Austin, P. (2012). Strengthening Primary Health Care through Public Health and Primary Care Collaborations Team. A scoping literature review of collaboration between primary care and public health. Primary health care research & development, 13(4), 327–346. https://doi.org/10.1017/S1463423611000491

Van den Broucke S. (2021). Strengthening health promotion practice: capacity development for a transdisciplinary field. Global health promotion, 28(4), 36–45. https://doi.org/10.1177/17579759211061751

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://rb.gy/ivh4ox