Health Promotion: Concepts and Context

Abstract

The meaning of health promotion remains dynamically ambiguous. In the words of the Ottawa Charter for Health Promotion (World Health Organization 1986), ‘health promotion is the process of enabling people to increase control over, and to improve, their health.’ A recent content analysis of the most influential health promotion definitions in the literature found that their major discriminating feature was indeed ‘the extent to which it involves the process of enabling or empowering communities’ (Rootman et al. 2001). O’Neill and Stirling (2007) usefully characterise this as health promotion’s discursive meaning, its broad penumbra of ‘the promotion of health’ within which its more organised set of practices occurs. These organised practices, in turn, are defined by Green and Kreuter as ‘any planned combination of educational, political, regulatory and organizational supports for actions and conditions of living conducive to the health of individuals, groups or communities’ (Green & Kreuter 2005). If the fulminating Ottawa Charter definition is the idealised ‘what’, the more technocratic approach to planned change is the pragmatic ‘how’.

All diseases have two causes: one pathological, the other political.

(Aphorism attributed to the nineteenth-century public health activist Rudolf Virchow)