Academic journal article Journal of School Health

Emerging Concepts of Health and Health Promotion

Academic journal article Journal of School Health

Emerging Concepts of Health and Health Promotion

Article excerpt

The meanings of health and health promotion have been transformed over the past decade. Influenced by the World Health Organization (WHO), health is seen as more than avoiding illness. Similarly, health promotion involves more than helping people to choose healthy lifestyles. An emphasis on values to guide health promotion activities is apparent as is a focus on the broader determinants of health. This commentary explores these emerging conceptions and considers the implications for school health personnel. Examples of practical activities that incorporate these emerging ideas are presented.

HEALTH PROMOTION PRINCIPLES AND VALUES

Health promotion in Canada and Western Europe has been influenced by WHO concepts contained in the Ottawa Charter for Health Promotion.[1] Health is viewed as a resource for daily living, a positive concept emphasizing social and personal resources, as well as physical capacities. Responsibility for health rests not only with the health sector but goes beyond supporting healthy lifestyles to promoting well-being. It occurs by building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services.

There is a focus on the broader determinants of health. The Ottawa Charter outlines the prerequisites for health as peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity. Health promotion professionals are expected to work for health through advocacy, enabling individuals, and mediating among diverse sectors.

Developments Since the Ottawa Charter

At the 10th anniversary of the Ottawa Charter, increasing emphasis is on social justice, reducing inequalities, and enhancing societal cohesion.[2] There is increasing awareness of the role values play in any health-related activity.[3] The United Kingdom Charter for Health Promotion[4] outlines justice, inclusion, social capital, enterprise, and getting local as priorities: "Economic and social policies over the preceding decades have contributed to an ever-widening gap between rich and poor. Compelling evidence confirms that exclusion -- both societal and material -- is inextricably linked to ever-rising health and social problems in the UK. Such inequalities limit development for all."[4]

The Action Statement for Health Promotion in Canada5 identifies advocating for healthy public policies as the single best strategy to affect the determinants of health. Priority areas include reducing inequalities in income and wealth, strengthening communities through local alliances to change unhealthy living conditions, supporting environments that promote healthy lifestyles, and developing a settings approach to practice. Community development is also a priority.[5]

Finally, The Jakarta Declaration on Health Promotion into the 21st Century[6] outlines priorities of promoting social responsibility for health, increasing investments for health development, consolidating and expanding partnerships, increasing community capacity, empowering the individual, and securing an infrastructure for health promotion.

Inequalities, Health, and Healthy Public Policy

Clearly, increasing concern exists about economic inequality and potential effects on the health of populations. The evidence of health inequalities in the United Kingdom was first brought together in Inequalities in Health.' The Black Report and the Health Divide.[7] In Canada, the Health of Canada's Children Report[8] revealed the profound variation in health and well-being between poor and nonpoor children. The Congressional report Adolescent Health documented these effects in the United States.[9] The recent work on health inequalities has been brought together in Unhealthy Societies: The Afflictions of Inequality.[10]

Health inequalities exist in levels of mortality and morbidity, accidents and injuries, risk behaviors, mental health, school achievement, and family violence. …

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