Unit 2: The Ottawa Charter

Health promotion empowers individuals to have more control over and improve their health (WHO, n.d.). Over the last few decades, several initiatives have guided the latter process. The Ottawa Charter is a hallmark among these initiatives, with global recognition that has reshaped our understanding of health and health promotion. Two distinct and unprecedented features of the Ottawa Charter make it unique. First, it shifts the focus from disease prevention to health promotion through each of its five action areas: (1) build healthy public policy, (2) create supportive environments, (3) strengthen community action, (4) develop personal skills, and (5) reorient health services (Public Health Agency of Canada, 2017). Second, it shuns away the responsibility from the individual to the greater society as only one of the five actions is directed towards the individual level, while the remaining four focus on social, economic, and environmental aspects of health (Public Health Agency of Canada, 2017).

According to WHO (n.d.), the conference that led to the development of the Ottawa Charter was held primarily in response to an increasing global call for health promotion. Therefore, the resulting Charter has been generally well received and has influenced global progress towards healthier decisions. For example, the WHO has a dedicated department for health promotion. Motivated and guided by the Ottawa Charter, the department at WHO strives to mitigate health risks associated with tobacco use, alcohol consumption, and physical inactivity (WHO, 2023). The WHO has contributed to better population health by developing and promoting "normative, fiscal and legal measures to enhance wellbeing, health literacy and engage multi-stakeholders through settings approach and community engagement strategies" (WHO, 2023).

In addition to WHO and other international agencies' efforts, activists, governments, and health agencies worldwide rely on Ottawa Charter recommendations to navigate today's healthcare challenges and promote healthier alternatives where possible. For example, the recent COVID-19 pandemic negatively affected most of the world's population in one way or another. In Sub-Saharan Africa (SSA), a region with a significant prevalence of HIV, the impact of the COVID-19 pandemic was devastating (Tarkang, 2020). The shift in focus towards COVID-19 management further compromised the management of people living with HIV (PLHIV) (Tarkang, 2020). Using the five action areas of the Ottawa Charter for health promotion, Tarkang (2020) advocated for changes to ensure HIV treatment is not compromised in SSA countries because of the pandemic.

Locally in Canada, we have witnessed several legislative and regulatory changes inspired by the Ottawa Charter. Health Promotion Canada (HPC) is an organization launched in 2016 in celebration of the 30th anniversary of the Ottawa Charter (HPC, 2017). HPC's mission is to advance the practice of health promotion in Canada, and it achieves this through its core values that are solely based on the Ottawa Charter (HPC, 2017). With a clear vision, HPC provides a target date of 2026 for its members to achieve the required level of connectedness and collaboration to progress workforce development and action in health promotion (HPC, 2017). HPC's ultimate goal is to equip all health promoters to achieve health equity for all and in all communities in Canada by 2046 (HPC, 2017).

Regardless of the platform, the concept of health promotion is a shared responsibility for all of us. As a clinician, we can use the action areas of the Ottawa Charter to help us guide our approach with our patients to achieve better outcomes. For example, in addition to treating the primary diagnosis, providing informational brochures and referring patients to community resources could help reduce the rate of readmissions. As frontline staff, we witness and are privy to information and patients' lived experiences, which we can use to advocate for policy changes and other social, political, and environmental changes that can get us closer to achieving the desired outcome of health equity while empowering patients to take control of improving their health.

References

Health Promotion Canada. (2017, March 3). What is Health Promotion Canada? Retrieved September 19, 2023, from https://www.healthpromotioncanada.ca/about-us/what-is-hpc/

Public Health Agency of Canada. (2017, November 14). Ottawa Charter for Health Promotion: an international conference on health promotion. Canada.ca. Retrieved September 18, 2023, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion.html

Tarkang, E. E. (2020). The fight against COVID-19 in sub-Saharan Africa-a threat to the continuous management of HIV patients: application of the action areas of the Ottawa charter for health promotion. The Pan African Medical Journal, 35(Supp 2). https://doi.org/10.11604/pamj.supp.2020.35.2.23224

WHO. (n.d.). The 1st International Conference on Health Promotion, Ottawa, 1986. Retrieved September 18, 2023, from https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference

WHO. (2023). Health Promotion - About Us. World Health Organization (WHO). Retrieved September 18, 2023, from https://www.who.int/teams/health-promotion/about