Recently, I was asked to reflect on the questions - What is the Ottawa Charter? How has it influenced Canada, the world and my professional practice? My immediate answer was I do not know. I wondered how can something that I know very little about influence the world around me? So, began my exploration of the Ottawa Charter for Health Promotion.
What is the Ottawa Charter?
The Ottawa Charter was developed back in 1986, when the first international conference on health promotion was hosted in Ottawa, Canada (WHO, 2022). The Ottawa Charter provides a definition for health promotion that is the process of enabling people to increase control over and to improve their health” (Fry & Zask, 2017, p. 902). The charter outlines five strategies for promoting health including building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services (Thompson et al, 2017). From this initial conference a unifying vision was formed that resulted in an agreement to guide health promotion which has been in use for almost 36 years (Thompson et al., 2017).
Influencing Perspectives in Canada and the World
As I explored current literature, it began to reveal that for almost 36 years the Ottawa Charter has been influencing the direction of health, nationally and globally. However, there are divergent opinions as to its effectiveness and continuing relevance.
The Ottawa Charter provides a unifying vision and direction for health promotion at local, national and international level. The charter has attempted to shift the view more upstream and away from primarily disease management at the individual level promoting consideration of the roles for organizations, systems and environments in illness prevention and health promotion (Thompson et al, 2017).
The Ottawa Charter promotes shared values and shared responsibility of sectors and systems to work together and looks for the integration of health into everyday life. Though we may not see ourselves as health promoters, the charter incorporates broad perspectives and provides a framework for action that resonates amongst system partners. Thompson et al. (2017) describes the Ottawa Charter “as a gold standard” for health promoters worldwide who wish to improve health and reduce inequalities with direct influence on policies and practices while challenging us to understand what action can be taken (p.73). However, at present there remains a tension with the primary focus on medical intervention and disease management and not on prevention or promotion.
People value health. It remains as one of the key topics in political, social and economic discussions in Canada and around the world. While strong health care systems are required to respond to medical needs, there is a need to focus on health promotion and the wellness of people in our communities in order to prevent illness. The importance of health is recognized in Canada but promotion feels like it is the secondary priority both in time, effort and funding allocation. The challenge remains in finding this balance.
Influences on My Perspective
Initially I became more aware of health promotion through work focused on implementing the Chronic Disease Prevention and Management (CDPM) framework with system partners. Similar to the Ottawa Charter, this CDPM model adopted for Ontario contains a focus on personal skill development and self-management supports for both providers and clients/caregivers (MOH, 2018). My role took me on a learning journey including the development of local programming focused on self-management skill development for patients, caregivers and health system partners. Though I would not have called myself a health promoter during this process or now, one might say I actually am as I share the values that are reflected in the definition health promotion.
References
Fry, D. & Zask, A. (2017). Applying the Ottawa Charter to inform health promotion programme design, Health Promotion International, 32 (5), 901–912, https://doi.org/10.1093/heapro/daw022
Ontario Ministry of Health (MOH) (2018). Preventing and managing chronic disease. www.health.gov.on.ca. https://www.health.gov.on.ca/en/pro/programs/cdpm/#1
Thompson, S. R., Watson, M. C., & Tilford, S. (2017). The Ottawa Charter 30 years on: Still an important standard for health promotion. International Journal of Health Promotion and Education, 56, 73-84. https://doi.org/10.1080/14635240.2017.1415765
World Health Organization (1986). Ottawa charter for health promotion. Retrieved from World Health Organization website: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/