This was found at http://www.monash.edu.au/health/health/htm

Also check out http://www.utoronto.ca/chp


                  Ottawa Charter for Health Promotion

The first International Conference on Health Promotion, held in November 1986, presented a
charter for action to achieve Health for
All by the year 2000 and beyond. This conference was primarily a response to growing expectations
for a new public health movement
around the world. Discussions focused on the needs in industrialized countries, but took into
account similar concerns in all other
regions. The following text provides a good framework to understand what health promotion is.

Health Promotion
Health promotion is the process of enabling people to increase control over, and to improve, their
health. To reach a state of complete
physical, mental and social well-being, an individual or group must be able to identify and to realize
aspirations, to satisfy needs, and
to change or cope with the environment. Health is, therefore, seen as a resource for everyday life,
not the objective of living. Health is
a positive concept emphasizing social and personal resources, as well as physical capacities.
Therefore, health promotion is not just
the responsibility of the health sector, but goes beyond healthy life-styles to well-being.

Prerequisites for health
The fundamental conditions and resources for health are peace, shelter, education, food, income,
a stable eco-system, sustainable
resources, social justice and equity. Improvement in health requires a secure foundation in these
basic prerequisites.

Advocate
Good health is a major resource for social, economic and personal development and an important
dimension of quality of life. Political,
economic, social, cultural, environmental, behavioural and biological factors can all favour health or
be harmful to it. Health
promotion action aims at making these conditions favourable through advocacy for health.

Enable
Health promotion focuses on achieving equity in health. Health promotion action arms at reducing
differences in current health status
and ensuring equal opportunities and resources to enable all people to achieve their fullest health
potential. This includes a secure
foundation in a supportive environment, access to information, life skills and opportunities for
making healthy choices. People cannot
achieve their fullest health potential unless they are able to take control of those things which
determine their health. This must apply
equally to women and men.

Mediate
The prerequisites and prospects for health cannot be ensured by the health sector alone. More
importantly, health promotion demands
coordinated action by all concerned: by governments, by health and other social and economic
sectors, by nongovernmental and
voluntary organizations, by local authorities, by industry and by the media. People in all walks of life
are involved - individuals,
families and communities. Professional and social groups and health personnel have a major
responsibility to mediate between
differing interests in society for the pursuit of health.

Health promotion strategies and programmes should be adapted to the local needs and
possibilities of individual countries and regions
to take into account differing social, cultural and economic systems.

Health Promotion Action Means:

Build healthy public policy
Health promotion goes beyond health care. It puts health on the agenda of policy makers in all
sectors and at all levels, directing them
to be aware of the health consequences of their decisions and to accept their responsibilities for
health.

Health promotion policy combines diverse but complementary approaches including legislation,
fiscal measures, taxation and
organizational change. It is coordinated action that leads to health, income and social policies that
foster greater equity. Joint action
contributes to ensuring safer and healthier goods and services, healthier public services, and
cleaner, more enjoyable environments.

Health promotion policy requires the identification of obstacles to the adoption of healthy public
policies in non-health sectors, and
ways of removing them. The aim must be to make the healthier choice the easier choice for policy
makers as well.

Create supportive environments
Our societies are complex and interrelated. Health cannot be separated from other goals. The
inextricable links between people and
their environment constitutes the basis for a socio-ecological approach to health. The overall
guiding principle for the world nations,
regions and communities alike, is the need to encourage reciprocal maintenance - to take care of
each other, our communities and our
natural environment. The conservation of natural resources throughout the world should be
emphasized as a global responsibility.

Changing patterns of life, work and leisure have a significant impact on health. Work and leisure
should be a source of health for
people. The way society organizes work should help create a healthy society. Health promotion
generates living and working
conditions that are safe, stimulating, satisfying and enjoyable.

Systematic assessment of the health impact of a rapidly changing environment - particularly in
areas of technology, work, energy
production and urbanization - is essential and must be followed by action to ensure positive benefit
to the health of the public. The
protection of the natural and built environments and the conservation of natural resources must be
addressed in any health promotion
strategy.

Strengthen community action
Health promotion works through concrete and effective community action in setting priorities,
making decisions, planning strategies
and implementing them to achieve better health. At the heart of this process is the empowerment of
communities, their ownership and
control of their own endeavours and destinies.

Community development draws on existing human and material resources in the community to
enhance self-help and social support,
and to develop flexible systems for strengthening public participation and direction of health
matters. This requires full and continuous
access to information, learning opportunities for health, as well as funding support.

Develop personal skills
Health promotion supports personal and social development through providing information,
education for health and enhancing life
skills. By so doing, it increases the options available to people to exercise more control over their
own health and over their
environments, and to make choices conducive to health.

Enabling people to learn throughout life, to prepare themselves for all of its stages and to cope with
chronic illness and injuries is
essential. This has to be facilitated in school, home, work and community settings. Action is
required through educational,
professional, commercial and voluntary bodies, and within the institutions themselves.

Reorient health services
The responsibility for health promotion in health services is shared among individuals, community
groups, health professionals, health
service institutions and governments. They must work together towards a health care system which
contributes to the pursuit of health.

The role of the health sector must move increasingly in a health promotion direction, beyond its
responsibility for providing clinical
and curative services. Health services need to embrace an expanded mandate which is sensitive
and respects cultural needs. This
mandate should support the needs of individuals and communities for a healthier life, and open
channels between the health sector and
broader social, political, economic and physical environmental components.

Reorienting health services also requires stronger attention to health research as well as changes
in professional education and
training. This must lead to a change of attitude and organization of health services, which
refocuses on the total needs of the individual
as a whole person.

Moving Into The Future
Health is created and lived by people within the settings of their everyday life; where they learn,
work, play and love.

Health is created by caring for oneself and others, by being able to take decisions and have control
over one's life circumstances, and
by ensuring that the society one lives in creates conditions that allow the attainment of health by all
its members.

Caring, holism and ecology are essential issues in developing strategies for health promotion.
Therefore, those involved should take as
a guiding principle that, in each phase of planning, implementation and evaluation of health
promotion activities, women and men
should become equal partners.

Call for international action
The Conference calls on the World Health Organization and other international organizations to
advocate the promotion of health in all
appropriate forums and to support countries in setting up strategies and programmes for health
promotion.

The Conference is firmly convinced that if people in all walks of live, nongovernmental and voluntary
organizations, governments, the
World Health Organization and all other bodies concerned join forces in introducing strategies for
health promotion, in line with the
moral and social values that form the basis of this CHARTER, Health For All by the year 2000 will
become a reality.

 ***********************************
 That which is sure is not sure.
 As things are, they shall not remain.
        -Bertolt Brecht
 ***********************************


Dennis Raphael, Ph.D., C.Psych.
Associate Professor
University of Toronto
Division of Community Health
Faculty of Medicine
Department of Behavioural Science
McMurrich Building, Room 101
Toronto, Ontario M5S 1A8
Tel: (416) 978-7567
Fax: (416) 978-2087
E-Mail: [log in to unmask]