Health promotion is the process of enabling people to gain greater control over and improve their health. A central approach within public health, it combines action on individual capabilities with changes to the conditions in which people live. The World Health Organization (WHO) treats health promotion as extending beyond the health sector and individual lifestyles: it includes public policy, supportive environments, community participation, and services that support well-being. Health is understood as a resource for everyday life rather than simply the absence of illness. (who.int)
Scope and related concepts
Health promotion overlaps with, but is not identical to, disease prevention. Prevention focuses on reducing risk factors, preventing disease, detecting it early, or limiting its progression and consequences. Health promotion has a broader focus on the resources, opportunities, and conditions that enable people to live healthy lives. The two approaches frequently operate together, particularly where interventions address both particular risks and their underlying determinants. (iris.who.int)
Health education is one component of health promotion. It uses learning and communication to develop understanding and skills, whereas health promotion also encompasses organizational and environmental change. Its concern with social determinants of health connects individual experience with such factors as income, housing, employment, and access to education. Information alone does not encompass the full range of action recognized in the health-promotion framework. (who.int)
Historical development
The first International Conference on Health Promotion, held in Ottawa, Canada, adopted the Ottawa Charter for Health Promotion on November 21, 1986. It built on earlier international work on primary health care, including the Declaration of Alma-Ata, and WHO’s “Health for All” strategy. The charter identified prerequisites for health, including peace, shelter, food, income, education, a stable ecosystem, sustainable resources, social justice, and equity. (canada.ca)
Subsequent conferences elaborated this framework. The 1997 Jakarta Declaration emphasized social responsibility, investment, partnerships, community capacity, and infrastructure for health promotion. The Shanghai conference in 2016 connected health promotion with the Sustainable Development Goals, highlighting governance, health literacy, and cities as important fields of action. These developments broadened the framework without replacing the Ottawa Charter’s central principles. (who.int)
Strategies and action areas
The Ottawa Charter distinguishes three basic strategies: advocacy, enabling, and mediation. Advocacy seeks conditions favorable to health; enabling concerns equitable opportunities and resources; mediation involves coordinating groups and sectors whose interests and responsibilities differ. Together, these strategies recognize that health promotion cannot be delivered by health professionals alone. (who.int)
The charter identifies five complementary action areas:
- Building healthy public policy: incorporating health considerations into decisions, including legislation, taxation, and organizational arrangements.
- Creating supportive environments: addressing living and working conditions and the relationships between people and their surroundings.
- Strengthening community action: involving communities in setting priorities, making decisions, and implementing activities.
- Developing personal skills: supporting learning, practical capabilities, and access to information throughout life.
- Reorienting health services: moving beyond an exclusively clinical and curative focus toward services that also support people and communities in achieving health.
These areas form an integrated framework rather than a sequence of separate stages. (canada.ca)
Equity and community participation
Health equity concerns the absence of unfair, avoidable, or remediable differences in health between population groups. Health promotion addresses both access to resources and the distribution of opportunities to influence health. This includes attention to how social and economic conditions can enable or constrain people’s choices, rather than treating health exclusively as a matter of individual responsibility. (iris.who.int)
Community empowerment involves increasing communities’ capacity to influence decisions and act on their priorities. Participation therefore extends beyond receiving messages or attending activities: it can include identifying needs, planning interventions, managing resources, and evaluating results. The Jakarta Declaration places community capacity and individual empowerment alongside investment and partnerships as priorities for health promotion. (who.int)
Settings and health literacy
The healthy-settings approach organizes health promotion around places where everyday life occurs, such as schools, workplaces, hospitals, and cities. It considers the setting as a whole, including its policies, environment, relationships, and services. Community participation, partnership, empowerment, and equity are central principles. The Healthy Cities programme is a prominent example of this approach. (who.int)
Health literacy concerns people’s ability to access, understand, and use health information and services. It extends beyond reading written materials to participating in decisions and collective action. Health-literacy work can address personal capabilities, organizational communication, and wider systems. WHO identifies these personal, organizational, and systemic levels as interconnected areas of activity, particularly in addressing barriers experienced by marginalized populations. (who.int)
Evaluation
Evaluation examines whether health-promotion initiatives achieve their aims and how their implementation can improve. Because these initiatives may address social and economic conditions as well as individual practices, evaluation encompasses more than clinical outcomes. Quantitative and qualitative methods provide complementary ways to investigate results, implementation, and the experiences of participating groups. (who.int)
Evidence also informs decisions about investment and accountability. WHO’s work on health-promotion evaluation distinguishes the need to demonstrate an initiative’s value from the need to increase its effectiveness. The Jakarta Declaration similarly emphasizes accumulating knowledge about practice, enabling shared learning, and maintaining transparency and public accountability. (who.int)