MHST 631, Unit 2 Learning Activity 5
The Ottawa Charter for Health Promotion was established in 1986 to further the objective by the World Health Organizations of Health for All by the year 2000 (World Health Organization, 1986). Within this blog post I discuss examples of how the Ottawa Charter has played a role in health promotion globally, in Canada, and within my own practice in workplace health promotion.
Global Impact
From my perspective, the most valuable role of the Ottawa Charter for Health Promotion globally is the establishment of a common definition of health promotion. Within the charter, health promotion is defined as "the process of enabling people to increase control over, and to improve, their health (World Health Organization, 1986, p. 1). Unlike the term "health", which can be defined in many different ways (check out my MHST 601 blog "What is health?" for a post about that). Critique can be made about whether the five strategies of the charter are representative to promote health equity (McPhail-Bell et al., 2013), however, I see the definition as a starting point for reviewing and refining health promotion strategies. At almost 40 years since its release, the Charter is still a relevant document for which its strategies have influenced decision making on public health challenges such as COVID-19 (Nutbeam et al., 2021). I am compelled by an interesting commentary by Nutbeam and Muscat (2021), which describes the Ottawa Charter as still holding a valid definition in our modern day, but that many elements of the charter strategies require an evolved description so that they have a contemporary application.
Canada & The Charter
In Canada, the Ottawa Charter is noted as acting as a guide to the areas of focus by the Public Health Association of Canada (1996), as well as it has been applied in conjunction with other frameworks or models to further health promotion programs. For example, Mulligan et al., (2024) provide discourse for how both, the Ottawa Charter for Health Promotion and Quintuple Aim for healthcare improvement, together offer a combined framework to equitably addressing the social, environmental and individuals’ health needs of individuals and groups through social prescribing. I want to pause to share more about two new terms that I think are worth sharing that I gleaned from the Mulligan et al., paper; “quintuple aim” and “social prescribing”, as I think the link to the Charter is interesting. Quintuple Aim is a framework for promoting value-based approaches to healthcare; represented by the following five key factors, improved population health, improved patient experience, reduced costs, improved provider experience, and overall health equity (Nundy et al., 2022). Social prescribing is a health promotion strategy which connects individuals to community-based services and resources; building the capacity of individuals and communities towards meeting their health needs and determinants (Mulligan et al., 2024). Published in the Journal Health Promotion and Chronic Disease Prevention in Canada, Mulligan et al., (2024) describe how these two frameworks (Ottawa Charter and Quintuple Aim), can be aligned to guide social prescribing promotion, for example, reorienting health services (Charter) and reducing costs (Quintuple Aim).
Impact on My Professional Practice
What stands out to me about the definition of health promotion from the Charter is that the responsibility lays beyond that of only the health sector (World Health Organization, 1986), as this is where environments and stakeholders for health play a role, such as employers and the workplace. I work in the realm of workplace health promotion and the Ottawa Charter adds value and perspective to viewing health promotion as something which all areas of our society have a role to create supportive environments. Which includes the role of the workplace and employer in worker health and wellbeing. In addition, the Charter can be used as a starting point for evaluating workplace health promotion efforts, such as exemplified by a study on a tobacco cessation program via the workplace (Chen et al., 2016). The Ottawa Charter is relevant to my professional practice as it outlines strategies that are applicable for employers to take action upon to improve the work environment, and thus positively impact worker health and wellbeing.
In summary, the Charter is not the one-size-fits-all solution to health promotion. It is a tool that can aid in designing and evaluating programs (Saadati, 2022 & Chen et al., 2016) and common understanding through an established definition (Nutbeam & Muscat, 2021). My role in workplace health promotion is not only influenced by the Ottawa Charter, but the philosophy of my practice is also influenced by other guiding frameworks such the Population Health Promotion Model and Social Determinants of Health. (But there will be more to come on that in future blog posts!)
Kylie
References
Canadian Institute for Health Information. (2024, June 18). Working toward achieving the Quintuple Aim. https://www.cihi.ca/en/using-patient-reported-data-to-better-assess-quality-of-care/working-toward-achieving-the-quintuple-aim
Chen, T.-H., Huang, J.-J., Chang, F.-C., Chang, Y.-T., & Chuang, H.-Y. (2016). Effect of Workplace Counseling Interventions Launched by Workplace Health Promotion and Tobacco Control Centers in Taiwan: An Evaluation Based on the Ottawa Charter. PLOS ONE, 11(3), e0150710. https://doi.org/10.1371/journal.pone.0150710
McPhail-Bell, K., Fredericks, B., & Brough, M. (2013). Beyond the accolades: a postcolonial critique of the foundations of the Ottawa Charter. Global Health Promotion, 20(2), 22–29. https://doi.org/10.1177/1757975913490427
Mulligan, K., Card, K. G., & Allison, S. (2024). Social prescribing in Canada: linking the Ottawa Charter for Health Promotion with health care’s Quintuple Aim for a collaborative approach to health. Health Promotion and Chronic Disease Prevention in Canada, 44(9), 355–357. https://doi.org/10.24095/hpcdp.44.9.01
Nundy, S., Cooper, L. A., & Mate, K. S. (2022). The Quintuple Aim for Health Care Improvement: A New Imperative to Advance Health Equity. JAMA, 327(6), 521. https://doi.org/10.1001/jama.2021.25181
Nutbeam, D., Corbin, J. H., & Lin, V. (2021). The continuing evolution of health promotion. Health Promotion International, 36(Supplement_1), i1–i3. https://doi.org/10.1093/heapro/daab150
Nutbeam, D., & Muscat, D. M. (2021). Health Promotion Glossary 2021. Health Promotion International, 36(6), 1578–1598. https://doi.org/10.1093/heapro/daaa157
World Health Organization. (1986). Ottawa charter for health promotion, 1986 (No. WHO/EURO: 1986-4044-43803-61677). World Health Organization. Regional Office for Europe. https://www.canada.ca/content/dam/phac-aspc/documents/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion/charter.pdf
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