The Ottawa Charter has played a significant role in the way we consider health promotion in Canada and the world. The charter was created in 1986 as a guide towards changing public health around the globe (World Health, 1987). It is comprised of five action areas which include strengthen community action, develop personal skills, build healthy public policy, create supportive environments, reorient health services. It was the first to include requirements for health (Kirk et al., 2014). The values presented in the charter spoke to countries across the globe and health promotion practices began to include addressing the social determinants of health for the population, and not just dealing with the individual (Kirk et al., 2014).
In Canada, we are challenged with our health services being delivered at the provincial/territorial level versus the federal level. This has made national health promotion programs difficult. It is specifically hard to capture the long-term data to support the effectiveness of a program or initiative. As healthcare becomes more business focused, data has become crucial (Kirk et al., 2014). Constantly dealing with acute health care needs has resulted in monetary resources to continue be funneled to acute care over proactive health promotion. Hancock (2011) shares his views on the missed opportunities in Canada, which include a lack of health policy adoption federally (build healthy public policy), poor health literacy in our seniors (which is connected to ‘develop personal skills’), continued focus on acute care services over disease prevention and promotion (tied to re-orient health services). Overall, Canada seems to be missing the opportunity to embrace health promotion. Federal and Provincial governments seem to either lack the vision to see the long-term benefits or find the resources required to truly make a concerted push towards prioritizing health promotion.
One Europe study seems to show that members of the public health association of Europe are doing about the same as Canada. While there are certainly areas that have seen action, there is much work left to be done when it comes to addressing social determinants as an important component of health promotion (Wilberg et al., 2019). Wilberg et al. (2019) notes that ‘developing personal skills’ seems to rank the highest of the five action areas for the countries studied with ‘re-orientation of health services’ being the lowest, certainly this is the area that would require the most investment to afford changes.
In the profession of a Radiation Technologist, the concept of health promotion is not common. As we continue to grow our profession, a balance between promoting health in the areas we deal with, such as radiation safety and breast cancer screening, while dealing with short patient exam times will be a challenge (Bardyova et al., 2021). Certainly, educational intuitions need to incorporate the topic of health promotion as well to clarify the role technologist’s play.
The Ottawa Charter action items are generally agreed as appropriate and relevant. There is certainly room for continued action and growth in health promotion both in Canada and the globe; the action items are broad and will be resource intensive to fully realize. Change occurs over time with increased learning and understanding of needs along the way. It will be interesting to see how the impact of the COVID-19 pandemic will enhance or restrict further adoption of public health promotion practices. Like every other initiative, anything is possible with adequate resources.
References
Bárdyová, Z., Horváthová, M., Pinčáková, K., & Budošová, D. (2021). The importance of public health in radiology and radiation protection. Journal of public health research, 10(3), 2141. https://doi.org/10.4081/jphr.2021.2141
Hancock, T. (2011). Health promotion in Canada: 25 years of unfulfilled promise. Health Promotion International. 26(2). Ii263-ii267, https://doi.org/10.1093/heapro/dar061
Kirk, M., Tomm-Bonde, L., & Schreiber, R. (2014). Public health reform and health promotion in Canada. Globe Health Promotion.21(2). 15-21. https://journals.sagepub.com/doi/10.1177/1757975913512157
Wilberg, A., Saboga-Nunes, L., & Stock, C. (2021). Are we thrre yet? Use of the Ottawa Charter action areas in the perspective of European health promotion professionals. Journal of Public Health. 29. 1-7. https://doi.org.10.1007/s10389-019-01108-x
World Health (1987). Ottawa charter for health promotion (pp. 16-17). World Health. https://www.who.int/publications/i/item/ottawa-charter-for-health-promotion
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