Health Promotion - History

History

The "first and best known" definition of health promotion, promulgated by the American Journal of Health Promotion since at least 1986, is "the science and art of helping people change their lifestyle to move toward a state of optimal health". This definition was derived from the 1974 Lalonde report from the Government of Canada, which contained a health promotion strategy "aimed at informing, influencing and assisting both individuals and organizations so that they will accept more responsibility and be more active in matters affecting mental and physical health". Another predecessor of the definition was the 1979 Healthy People report of the Surgeon General of the United States, which noted that health promotion "seeks the development of community and individual measures which can help... to develop lifestyles that can maintain and enhance the state of well-being".

At least two publications led to a "broad empowerment/environmental" definition of health promotion in the mid-1980s:

• In 1984 the World Health Organization (WHO) Regional Office for Europe defined health promotion as "the process of enabling people to increase control over, and to improve, their health". In addition to methods to change lifestyles, the WHO Regional Office advocated "legislation, fiscal measures, organisational change, community development and spontaneous local activities against health hazards" as health promotion methods.
• In 1986, Jake Epp, Canadian Minister of National Health and Welfare, released Achieving health for all: a framework for health promotion which also came to be known as the "Epp report". This report defined the three "mechanisms" of health promotion as "self-care"; "mutual aid, or the actions people take to help each other cope"; and "healthy environments".

The WHO, in collaboration with other organizations, has subsequently co-sponsored international conferences on health promotion as follows:

• 1st International Conference on Health Promotion, Ottawa, 1986, which resulted in the "Ottawa Charter for Health Promotion". According to the Ottawa Charter, health promotion:
  • "is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being"
  • "aims at making... favourable through advocacy for health"
  • "focuses on achieving equity in health"
  • "demands coordinated action by all concerned: by governments, by health and other social and