The Ottawa Charter for Health Promotion (VCE SSCE Health and Human Development): Revision Notes

The Ottawa Charter for Health Promotion

What is the Ottawa Charter?

The Ottawa Charter for Health Promotion is a framework created by the World Health Organization to guide organisations in developing health promotion strategies. It was developed at the First International Conference on Health Promotion held in Ottawa, Canada, in 1986. Before this conference, there were no clear guidelines for how to incorporate health promotion ideas into policies and campaigns.

The Ottawa Charter aims to reduce inequalities in health and wellbeing. It reflects the social model of health, which recognises that health is influenced by many factors beyond just biology and healthcare. The framework consists of three core strategies and five action areas that work together to improve health status across populations.

According to the World Health Organization, health promotion is the process of enabling people to increase control over, and to improve, their health. This approach focuses on prevention rather than cure. Instead of simply treating diseases after they occur, health promotion addresses the underlying causes of disease and aims to stop health problems before they start.

Strategies for health promotion

The Ottawa Charter identifies three fundamental strategies that underpin all successful health promotion work. These strategies provide the foundation for implementing the five action areas.

Advocate

Good health and wellbeing represents a major resource for individuals, communities, nations and the world. Many different factors can either support or harm health and wellbeing. The advocacy strategy aims to make these factors more supportive through targeted action.

Advocacy for health involves taking action to gain support from governments and societies to improve health and wellbeing for everyone. This is crucial because many factors that affect health require policy changes or societal shifts that individuals cannot achieve alone.

Examples of advocacy actions include:

• Running media and social media campaigns to raise awareness
• Public speaking at community events or forums
• Conducting and publishing research to build evidence
• Gathering and sharing public opinion data
• Lobbying governments, where individuals or groups work to influence those who make policies and laws

Advocacy ensures that health promotion remains visible and prioritised in government decision-making and community planning.

Enable

Health promotion recognises that different population groups experience different levels of health and wellbeing. The enable strategy focuses on achieving equity by working with those who face poorer health status.

Enabling is about reducing differences in health outcomes between population groups. This involves ensuring equal opportunities and resources are available so all people can achieve optimal health and wellbeing. Importantly, enabling means empowering people to take control of factors affecting their health, not simply providing handouts or doing things for people.

To achieve optimal health and wellbeing, people need access to:

• Quality education
• Meaningful employment
• Adequate housing
• Nutritious food
• Healthcare services

This enabling approach applies equally across all population groups, including women and men, Indigenous and non-Indigenous Australians, people in different socioeconomic groups, and those living in cities versus regional and remote areas. The goal is to give people the tools and resources they need to make healthy choices, rather than making choices for them.

Mediate

Health promotion often requires changes to funding structures, legislation, policies, and physical and sociocultural environments. These types of changes inevitably create conflict between different stakeholders, including individuals, community groups, businesses and political parties.

Mediating involves helping these diverse groups resolve conflicts and reach outcomes that promote health and wellbeing. Health professionals and community organisations play an important role in bringing different perspectives together.

The mediation strategy recognises that health promotion requires negotiation and compromise. By facilitating dialogue between stakeholders with different interests, mediators can help create policies and programs that have broad support while still advancing health goals.

Action areas of the Ottawa Charter

The Ottawa Charter outlines five specific action areas that provide a comprehensive framework for health promotion. These action areas work together and often overlap in practice. Understanding each area helps health professionals and policymakers design more effective programs.

Build healthy public policy

This action area focuses on government and organisational decisions about laws and policies. The goal is to create a policy environment that makes healthy choices the easier choices for people.

Healthy public policy can work in several ways. It can make unhealthy behaviours more difficult or less appealing, while simultaneously making healthier options more accessible and attractive. This shifts the environment in which people make decisions, rather than simply telling people what to do.

Australian examples of healthy public policy include:

Policy approach	How it works	Health benefit
Removing GST from unprocessed foods	Makes healthier whole foods cheaper to purchase compared to processed alternatives	Encourages consumption of nutritious foods
Increasing taxes on tobacco and alcohol	Makes these products more expensive, which discourages purchase, particularly among young people	Reduces rates of smoking and harmful alcohol consumption
Banning smoking in public places	Creates smoke-free environments in restaurants, workplaces, and other public venues	Protects everyone from secondhand smoke exposure
Mandatory seatbelt laws	Requires all vehicle occupants to wear seatbelts	Dramatically reduces deaths and serious injuries from vehicle crashes

Create supportive environments

This action area recognises that broader determinants significantly impact health and wellbeing. The physical and sociocultural environments in which people live, work, learn and play greatly influence their health outcomes.

A supportive environment is one that actively promotes health and wellbeing by being safe, stimulating, satisfying and enjoyable. These environments make it easier for people to make healthy choices in their daily lives without requiring constant conscious effort.

Physical environment examples include:

• Providing safe, well-lit walking and cycling paths
• Creating shaded areas in school playgrounds and outdoor spaces to reduce UV exposure
• Ensuring smoke-free areas in public spaces
• Maintaining safe working conditions in employment settings

Sociocultural environment examples include:

• Having a supportive family where healthy behaviours are practiced and encouraged
• Creating inclusive communities where all members feel valued
• Establishing services like Quitline that provide support for people trying to quit smoking
• Investing in sustainable energy production to ensure future generations inherit a healthy environment

Supportive environments reduce barriers to healthy living. When the environment is designed with health in mind, healthy choices become the natural, convenient option.

Strengthen community action

This action area centres on building connections between individuals and their communities. It recognises that communities often know best what they need and can be powerful drivers of change.

Strengthening community action means communities working together toward common health goals. When people feel a sense of ownership over health strategies in their area, participation increases and programs become more effective. This bottom-up approach contrasts with top-down programs designed without community input.

Another example is immunisation strategies in Australia. These involve multiple groups - media organisations, medical professionals, schools and parents - working together to achieve higher immunisation rates for children. Each group brings different strengths and reaches different audiences, but all work toward the shared goal of protecting children from preventable diseases.

Community action is effective because it:

• Builds on existing community strengths and resources
• Respects local culture and knowledge
• Creates sustainable change led by community members themselves
• Increases trust in health programs
• Addresses issues most relevant to that specific community

Develop personal skills

Education forms the core of this action area. Developing personal skills means providing people with health-related knowledge and practical skills that allow them to make informed decisions affecting their health and wellbeing.

This education goes beyond simply providing information. It includes teaching practical skills and building confidence so people can apply their knowledge in real-life situations. Education might be directly about health topics, or it might address skills that indirectly support health, such as conflict resolution, cooking, budgeting or stress management.

Health education can occur in many settings:

• Schools teaching nutrition, physical activity, relationships and mental health
• Workplaces offering professional development and wellbeing programs
• Families passing on knowledge and modelling healthy behaviours
• Community health centres running classes and workshops
• Government and non-government organisations providing public health campaigns

Australian examples include:

• Community health centres running cooking classes that teach people how to prepare nutritious, affordable meals
• Quit campaigns educating people about the harmful effects of smoking and providing strategies to quit
• Sun safety programs teaching parents and children about sunscreen application and UV protection
• Schools teaching students about healthy relationships and conflict resolution
• Workplace training on stress management and work-life balance

Reorient health services

This action area calls for a fundamental shift in how health systems operate. Instead of focusing primarily on diagnosing and treating illness (the biomedical approach), health services should prioritise promoting health and preventing disease.

Reorienting health services means addressing all factors that influence health and wellbeing, not just diseases and their treatments. This requires health professionals to expand their role beyond clinical care to include education, advocacy and health promotion.

In practice, this might look like:

• Doctors discussing healthy eating and exercise as the first approach to managing cardiovascular disease risk, rather than immediately prescribing medication
• Medical professionals recommending physical activity programs to prevent type 2 diabetes before it develops
• Health services providing funding for community walking groups or cooking classes
• Healthcare providers implementing health promotion campaigns in their communities

The My Health for Life program in Queensland exemplifies this action area. Rather than waiting for people to develop chronic conditions and then treating them, this government-funded initiative works to prevent conditions like type 2 diabetes, heart disease and stroke from occurring in the first place. By funding prevention programs, the health system demonstrates a commitment to keeping people healthy rather than just treating them when they become ill.

This reorientation also means recognising social determinants of health. Health services might advocate for affordable housing, support employment programs, or work to improve food security in their communities, understanding that these factors fundamentally affect health outcomes.

The Ottawa Charter in action - My Health for Life

The My Health for Life program demonstrates how the Ottawa Charter action areas work together in practice. This Queensland government initiative shows how a single program can address multiple action areas simultaneously.

The My Health for Life program shows how effective health promotion addresses multiple action areas simultaneously. By combining education, support, community partnerships and a prevention focus, the program creates conditions where people can successfully improve their health.