Ottawa Charter

by

Evelyne de Leeuw

• LAST REVIEWED: 05 May 2017
• LAST MODIFIED: 31 March 2016
• DOI: 10.1093/obo/9780199756797-0070

Introduction

The Ottawa Charter for Health Promotion (see Introductory Works) is widely regarded as the visionary gospel for the international health promotion movement. Agreed upon and published at the First International Conference on Health Promotion (Ottawa, 17–21 November 1986), it codified and amalgamated a number of changes in health perspectives that started to emerge in the 1960s and 1970s. It called for a broader social model of health to complement, not replace, the disease-oriented and often-individual behaviorist clinical perspective.

Introductory Works

Although many believe that the Ottawa Charter launched the notion of “health promotion,” this concept had existed in English-speaking nations since the late 1970s. The European office of the World Health Organization (WHO) took the lead in adding consistency to the concept. This development aligned with the ambition of WHO and its member states to accomplish “Health for All by the Year 2000.” In the European region, work toward this goal started in earnest in the early 1980s with the development of sets of targets (World Health Organization Regional Office for Europe 1984a and World Health Organization Regional Office for Europe 1984b). These evolved from a large set of quantitative disease-oriented parameters to a smaller set of requirements, as discussed in de Leeuw 1985. The Ottawa Charter reflects this health orientation and determinants approach (Kickbusch 2003).

• de Leeuw, E. 1985. “2000—A health odyssey: An inquiry into the planning and design of a regional strategy for health for all by the year 2000 in the European Region of the World Health Organization.” PhD diss., University of Limburg, Maastricht, The Netherlands.

  Describes the shift in processes and priorities: focus turned from epidemiological measures to social and political measures for European WHO policy in the late 1970s and early 1980s.

• Kickbusch, I. 2003. The contribution of the World Health Organization to a new public health and health promotion. American Journal of Public Health 93.3: 383–388.

  DOI: 10.2105/AJPH.93.3.383

  A historical analysis, with a realist reflection on the role of WHO as a change agent in global disease prevention and health promotion.

• World Health Organization, Health and Welfare Canada, and Canadian Public Health Association. 1986. Ottawa Charter for Health Promotion: An international conference on health promotion—the move towards a new public health, Nov. 17–21, Ottawa. Geneva, Switzerland: World Health Organization.

  Very brief (three pages) but highly influential conference statement calling for (1) advocacy for health; enabling people to take control; and mediation across sectors and groups for health; (2) Healthy Public Policies, which must be established to ensure comprehensive policy approaches in all sectors toward health; (3) supportive social and physical environments for health, to make intersectoral health development possible in a socio-ecological health approach; (4) community action and development, which is at the core of public control over defining health determinants, and the development of personal skills to enable individuals to make healthier choices; and (5) reorientation of health services toward active pursuit of community health rather than a focus on the cure of individual diseases.

• World Health Organization Regional Office for Europe. 1984a. Regional targets in support of the regional strategy for health for all. Document EUR/RC34/7, 14 July 1984. Copenhagen: World Health Organization Regional Office for Europe.

  Landmark WHO Europe publication, explicitly acknowledging for the first time the importance of addressing social and political determinants of health.

• World Health Organization Regional Office for Europe. 1984b. Health promotion: A discussion document on the concept and principles. ICP/HSR 602. Copenhagen: World Health Organization Regional Office for Europe.

  The conceptual groundwork for the Ottawa Charter for Health Promotion. Broad discussion of social and environmental trends, and shifts in (popular/lay) views of health and medicine. Reprinted in Health Promotion 1.1 (1986): 73–76 and Public Health Review 14.3–4 (1986): 245–254.