Is the Ottawa Charter still relevant? A survey among Health Promotion practitioners and researchers

Abstract

The Ottawa Charter for Health Promotion celebrated its thirtieth anniversary in November 2016, stimulating discussion regarding the guiding principles of the Ottawa Charter and the progress of health promotion. This study explores the opinions of health promotion researchers and practitioners on the current relevance and application of health promotion principles based on the Ottawa Charter. Four research questions shape this inquiry which include: What is the Ottawa Charter and Health Promotion? What progress and changes have occurred globally and within Health Promotion since the Charter was introduced, how the Charter and Health Promotion concepts and practices been applied and Is the Charter known and still relevant in today’s context and where does Health Promotion stand? An invitation to survey participation was sent to members of the EUPHA Health Promotion section. A total of 193 members (67% females) from 26 European countries responded. Demographic and professional information was collected, and responses addressed the relevance, strengths and weaknesses of health promotion. Respondents rated the use of the five action areas of the Ottawa Charter in their geographic region as well as the perceived progress and value of Health Promotion. Qualitative inquiry explored the reasons for various ratings by identifying meaningful units in participant responses, developing various categories according to their meaning, and organizing these into five central themes addressing the overall research questions. 44% of respondents stated that Health Promotion is well developed in their country and 50% of participants declared the same for Europe. The percentage of use (regularly/very often) of the five action areas in one´s country was rated highest for “Developing personal skills and knowledge” at 64%, followed by “Developing healthy public policy” at 44%, and lowest for “Reorientation of health services” with 31%. Health promotion was rated as a necessary field by 73% of respondents and 5 core themes organizing various categories emerged: Concept, Practice, Impact, Potential and Barriers. Though Health Promotion was perceived to embrace positive vision and values and promote social responsibility for health with various health and social benefits, it is at times an unclear concept with various professional and academic concerns and low awareness in the professional and public sphere. Though HP demonstrates great potential for individuals and communities and holds good intentions that demand action, challenges include permeating social, political and investment barriers, competing interests and lack of intersectionality, the perceived dominance of curative/disease oriented perspectives, lack of immediate outcomes and evidence and over-reliance on individual behaviour change. Though 80% of respondents felt that overall knowledge of health promotion has somewhat progressed, 80% felt that Health Promotion is due for a deeper reflection. Strategies to apply the five action areas in various countries and putting principles into practice may be beneficial, as well as systematically addressing professional concerns regarding perceived weaknesses, threats and challenges influencing Health Promotion.