The Ottawa Charter - Still Relevant After 30 Years?

May 10, 2022

The Ottawa Charter was created in 1986 to create a framework used when building public health promotion strategies (WHO, 2022). Its main goal is to enable people to make decisions to improve their health and allow for patient-centered care to be at the forefront of health initiatives (WHO, 2022). The health promotion movement targets not only the complete physical health of patients but also complete psychological and social well-being (WHO, 2022). Their five main strategies are:

• Build healthy public policy

• Create supportive environments

• Strengthen community actions

• Develop personal skills

• Reorient health services

I believe that after 30+ years the Ottawa Charter still has some relevant strategies in practice and its basis can still be applied. However, a lot has to be updated to properly promote health and reach a larger scale of the population around the globe. Since moving to northern Alberta, it has become abundantly clear that Indigenous communities are not offered the same level of care as the rest of Canadians and this can be seen in their higher rates of chronic disease, as well as shorter life expectancy (NCCIH, 2019). In a paper written by Sanchez-Pimienta and Masuda (2020), they raise awareness on the issue that health promotion is targeted toward Western communities and does not properly grasp the needs of minority groups such as Indigenous People. In their paper, they mention that the goal should go beyond making health promotion 'culturally appropriate', but rather understanding their culture and values and including this main concept into health promotion and making it accessible to the Indigenous population (Sanchez-Pimienta & Masuda, 2020). This group is not the only group affected by differing levels of care due to their race or culture. Creating strategies specifically targeted for these minority groups would better represent our healthcare system in general and allow for health promotion to be inclusive. These strategies could include; education and promotion of health in minority groups could at the community level with information sessions in their native language, offering healthcare services in their communities, or improving roads to allow for easier travel to healthcare facilities.

Another important update to improve health promotion is accountability. The Ottawa Charter includes 3 actions; advocate, enable and mediate (WHO, 2022). The actions currently available are important, but there is no followthrough or reevaluation process to ensure the policies built are actually working. When thinking of personal skills and responsibility, the degree of action needed for people to stick to healthier habits is immense (Resnik, D.B., 2007). People need constant reminders until an action or healthy behaviour becomes a habit, and even then they could fall off the wagon. The Ottawa Charter should focus on strategies that result in measurable results and reassess if desired goals are not met, as well as procedures to improve current strategies.

The way to reach and communicate with people has shifted immensely in the last 10 years. We’ve become digitally connected and this is something that needs to also be taken into consideration when building public health initiatives. Altogether, the Ottawa Charter is a great first building block when creating public health initiatives. It does however need to be updated to represent our modern-day situations and include all communities with a special thought on reaching more minority groups.

Andree Marcille