Understanding the Ottawa Charter
The Ottawa Charter for health promotion was established in 1986 creating a major step forward in enabling individuals to understand their health and the choices they make in regard to living a healthy life with the concepts of keeping peace, shelter, education, food, income,
a stable eco-system, sustainable resources, social justice, and equity at its core value (WHO, 1986). The Charter is comprised of five main strategies that include building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services that was developed as a response to the growing expectations for a new public health motion (WHO, 1986). Although the goal was for individuals to reap the benefits of the positive outcomes from the action plan, many individuals in minority communities did not experience these outcomes leading many to wonder, is the Ottawa Charter relevant in society today?
Many individuals raise concern over some of the criteria, values, principles, and process the Ottawa Charter sets outs and its strategies for health promotion action. When looking back
Despite the many advancements and positive outcomes the Ottawa Charter brought to life, when individuals reflect back upon the charter, it is evident that there are some cultural biases as well as other forms of bias that exist and pose a risk to many populations. In addition to that, there are main areas within the charter that lack evidence implemented in practice, application of evidence of health impacts in public policy, and lack sufficient capacity for health promotion practice globally (Potvin & Jones, 2011).
Where the Charter lacks inclusivity
Although the goal of the Ottawa Charter was for individuals to achieve equity in health and with the introduction of health promotion the charter was able to provide a guide for health improvements in order to enhance the quality of lives for Canadians, there is still a need to have a more inclusive charter that takes into consideration commercial determinants of health and non-communicable diseases. In addition to that, marginalized populations such as those part of the 2SLGBTQIA+ seem to be excluded from majority of the health promotion research, policies, and practice (Mulé et al., 2009). Areas that lack inclusivity include pressures from both macro (structurally) and micro (personally) dynamics that result in oppression of these individuals (Mulé et al., 2009). Specific ties include health disparities that are directly related to the individual’s income, gender, culture, physical and social environments, biology and genetic endowment, and social support networks (Mulé et al., 2009). When examining this issue globally, the outcomes seem to be even more negative as there are many other countries in which being a different gender is not legal and in turn, that creates grater issues with the Charter and supporting these individuals. More specifically, the European Public Health Association (EUPHA) launched the “Vienna Declaration” in response to the Ottawa Charter but with a goal to renew and revise some of the criteria (Wilberg, et al., 2019). Unfortunately, due to many social, political, and economic impacts, health promotion has been limited in many areas in Europe (Wilberg, et al., 2019). Though validated globally through many conferences, the charter does not provide transparency and accountability of public institutions leading to the many social determinants of health stemming from structural issues (Wallerstein et al., 2011). Essentially, the Charter lacks the ability to understand and act upon both the systemic and social barriers posed upon these marginalized groups (Mulé et al., 2009).
When I reflect upon my experience with the Ottawa Charter and the individuals, I support who are part of those populations marginalized, I feel as though despite Canadas effort in making steps in the right direction to support marginalized populations and improving their access to healthcare, there are still ways to go. Personal experiences have led me to believe that without addressing all the underlying barriers, marginalized individuals do not and will not have the same access to healthcare as others. Some of these barriers that still exist include a lack of stable employment, poor housing, no social support, and gaps found in health policy (Mulé et al., 2009). The limited knowledge individuals and the Charter have regarding impaired or disabled individuals is what I believe to be the root cause of the lack of health promotion for this group. There needs to be change implemented to work as a community to support these individuals, so they are able to flourish in the proper environment.
So, what do you think, does the Ottawa Charter require an update with more expansive and updated strategies to address new barriers individuals and the healthcare system face?
References:
Mule, N. J., Ross, L. E., Deeprose, B., Jackson, B. E., Daley, A., Travers, A., & Moore, D. (2009). Promoting LGBT health and wellbeing through inclusive policy development. International Journal for Equity in Health, 8(1), 18. https://doi.org/10.1186/1475-9276-8-18
Potvin, L., & Jones, C. M. (2011). Twenty-five years after the Ottawa Charter: The Critical Role of Health Promotion for Public Health. Canadian Journal of Public Health, 102(4), 244–248. https://doi.org/10.1007/bf03404041
Wallerstein, N., Mendes, R., Minkler, M., & Akerman, M. (2011). Reclaiming the social in community movements: Perspectives from the USA and Brazil/south America: 25 years after Ottawa. Health Promotion International, 26(2), ii226–ii236. https://doi.org/10.1093/heapro/dar077
Wilberg, A., Saboga-Nunes, L., & Stock, C. (2019). Are we there yet? use of the Ottawa charter action areas in the perspective of European Health Promotion Professionals. Journal of Public Health, 29(1), 1–7. https://doi.org/10.1007/s10389-019-01108-x
World Health Organization. (1986). Ottawa charter for health promotion, 1986 (No. WHO/EURO: 1986-4044-43803-61677). World Health Organization. Regional Office for Europe. https://www.canada.ca/content/dam/phac-aspc/documents/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion/charter.pdf
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