Defining Health Promotion Practice
There have been many definitions of "Health Promotion," but the one that forms the basis of our approach to “health promotion practice”is the World Health Organization’s definition as stated in the Ottawa Charter for Health Promotion:
"Health promotion is the process of enabling people to increase control over, and to improve, their health."
This seems straightforward. However, our students and colleagues often seem to be uncertain about what health promotion means in practice. What do “health promoters” do? What is the difference between “health promoters” and other public health employees (e.g., public health nurses)? How does our conceptualization of “health promotion” differ from disciplines such as social work?
Fundamentally, “health promoters” are challenged to respond to the question: What is the added value that health promoters bring to addressing health-related issues?
“Health promoters” are not unique in finding it difficult to identify characteristics that define their field of practice in ways that are clear, unique, and practical. “Teachers”, “nurses”, ‘lawyers”, “engineers”, “IT specialists,” and many other fields of practice and professions, experience similar difficulties; “health promoters” share the same problems that these inter-disciplinary and multi-disciplinary fields of practice.
To help in responding to the challenging questions “What is health promotion practice, and what is its added value?”, we will employ two “typologies” that define “health promotion” and “health promotion practice.”
As we will see, this analysis will result in the following definition of “health promotion practitioner”:
“A health promotion practitioner is academically and professionally prepared in the field of health promotion, demonstrates competence in both theory and practice, and accepts responsibility to support the values, and advance the aims, of the health promotion profession.”
Let us back up and consider the two typologies that underlie this definition of “health promotion practitioner.”
Typology 1: Defining “Health promotion”
Previous definitions of health promotion have focused on one or more of the following:
- Health promotion as a goal or objective
- Health promotion as a process
- Health promotion as a perspective (1) in identifying and understanding the nature and origins of health-related issues, and (2) in developing strategies, interventions, or activities in response to health-related issues
However, there is appears to be consistency in viewing health promotion as possessing the following characteristics:
1. Goal: “Enhancement of health” which includes: positive health & enhancement of well-being; achieving health for all; and holistic health (i.e., the inter-related domains of physical, mental, social and spiritual health)
2. Process or mechanism: HP “empowers” individuals & communities,which increases their control over decisions that affect their health
3. Perspectives in identifying and responding to health-related issues:
a. HP takes a socio-cultural perspective (1) in understanding the nature & origins of health-related issues or problems, and (2) in responding to health-related issues/problems. Health promotion focuses on the broader socio-economic environmental factorsthat contribute to creating/enhancing inequities in health status; strategies that are important in reducing the existence or impact of these social determinants of health include: creating supportive environments; strengthening community actions; building healthy public policy; and reorienting health services towards shifting balance of resources towards prevention, rather than clinical interventions
b. HP focuses on individual-level factors, including: developing/enhancing personal skills; influencing the individual determinants of health-related behaviour, and behaviour change
Typology 2: Defining: “health promotion practice”
1. Health promotion practice as a discipline:
“Health promotion integrates and employs values, theory, evidence, research methodologies, and practices from a wide range of disciplines, including: the social sciences (e.g., sociology, psychology, anthropology, political science); health sciences (e.g., epidemiology, biostatistics, public health); other inter-disciplinary fields (e.g., education, social work, women’s studies, international development)” (Goodstadt)
2. Health promotion practice as a field of practice:
“Health promotion is the multidisciplinary field of practice that is concerned with designing, implementing, and evaluating interventions (i.e., program, policies, services) that enable individuals, families, groups, organizations, and communities, to play active roles in achieving, protecting and sustaining health” (Adapted from the Joint Committee on Health Education Terminology,1991)
3. Health promotion practice as a profession:
“Health promotion is the profession that is committed to employing health promotion best practices, that is: processes and activities that are consistent with health promotion values, goals, ethics; theories and beliefs; evidence; and understanding of the environment that are most likely to achieve health promotion goals with respect to any health-related issue, in a given context or situation” (Adapted from Kahan & Goodstadt, 2001)
The integration of these concepts of health promotion and health promotion practice leads us to a definition of “health promotion practitioner” as:
“A health promotion practitioner is academically and professionally prepared in the field of health promotion, demonstrates competence in both theory and practice, and accepts responsibility to support the values, and advance the aims, of the health promotion profession.”
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