07/04/2014
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Health Promotion Foundations
Module Two
Milestones in the History of Health Promotion
LEARNING OBJECTIVES
1. List the historical milestones
that led to the development of
the health promotion field in
Canada.
2. Describe the developments
that influenced thinking about
the root causes of health.
3. Recognize how key
developments might shape
the field of health promotion.
STOP AND THINK
1
2
In your opinion, what are the three most significant
milestones that affected the development of health
promotion in Canada?
Module Two: Milestones in Health Promotion
PublicHealthOntario.ca
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01
BEGINNINGS
02
MID 1970’S - 2000
03
2000 AND BEYOND
04
REFLECTIVE EXERCISES
HEALTH PROMOTION EMERGES
• Early 20th century health promotion emerges as a
distinct concept
What key developments do you see happening over the
next five years that will influence health promotion in
Canada?
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ENDURING STRATEGIES
BEGINNINGS: 1920 to 1972
‘the art and science of preventing
disease, prolonging life and
promoting health and well-being
through organized community
effort for the sanitization of the
environment, the control of
communicable infections…the
education of the individual in
personal health and the
development of a social machinery
to ensure a standard of living
adequate for the maintenance or
improvement of health’
--C.E.A. Winslow
1. Education about healthy behaviours
2. Healthy public policy development
BEGINNINGS: 1920 to 1972
1920: Earliest reference
BEGINNINGS: 1920 to 1972
1946: Concept refined
• Prerequisites for health:
o A decent standard of
living
o Good labour conditions
o Education
o Physical culture
o Rest and recreation
1946: Concept refined
‘ health is promoted by providing a decent standard of living, good
labour conditions, education, physical culture, and means of rest and
recreation.’
Harry Sigerist
BEGINNINGS: 1920 to 1972
1948: WHO provides a
comprehensive, positive
definition of health
‘A state of complete physical,
mental and social well-being
and not merely the absence
of disease and infirmity.’
--World Health Organization
(WHO)
BEGINNINGS: 1920 to 1972
Health status of western
industrialized countries
improves due to:
1. Mandatory public
health measures
2. Development of the
‘social safety net’
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BEGINNINGS: 1920 to 1972
BEGINNINGS: 1920 to 1972
• Chronic disease becomes
leading cause of
mortality in the
western world
1969: Medical Care Act
passed by Trudeau government
• Ensures universal access to
health care for all Canadian
citizens
• Emphasis shifts to
addressing risk factors by
promoting healthy
lifestyles
• Emphasis on health
promotion and disease
prevention
BEGINNINGS: 1920 to 1972
1972: ParticipACTION
is launched
• The first Canada-wide
media campaign
promoting healthy
lifestyles
MID 1970s to 2000
1974: Lalonde Report marks the beginning of another phase in
health promotion development in Canada
Module Two: Milestones in Health Promotion
Later re-introduced as the
Canada Health Act.
01
BEGINNINGS
02
MID 1970’S - 2000
03
2000 AND BEYOND
04
REFLECTIVE EXERCISES
MID 1970s to 2000
1974: Lalonde Report
• Health field concept
• Health as a product of
1. Lifestyle
2. Biology
3. Environment
4. Health care
organization
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MID 1970s to 2000
1978: Canadian government
establishes Health
Promotion Directorate
MID 1970s to 2000
1979: The University of Toronto establishes the first Canadian
postsecondary degree program in health promotion
• The first bureaucratic
structure devoted to health
promotion in the world
MID 1970s to 2000
MID 1970s to 2000
1984: Birth of the
Healthy Cities
movement
1979 – 1984:
• Black Report and Alameda County study demonstrate importance
of social, economic, and environmental determinants of health
• Lalonde Report and lifestyle approach face criticism for victimblaming
• Comprehensive
approach to health
policy at the local
level
• Adopted in cities,
towns, villages and
communities
worldwide
MID 1970s to 2000
MID 1970s to 2000
1986-1991:
1986: First international
conference of health promotion
convened in Ottawa
• Ottawa Charter for Health
Promotion is developed and
becomes the predominant
framework for health
promotion practice
worldwide
• Health promotion
expands
• Provincial governments
include health
promotion in
bureaucratic structures
and funding
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MID 1970s to 2000
MID 1970s to 2000
1991 – 1996:
• Health promotion
field faces challenges
1997: The Jakarta Declaration on
Leading Health Promotion into
the 21st Century
• Emphasis on
accountability and
effectiveness
• Identifies poverty as ‘the
greatest threat to health’
Module Two: Milestones in Health Promotion
• Canadian
government shifts
focus to population
health
• Warns of dangers posed by
globalization and
environmental degradation
2000 AND BEYOND
• New technologies
embraced
01
BEGINNINGS
02
MID 1970’S - 2000
03
2000 AND BEYOND
04
REFLECTIVE EXERCISES
2000 AND BEYOND
• 2003: Public Health Agency of
Canada (PHAC) is created
• Separate provincial ministries
with public health/health
promotion mandate are
established
• Continuing climate of fiscal
restraint
• Renewed interest in public
health due to reemergence of
communicable disease
threats
• Development of
professional competencies
2000 AND BEYOND
2004 - 2007:
• PHAC initiates the
development of
discipline-specific
competencies for health
promotion
• First Canadian set of
health promotion
competencies is
developed
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2000 AND BEYOND
2000 AND BEYOND
2005: Bangkok Charter for Health Promotion in a Globalized World
2005: Commission on Social Determinants of Health
Make health promotion:
1. central to the global development agenda;
3. a key focus of communities and civil society;
2. a core responsibility for all of government;
4. a requirement for good corporate practice
2000 AND BEYOND
• To improve daily conditions, and understand and tackle
unequal distribution of resources
2000 AND BEYOND
2011: Rio Political Declaration on the Social Determinants of Health
• Sparks international interest in clarifying the purpose, value and
use of standardized competencies for health promotion practice
• Global interest in adopting a social determinants of health approach
2000 AND BEYOND
• 2011 marked 25 years since the establishment of the Ottawa
Charter for Health Promotion
• A critical time for reflection
Module Two: Milestones in Health Promotion
2008: Galway Consensus Conference Statement
01
BEGINNINGS
02
MID 1970’S - 2000
03
2000 AND BEYOND
04
REFLECTIVE EXERCISES
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STOP AND THINK
1
2
REVIEW
One unanticipated development affecting the broader public health
sector over the past decade is an increased emphasis on communicable
disease prevention due to the emergence of West Nile, SARS, H1N1 and
other threats to population health such as climate change. How do you
think this development will impact on the development of health
promotion?
Learning Objective #1:
List the historical milestones that led to the
development of the health promotion field
in Canada.
Health promotion emerged as a distinct
concept early in the 20th century and has
been evolving ever since. The changes have
been fueled by societal events and trends,
and continuing research and debate within
the field itself.
Can health promotion play a role in addressing these health risks?
REVIEW
REVIEW
Learning Objective #2:
Describe the developments that influenced
thinking about the root causes of health.
Learning Objective #3:
Recognize how key developments might
shape the field of health promotion.
The evolution of health promotion has
involved an ever-widening circle of
stakeholders and professions as we have
come to understand that health is determined
by a complex interplay between physical,
mental, social and societal factors.
The concept of health promotion will
continue to evolve. Its path will be shaped by
chronic and infectious disease trends,
environmental conditions, financial and
political developments and many other
factors that unfold in the years to come.
PHO Health Promotion
Capacity Building
• For service request inquiries, including consultations, webinars, workshops,
or to sign up for our mailing list, please go to:
http://www.publichealthontario.ca/en/ServicesAndTools/HealthPromotionSe
rvices/Pages/service-request-form.aspx
• Our events calendar is at:
http://www.publichealthontario.ca/en/LearningAndDevelopment/Events/Pag
es/default.aspx
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