Learning lessons from past mistakes: how can Health in All Policies fulfil its promises?

摘要

The Ottawa Charter has exerted a great deal of influence on the public health debate and on health promotion practices over the last 25 years. The Charter shifted the main focus from individual risk behaviours to social determinants of health, and introduced innovative strategies such as participatory processes and empowerment of communities. This new public health era is based, essentially, on the introduction of health promotion to increase people's opportunities to make healthy choices. Building healthy public policies (HPP) is a core area, even an overriding concern for health promotion, as it seeks to put health onto the agenda of policy-makers across different sectors, to improve the conditions under which people live. HPP is concerned with equity, and has, by its nature, an intersectoral focus with an explicit interest in the impacts of all policies on the health of the population. It represents a reaction against the individualistic and victim-blaming approach of curative medicine and the excessive focus previously placed on health education.