More effective action for equity in health: strengthening the lUHPE's hand

摘要

I have chosen to focus on just one aspect of today's theme, 'Creating the Conditions for Health', and that's the aspect related to pathways into the future. I've chosen, also, to identify clearly the position from which I speak, and that is in my role as a representative of the IHUPE. The point I wish to emphasise this morning is that we, the IUHPE - and indeed all of health promotion — need to strengthen our hand considerably if we are to make serious advances in the quest for equity in health. The starting point for my remarks is John Catford's recent editorial in Health Promotion International, in which he summarised 20 years of health promotion history in terms of three themes, or dimensions, which have characterised our work during the 1970's, the 80's, and the 1990's (Catford, 2004). The earliest theme, that of the 70's, focussed on chronic disease prevention and behavioural risk factor reduction, mostly through educational intervention and persuasion communications. The theme of the 80's reflected an expanded understanding of the forces that determine individuals'health. It is from that period that we have the touchstone document, the Ottawa Charter, and a theory of health promotion that emphasises the advantages of combining education, community action and structural solutions in pursuit of health for all. Moving on, John characterises the most recent period, that of the 90's, as a time when the importance of settings-based health promotion has risen to the fore — witness all the regional, national and international initiatives, and research networks, for health promoting schools, work places, hospitals, prisons, islands, and so on.