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Think of HP Globally, Act on HP Locally



A. Introduction



Twenty years after the World Health Organization (WHO) member states made a commitment to a global strategy of Health for All, the WHO Executive Board has adopted the first ever resolution on health promotion (see OHPE Bulletin #39.1 and below). In May, 1998 this resolution will be forwarded to the Fifty-first World Health Assembly. At a time when health promoters in Ontario are trying to "affirm" health promotion amidst regional and local priorities, downloading, amalgamation and rationalizing - what influence does this global resolution have on our work?



Member states of WHO will be urged to promote social responsibility for health, increase investments for health development, consolidate and expand "partnerships" for health, increase community capacity and "empower" the individual in matters of health; and secure an infrastructure for health promotion. The new Director-General of WHO, Gro Bruntland, who headed the Bruntland Commission on Environment & Economy, has a well-deserved reputation as a "Do-It" person who makes-things-happen. We can expect her, to "take the lead in establishing an alliance for global health promotion". What will our part be?



As we work to both maintain and increase the recognition of health promotion can we take the WHO resolution as a focus and direction to influence local decision-making? A global resolution on health

promotion can confirm our capacities to advance the work of health promotion. Maybe the WHO declaration won't catch the attention of municipal councillors BUT it is the responsibility of health promoters to take hold of this recommendation. Let's consider how we in Ontario (and Canada) will use this first ever resolution to be leaders to bring about change.



-Peggy Schultz for OHPE


WORLD HEALTH ORGANIZATION [WHO] RESOLUTION ON HEALTH PROMOTION



Dr. Gro Brundtland, former Prime Minister of Norway, now the Director General of WHO, will present this resolution to this years World Health Assembly in May.



More information can be accessed on the WHO website. http://www.who.ch You will find the WHO resolution on health promotion at http://www.primnet.se/public/html/nhprin/index.htm



The [WHO] Executive Board,

Having considered the report of the Director-General on health promotion, RECOMMENDS to the Fifty-first World Health Assembly the adoption of the following Resolution:



Mindful that there is now clear evidence that:

(1) Comprehensive approaches that use combinations of the five strategies are the most effective;

(2) Certain settings offer practical opportunities for the implementation of comprehensive strategies, such as cities, islands, local communities, markets, schools, workplaces, and health facilities;



(3) People have to be at the centre of health promotion action and decision-making processes if they are to be effective;



(4) Access to education and information is essential in achieving effective participation and the "empowerment" of people and communities;



(5) Health promotion is a "key investment" and an essential element of health development;



1. URGES all Member States:

(a) to promote social responsibility for health;

(b) to increase investments for health development;

(c) to consolidate and expand "partnerships for health";

(d) to increase community capacity and "empower" the individual in matters of health;

(e) to secure an infrastructure for health promotion;



2. CALLS ON organizations of the United Nations system, intergovernmental and non-governmental organizations and foundations, donors and the international community as a whole:



(a) to mobilize Member States and assist them to implement these strategies;

(b) to form global health promotion networks;



3. CALLS ON the Director-General:

(a) to enhance the Organization´s capacity with that of the Member States to foster the development of health promoting cities, islands, local communities, markets, schools, workplaces, and health facilities;



(b) to implement strategies for health promotion throughout the life span with particular attention to the vulnerable groups;



4. REQUESTS the Director-General:

(a) to take the lead in establishing an alliance for global health promotion and in enabling Member States to implement the Jakarta Declaration;



(b) to support the development of health promotion within the Organization.



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B. THINKING GLOBALLY ABOUT HEALTH PROMOTION



1. From A Canadian Perspective

i) Health Promotion in Canada - vol 34 #3

In the magazine that has served people in the field for more than 35 years, and is now published independently of Health Canada, there continues to be key articles and perspectives offered about health promotion from a Canadian perspective. In particular, please consider the recent publication of the late Ron Draper's speech from the CPHA 88th annual conference in Halifax. Ron Draper was the first Director-General of the Health Promotion Directorate established by the federal government in 1978. He was a key author of the 1974 "Lalonde Report" on Health, and was central to the publication of Achieving Health for All: A Framework for Health Promotion (1986). In this speech he looks back at what we have achieved since 1986 and some of the barriers we are facing in maintaining a global leadership role in health promotion.



"Just as the public health community stands ready with scientific evidence and practical knowledge to move healthy public policy into a new dimension, the political climate has become distinctly unfriendly." He recommends a political strategy over an extended period of time.



1) We need to gain a better understanding of the political climate

2) We need to ask some critical and provocative questions about the recent history of health policy in Canada



3) We need to build strong formal but flexible networks amongst those who are active in healthy public policy activities. An example is Healthy Communities



4) We need an immediate avenue for regular communication of case studies analysis and opinions on healthy public policy issues.



5) Finally Canada needs an institute on healthy public policy



"To summarize it is not possible to influence public policy without carefully considering the political climate. This means that some of our own ideas will have to change and also that we will have to work

together to bring about changes in that climate."



For more information on these issues and many more - see Health Promotion in Canada, 360A Newkirk Rd. Richmond Hill, ON L4C 3G7. Tel. 905-884-2612; fax 905-884-1478



Subscription rates - Canada one year $27.55



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WHO Collaborating Centre on Health Promotion in Canada



The Centre for Health Promotion at University of Toronto was designated as a WHO Collaborating Centre on Health Promotion in June 1996. One of the first activities of the CHP in its designation as a WHO Collaborating Centre was the organization of the international symposium on the Effectiveness of Health Promotion. The abstracts and the proceedings for that three day event are available on the Centre for Health Promotion web-site in downloadable PDF files at:



http://www.utoronto.ca/chp/chp/chp-publications.html or copies can be ordered from the Centre.



Work has continued from that event through three Task Groups: Evaluation, Consolidating the Evidence and Continuous Quality Improvement/Best Practices. The Centre continues to make important contributions to the international arena of health promotion. In addition to participating in planning the Fourth International Conference on Health Promotion, held in Jakarta in July 1997, the

CHP contributed an annotated bibliography on health promotion, a project and workshop on International Indicators of Health Promotion led by Suzanne Jackson, and a Workshop on Evaluating Public Policies based on work being done with the WHO Working Group on Evaluation.



The Centre for Health Promotion has extended its influence in health promotion internationally with an official agreement of collaboration with the Asociacion Chilena de Seguridad (ACHS), and organization

that works with over 30,000 companies in Chile. A Health Promotion in the Workplace school was organized in Chile in January 1998, with two representatives from the Centre for Health Promotion.



Dr. Irving Rootman, director of the Centre has been a leader in bringing Canadian perspectives to the international and national development of health promotion. He chairs the Canadian Consortium for

Health Promotion Research, intending to initiate collaborative activities to stimulate the further development of health promotion in Canada. Irv welcomes ideas and involvement in expanding the Centres international efforts. Contact Irv Rootman by email at [email protected]



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2. From a U.S. Perspective

i) Health Promotion: Global Perspectives

From the editor of the American Journal of Health Promotion comes a new newsletter. After travelling to 7 countries to speak on health promotion in the United States and to discuss health promotion

strategies, Michael P. O'Donnell drew 2 conclusions:



"1) The science and profession of health promotion are more well developed in the United States than anywhere else in the world." And "2) Health promotion professionals all over the world can learn by

observing health promotion efforts in other parts of the world".



Therefore together with the American Journal of Health Promotion the National Center for Health Fitness at American University will publish a global newsletter called "Health Promotion: Global Perspectives" starting in March 1998. The eight-page newsletter will feature international articles on a different topic and will include commentaries on how to apply some of the health promotion principles

in different countries.



The newsletter will be accessible on the IIHP website [see below -

http://www.healthy.american.edu/iihpnewsletter.html ] via a link to the American Journal of Health Promotion [web-site to be announced in April]. During the first year, all direct individual subscribers to

the American Journal of Health Promotion will receive a subscription to Health Promotion: Global Perspectives for no additional charge.



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ii) The American University's International Institute for Health Promotion (IIHP)

See Web-site at: http://www.healthy.american.edu/iihp.html



The IIHP was formed in 1994 as an addition to the National Centre for Health Fitness at American University to assist in leading, facilitating and coordinating the efforts of many international individuals and organizations. "The need for an international institute in health promotion has been articulated by many health professionals worldwide. The desire for intense networking and collaboration in the field of health promotion has increased significantly over the past few years, especially due to the phenomenal developments in information technology. According to the input of many health promotion professionals within the IIHP network the following issues are to be addressed by the IIHP:



- personal exchange

- cooperation and networking (communication link through emerging technologies)

- promotion / marketing of quality of life concept

- new educational programs

- research and development (global database on health promotion)"



The IIHP represents a growing network of leading institutions in health promotion from all over the world. It now has more than 50 members from 25 nations. Each has a partnership agreement with the IIHP.



For more information on the IIHP, contact 202-885-6275 or visit the web site.



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iii) A letter from an American about the WHO Resolution



Following the publication on the Health-Promotion list-serv (and CLICK4HP list-serv) of the WHO Resolution on Health Promotion, a small debate ensued about the directions and language used. Donald Ardell, publisher of the Wellness Report, felt that the Ottawa Charter for HP (1986) has "NOT been a worldwide source of guidance and inspiration for health promotion development. ..



How many health educators not involved in its development have ever heard of it, let alone been guided by it?" A quick retort by Dennis Raphael of U. of Toronto was "Donald is correct in stating that the

Ottawa Charter is unknown by most health promoters (in the USA, that is). This is more of a reflection of the US value system.".



Mary Arnold responded:

I'm one of those awful Americans who, as Dennis so specifically pointed out, had no knowledge of the Ottawa Charter until last summer. I attended a summer institute at the University of Ottawa to learn more about the Canadian system as we routinely compare our system to yours, and I felt that it was important for me to go and find out more myself.



Since that time, I have incorporated the concepts of the Charter into my lectures as well as the concepts of Population Health. Yesterday my lecture revolved around definitions of health which included the WHO definition. From there I worked the resolution re: health promotion and the importance of the resolution because for the first time the WHO has to admit that their time honored definition of health (that we all know by heart!) can't possibly be actualized without health promotion.



So, word of the Ottawa Charter does make it over the border and I'm making sure my students know of the contents and importance of the document to world health.



Mary Arnold RNC, MS, CHES

email: [email protected]



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iv) The International Union for Health Promotion and Education (IUHPE)



The IUHPE is a global association of people and organizations working in the fields of health promotion and health education, which is dedicated to improving world health. It gathers:



- national trustee members which are organizations of national scope, responsible for organising health promotion and health education in their country (eg. National agencies, authorities, councils, institutes, and units);

- national members which are organizations of national scope, one of whose main purposes is to undertake or promote one or more aspects of health promotion and health education (eg. Heart health, school health, health advocacy, professional development, etc);

- group members which are institutes, groups, societies, and associations in a country whose objectives and activities are concerned with health promotion and health education;

- individual members who are individuals with a professional or personal interest in health promotion and health education;

- honorary members which are organizations or individuals giving special support to the IUHPE.



Promotion & Education is the quarterly international journal of health promotion and education. A recent issue (December 1997 Vol IV #4) features an international look at Adolescent Health Promotion. [OHPE hopes to refer to this issue in an upcoming feature]. The journal is $US55/yr.



If you wish further information on the IUHPE contact the North American Office:



IUHPE/NARO; 1015 - 15th St. NW Suite 300; Washington DC 20015 USA

or by email - [email protected]