The interdisciplinary nature of health promotion places it at the cutting edge of health and wellbeing: offering creative and effective ways to promote wellbeing and protect groups, communities and populations from health challenges. It shares a common ground with several disciplines that focus on human and ecological wellbeing.  One such discipline is social development. We have reached a point where the challenges facing social and economic wellbeing are global; requiring action at all levels from local and national to regional and worldwide.  We have seen the limitations of a narrow, discipline-focused approach. According to Sir Mason Durie:[1] “…the failure of groups working in isolation to make substantial gains requires new approaches that are not handicapped by sectorial limitations or simplistic conclusions that one body of knowledge or one professional group has all the answers.” Health promotion and social development share many common principles Although based in different sectors, the fields of social development and health promotion share some common underlying principles. This common ground provides a strong framework for closer collaboration between the different disciplines; yielding benefits, effectiveness and efficiency for all concerned. Some of these common principles are:
  • The aim of advancing  the  holistic health and wellbeing of peoples and communities
  • A core set of underlying causes  or determinants that can make or break the health and social wellbeing of peoples and communities
  • The understanding that health and development must be achieved with approaches that are sustainable for both humans and the rest of the ecology
  • A belief in the inherent power and ability of peoples and communities to take control of these underlying causes, and, therefore, be the masters of their own futures[i]
  • Similar strategies, such as community development, whānau  and family capacity building, for addressing the needs of peoples and communities.
  Whānau  Ora: a strong example of health promotion’s interdisciplinary approach The Whānau Ora approach is a strong example of an initiative that acknowledges the shared principles; operating across the health, social development, education and justice sectors.  It is health promotion at the whānau  level. While the terminology of Whānau  Ora is of Māori origin, the philosophy and practice can be found in many Pacific cultures. In many cases, the terms used are also linguistically related: Fanau Ola, for example, is a term used in Tongan and Samoan cultures to express the collective wellbeing of the extended family. Like its Māori equivalent, Fanau Ola in Pacific cultures refers to extended families and communities leading their own holistic development and being in control of their wellbeing and future. As more and more Māori  and Pacific providers take up a Whānau  Ora and Fanau Ola approach in working with communities, they realise that whānau  and families are empowered not only because the approach resonates with their Indigenous worldviews, values and practices, but also whānau  and families are taking control of their future and leading themselves, rather than relying on others and providers. Our challenge now is to build on the interdisciplinary model of health promotion.   [1] Durie, M. (2011), Nga Tini Whetu Navigating Māori  Futures, Huia Publishers, Wellington, p. 65     April 2014 By Sione Tu’itahi Edited by Jo Lawrence-King  
0

HPF video answers the question; What is health promotion?

Watch the 2 minute 30 second video, including contributions from IUHPE president Michael Sparks and HPF Deputy Executive Director Trevor Simpson.

Prof John Raeburn: Health Promotion advocate

Read this warm, humble and in-depth interview with Emeritus Prof John Raeburn, whose 40+ years in health promotion have helped shape the profession.

Defining health promotion

Health promotion is both a discipline and a process. It focuses on empowering people and communities to take control of their health and wellbeing. Ranging from action at a community level to developing policies, it is founded on the principle that health and wellbeing begins in the settings of everyday life. Read more

Video: What if?…. health promotion campaigns actually worked?

In this 50 minute video, Dr Ekant Veer from the University of Canterbury discusses the severe limitations of NZ’s heavy reliance on mass media as a way of sharing knowledge to attempt health promotion. He explores the other factors needed to create successful health promotion initiatives, such as:
  • social norms
  • past experience
  • perceived consequences
  • environment
  • personal ability

The need for health promotion as a distinct approach

The World Health Organisation (WHO) asserts that factors such as where we live, our environment, genetics, education and relationships have a greater influence on our health and wellbeing than the commonly considered factors such as access to health care services [vi]. Although the causal pathway between the two is long, evidence to support this correlation is growing. Health promotion includes work to build that evidence and identify ways to build population health by improving the determinants.

Health promotion is at the cutting edge of hauora

The interdisciplinary nature of health promotion places it at the cutting edge of health and wellbeing: offering creative and effective ways to promote wellbeing and protect groups, communities and populations from health challenges. Read more

Health promotion: a distinct discipline

In his 2013 paper, Prof. John Kenneth Davies concludes health promotion has a unique and specialised role within a wider multidisciplinary approach to maintaining and improving health.

Video: The close link between human rights and health promotion

“States and others have legally binding obligations to engage in health promotion,” says Paul Hunt at the 20th Conference of the International Union of Health Promotion and Education. Health promotion is part of the government’s role in upholding a person’s right to the hightest attainable standard of health. Also see HPF’s The Right to Health – Proceedings of the Health and Human Rights Workshops, 2012.

Video: Understanding Health Promotion (Canada)

Ass’t Prof Suzanne Jackson discusses health promotion under the frameworks of the Ottawa and Bangkok charters. (8 mins)

Keeping Up to Date paper: Health promotion and spirituality: making the implicit explicit

Richard Egan explores the place of spirituality in health promotion in the 34th of HPF’s Keeping Up to Date peer-reviewed papers.  “In New Zealand, partly due to the contributions and aspirations of Māori, spiritual concerns are understood as an essential component of health.”  Egan’s paper argues that, due to growing evidence and a principled approach, attending to spirituality in health promotion is an ethical imperative, critical to our reflective practice and necessary for comprehensive planning, action and evaluation. Richard is a Research and Teaching Fellow at the Cancer Society Social and Behavioural Research Unit, Te Hunga Rangahau Arae Mate Pukupuku, Department of Preventive and Social Medicine, University of Otago, Dunedin.
0

The Health Promotion Forum has been striving to encapsulate the discipline of health promotion in a few words.  This is a challenge that has vexed the profession since it first emerged several decades ago.   It is widely acknowledged that we need a clear definition of health promotion to effectively communicate its purpose and value to others. Below is our definition, which we invite health promoters around the country – and the world – to adopt.
Health promotion is both a discipline and a process.  It focuses on empowering people and communities to take control of their health and wellbeing.  Ranging from action at a community level to developing policies, it is founded on the principle that health and wellbeing begins in the settings of everyday life.
Health Promotion Forum of New Zealand
Runanga Whakapiki Ake i te Hauora o Aotearoa
April 2014
  At HPF the discussions around defining health promotion have covered  a wide range of topics.  Our conclusions – on some of these topics – have been:
  1. There are three perspectives on health promotion relevant to the Aotearoa New Zealand setting.
  2. Health promotion is a unique discipline and is distinct from public health and health education.
  3. Health promotion is one of the disciplines that together work towards optimising population health.
Three equally important perspectives on health promotion In Aotearoa New Zealand, health promotion is primarily based on two foundation documents: Te Tiriti o Waitangi and the Ottawa Charter, a global framework of the World Health Organisation[i]. There are at least three major perspectives of health promotion in New Zealand – Western, Māori, and Pasifika. While they have many things in common, each has its own unique elements and distinct source, history and strengths.
  1. From a Western perspective, health promotion is a public health discipline. It is the process of enabling peoples and communities to take greater control of their health[ii].
  2. From a Māori view point, health promotion is the enabling of Māori to take greater control of the determinants of their health and therefore their future[iii].
  3. From a Pasifika perspective, health promotion is the empowering of Pasifika peoples to control their wellbeing and their future[iv].
All three are ever-evolving systems of knowledge.  All require equal respect and acknowledgement in our collective learning and enrichment: as fellow human beings with equal rights and responsibilities. HPF acknowledges that all three perspectives have merits and strengths to contribute.  We respect the need to provide space for the respective autonomy of each.  At the same time, where our perspectives overlap, we encourage collaborative effort and partnership for the collective wellbeing of society at all levels. Health promotion is a unique discipline – distinct from public health and health education “Health promotion is a discipline with its own ideology and ordered field of study.”  That is the conclusion of John Kenneth Davies, Professor of International Health Promotion (HPF) at the University of Brighton, England, in a paper commissioned by the Health Promotion Forum, November 2013. Some people see health promotion as a strategy for achieving public health.  Others see it as a form of health education: encouraging behavioural change. Davies disagrees with both beliefs.  He asserts that health promotion’ uniqueness is founded in its work to tackle the determinants of health (the ‘causes of the causes’), and that it is distinct from public health by virtue of its more holistic approach. “Health promotion has a unique and specialised role within a wider multidisciplinary approach to maintaining and improving health,” says Prof Davies in his paper Health Promotion: A Unique Discipline? He quotes Wills and Douglas (2008) as saying it is “a moral and political project and is fundamentally values-based.” The discussion on health promotion and population health In an attempt to tease out the distinction between population health and health promotion, HPF Senior Health Promotion Strategist Karen Hicks posed a question to a professional group on LinkedIn.  Over 60 contributions from 15 members gave rise to a sometimes heated discussion on the topic. While some people hold a clear view about the distinction between health promotion and population health, for many there is still much confusion.  The majority of people who took part in Karen’s LinkedIn discussion see health promotion as a way of moving towards improved population health.  However there were differing views on how this is achieved.  Some see health promotion as individually focused behavioural change.  Others see it as a strategic approach to health inequities and the underlying social determinants of health. Karen suggests that, perhaps a way to see health promotion is as one of the disciplines – along with public health and social development – that, together, work towards improving overall population health? Further she suggests we might see health promotion as a continuum:  health promotion practitioners work at the community level, implementing programmes to improve hauora, while health promotion strategists work at the national and global policy level; aiming to improve the social determinants of health and address health inequities.
We look forward to continuing discussions around this complex question.

[i] World Health Organization. 1986.  Ottawa Charter, Geneva  
[ii] World Health Organization 1986. Ottawa Charter, Geneva  
[iii] Mihi Ratima, M. 2010.  Māori health promotion – a comprehensive definition and strategic considerations, Health Promotion Forum, Auckland  
[iv] Tu’itahi, S. & Lima, I. 2014. Pacific health promotion, a chapter soon to be published in textbook of health promotion, Otago University Press.  
    April 2014 By Jo Lawrence-King, Karen Hicks and Sione Tu’itahi Edited by Jo Lawrence-King  
0