Health Promotion

Health Promotion Basics

It has been known since the Alma Ata declaration in 1978 that participation in decisions improves one's health. Having that sense of control is a direct contributor to one's health, as well as enabling individuals and communities to advocate for changes to situations that are bad for health. For example, direct discussion with caregivers about one's health care can lead to faster recoveries, and families working together can advocate for soil testing and removal when their children show signs of lead poisoning. Although health is affected by individual behaviours like smoking or physical activity, it is also affected by socio-economic policies and conditions in the environment that are beyond individual control, such as lead in soil or poverty. Health promoters rapidly recognized the importance of socio-economic policies and the environment and that creating supportive environments for behaviour change and changing policies are health promotion strategies. The first three major strategies in the Ottawa Charter recognize the importance of involving community members in addressing the broader policy issues through ‘Building Healthy Public Policy’, ‘Creating Supportive Environments' and ‘Strengthening Community Action’. Engaging community members in actions to improve their health often means working with the most marginalized and those with the weakest voices in political processes. For example, residents of a high-rise apartment building in Toronto did not like the drug dealing happening in the lobby of the building, so they met as a group (many for the first time) and brainstormed possible solutions. They organized community functions in the lobby in front of the elevators for families in the building, thereby creating an environment unsupportive of drug dealing and strengthening their sense of community. These are examples of health-promoting strategies built around participation.

PAR in Health Promotion

PAR is a natural fit for health promoters. It requires participatory processes, connects research directly to action and focuses on giving voice to those usually excluded from research and decision-making. PAR's espoused processes enable participants to create and share experiential knowledge and then work together to take action. PAR could be seen as a type of health promotion intervention. Through direct involvement, participants can be part of the planning and creative process from the beginning, including the determination of the data collected, interpretation and actions to take. The problem of how to ‘disseminate’ the research is non-existent—participants already know what to do with the results. This connection between action [Page 399]and research is what health promoters strive for in all interventions.

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