The Ottawa Charter has impacted health promotion in Canada and worldwide over the past 30 plus years. The Ottawa Charter, created in 1986, outlines five actions and three strategies as a template to guide health promotion work. The five actions include: build healthy public policy, create supportive environments, strengthen community action, develop personal skills and reorient health services. The charter outlines three strategies: advocate, mediate, enable. This post will examine the continued relevance of the Ottawa Charter today and reflect on it's ability to represent the call to action for minority groups such as Indigenous populations.
Vinko et al. (2016) report that the Ottawa Charter is largely still relevant today. Citing that the suggested changes are practical by their very nature (Vinko et al., 2016). They believe the charter lays out strong philosophical underpinnings about how health is perceived and speaks to the building blocks of health namely shelter, education, stable economic systems, equity and social justice (Vinko et al., 2016).
Similarly, Milczarski (n.d.) found the content of the Ottawa Charter to be largely relevant today with it's goal of health for all resonating with today's needs. Milczarski (n.d.) noted the Ottawa Charter's goal of empower people to take an active role in their own health remains unfinished.
The Ottawa Charter has certainly played a huge role in health promotion over the past 30 years and the strategies of advocate, mediate and enable as a road map to health for all remain relevant today despite health facing both old and new challenges (McPhail-Bell et al., 2013). McPhail-Bell et al. (2013) caution us to challenge and critique it's claims of universality and inclusivity, encouraging us to consider the context in which the charter was created.
As we take a closer look at the relevance of the Ottawa Charter and consider the health of marginalized communities, it is important to consider if the charter maintains its relevance when we apply it to the health of Indigenous communities. McPhail-Bell et al. (2013) point out that we need to consider the role that colonization played as a part of health promotion practice in the past and create a decolonized path to move forward in the future. For example, a western centric worldview was apparent in the background papers submitted to the conference and the discussions there focused on the needs of industrialized countries only (McPhail-Bell et al., 2013).
By excluding the voice of non-developed countries and Indigenous voices, McPhail-Bell et al. (2013) argue that this could be associated with the privileged ignoring the role that they play in furthering inequality. In another article, McPhail-Bell et al., (2015) highlight the the similarities between the history of colonialism and control of Indigenous lands, lives and cultures and health promotion interventions that have an agenda of control over Indigenous peoples behaviors with the goal of better health. They encourage the acknowledgement of health promotion's colonial bias as a starting point to moving forward with the co-creation of health promotion plans with Indigenous peoples (McPhail-Bell et al., 2015).
Walking through the research to review the relevance of the Ottawa Charter for Indigenous communities has been enlightening for me. At first glance, the actions and strategies laid out in the Ottawa Charter appeared to be broad enough to be all encompassing for many if not all health promotion activities across all communities and people. On closer examination, it is evident that the worldview of those who participated in the charter's creation, the research papers that guided the participants and the lack of Indigenous input and voices, has lead to the creation of a charter for health promotion that embodies colonial principles and assumptions. It is evident to me that this bias needs to be acknowledged when using the principles to guide health promotion.
Kimberly
References:
McPhail-Bell, K., Fredericks, B., & Brough, M. (2013). Beyond the accolades: A postcolonial critique of the foundations of the Ottawa Charter. Global Health Promotion, 20, 22–29. https://doi.org/10.1177/1757975913490427
McPhail-Bell, K., Bond, C., Brough, M., & Fredericks, B. (2015). ‘We don’t tell people what to do’: Ethical practice and Indigenous health promotion. Health Promotion Journal of Australia, 26(3), 195–199. http://dx.doi.org/10.1071/HE15048
Milczarski, A. (n.d.). Is the Ottawa Charter still relevant? A survey among Health Promotion practitioners and researchers Master Thesis.
Vinko, M, Blenkuš, M. V., Robnik , M. (2016, November 21). 30 Years after the Ottawa Charter: Is it Still Relevant in the Face of Future Challenges for Health Promotion? EuroHealthNet Magazine. https://eurohealthnet-magazine.eu/30-years-after-the-ottawa-charter-is-it-still-relevant-in-the-face-of-future-challenges-for-health-promotion/
Comments