Key points
- Health promotion is the process of enabling people to increase control over, and to improve, their health — the WHO Ottawa Charter definition, 21 November 1986.
- The Charter sets five action areas: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and re-orient health services.
- Its three strategies are to advocate, enable and mediate — health promotion works through policy and communities, not only through telling individuals what to do.
- Health is a resource for everyday life, not the objective of living — the Charter's own framing, carried through the Bangkok Charter (2005), Shanghai (2016) and Geneva (2021).
- Health promotion is not health education: education gives information, promotion changes the conditions that make healthy choices possible.
Direct answer: Health promotion is the process of enabling people to increase control over, and to improve, their health. Those are the words of the Ottawa Charter for Health Promotion, adopted at the first International Conference on Health Promotion in Ottawa on 21 November 1986. The Charter treats health as a resource for everyday life, not the objective of living — and it says people cannot reach their fullest health potential unless they can take control of the things that determine their health. Health promotion is therefore about conditions as much as behaviour: policy, environments, communities and services, alongside personal skills.
The Ottawa Charter, 1986
The first International Conference on Health Promotion met in Ottawa, Canada, on 17–21 November 1986, organised jointly by the World Health Organization, Health and Welfare Canada and the Canadian Public Health Association. Two hundred and twelve participants from 38 countries adopted the Charter for action to achieve Health for All by the year 2000 and beyond. Its starting point was the WHO Constitution’s definition of health as a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity — and its claim that peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity are fundamental conditions and resources for health.
The Charter’s logic is simple and still radical: health is created where people live, work, learn and play, so improving health means changing those places, not only treating people after they fall ill. That is why the Charter’s five action areas, in the next section, spend most of their attention outside the clinic.
The five action areas
Build healthy public policy. Health promotion puts health on the agenda of policy-makers in all sectors, so that the health consequences of a decision are considered before it is taken — in transport, housing, food, work and taxation, not only in health policy. A tax on tobacco, a speed limit, a school meals programme and clean-air regulation are all healthy public policy.
Create supportive environments. People live in environments that help or harm health: the air, the water, the safety of streets, the availability of green space and healthy food. Promotion works on the environment itself, so the healthy choice is the easy choice rather than a test of willpower.
Strengthen community action. Communities take part in setting priorities, making decisions and running programmes. The Charter treats community action as a source of health in itself: people who shape their surroundings are healthier than people who only receive services.
Develop personal skills. People need information, education and life skills to make choices about their health — and to influence the conditions around them. This is the part of promotion closest to health education, but the Charter places it fourth, after policy, environments and community.
Re-orient health services. Health services should move beyond clinical and curative services toward prevention and promotion — sharing responsibility with individuals, community groups and other sectors, and respecting cultural needs. A hospital that helps patients stop smoking, a clinic that works with schools, and a health service that measures prevention are all re-orientation in practice.
Three strategies: advocate, enable, mediate
Under the five areas sit three strategies. Advocate: to boost the factors that encourage health — speaking for health in rooms where it is not otherwise heard. Enable: allowing all people to achieve health equity, by reducing differences in health status and ensuring equal opportunities and resources. Mediate: collaboration across all sectors — health promotion cannot be done by the health sector alone, because the determinants of health sit in every sector’s hands.
The timeline after Ottawa
Ottawa was the beginning of a sequence, not a one-off. The Jakarta Declaration of 1997 addressed the challenges of promoting health in the 21st century. The Bangkok Charter for Health Promotion in a Globalized World (2005) updated the definition for a globalised world: the process of enabling people to increase control over their health and its determinants, and thereby improve their health. The Shanghai Declaration (2016) linked health promotion to the Sustainable Development Goals and to healthy cities. The Geneva Charter for Well-being (2021) carried the agenda forward into well-being and the post-pandemic world. The Ottawa definition has survived all of them — each later charter extends it rather than replacing it.
Settings: where promotion happens
Promotion happens in settings — the places where daily life happens. Schools that teach health and serve healthy food; workplaces with safe conditions and support for workers; hospitals that promote health rather than only treating illness; cities designed for walking, clean air and social connection. The settings approach follows directly from the Charter: if health is created where people live, work, learn and play, then those places are where promotion must work. Settings are also where promotion meets the other guides on this site — schools and wellbeing, mental health at work, and the social determinants of health are all, in Charter terms, settings work.
Health promotion vs health literacy vs health education
The three terms are often swapped, and they are not the same. Health education gives people information and skills about health. Health literacy is the ability to find, understand and use that information — a property of people and of the organisations that communicate with them. Health promotion is the widest of the three: it includes education and literacy, but it also changes policy, environments, communities and services. A leaflet about handwashing is health education. A school that teaches handwashing, provides soap and clean water, and involves parents in the programme is health promotion. The distinction is the point of the Charter: information alone cannot overcome conditions that make healthy choices hard.
Frequently asked questions
What is the difference between health promotion and health education?
Health education gives people information and skills. Health promotion is wider: it also changes policy, environments and services so that healthy choices are possible in the first place. Education is one of promotion's tools, not the whole of it.
Is health promotion just telling people to live healthily?
No. Telling individuals what to do is the smallest part of it. The Ottawa Charter puts policy, environments, community action and re-orienting services alongside personal skills — because advice alone cannot overcome unhealthy conditions.
What is a healthy setting?
A place where daily life happens — a school, a workplace, a hospital, a city — organised so that the healthy choice is the easy choice: clean air and water, safe streets, healthy food available, and support for people who need it.