Health Promotion

Intermediate

Health promotion is the process of enabling people to increase control over and improve their health. Rooted in the 1986 Ottawa Charter for Health Promotion, the field extends far beyond the prevention of disease to encompass the social, economic, and environmental conditions that shape well-being. Health promotion operates at multiple levels: individual behavior change, community empowerment, organizational policy, and broader public policy advocacy. It draws on disciplines including epidemiology, psychology, sociology, education, and public policy to create strategies that help populations achieve optimal health outcomes.

Central to health promotion is the understanding that health is determined not only by individual choices but by a complex web of social determinants such as income, education, housing, and access to healthcare services. Models like the Health Belief Model, the Social-Ecological Model, and the Transtheoretical Model of Change provide theoretical frameworks for designing interventions that address these multiple layers of influence. Effective health promotion programs combine health education, community mobilization, policy change, and environmental modification to create conditions in which healthy choices become the easier choices for everyone.

In practice, health promotion takes many forms: workplace wellness programs, school-based nutrition education, mass media campaigns to reduce tobacco use, urban planning that encourages physical activity, and legislative actions such as sugar-sweetened beverage taxes. The field has grown increasingly evidence-based, relying on randomized controlled trials, program evaluation, and health impact assessments to determine what works and for whom. As global health challenges evolve with rising rates of non-communicable diseases, mental health conditions, and health disparities exacerbated by climate change, health promotion remains a critical discipline for building healthier, more equitable societies.

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Key Concepts

The conditions in the environments where people are born, live, learn, work, play, and age that affect a wide range of health outcomes and risks. These include socioeconomic status, education, neighborhood environment, employment, social support networks, and access to healthcare.

Example

Children in low-income neighborhoods with limited access to grocery stores and safe parks have higher rates of obesity than children in wealthier areas with abundant healthy food options and recreational facilities.

A 1986 document from the first International Conference on Health Promotion that defined health promotion and established five action areas: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services.

Example

A city that bans smoking in all public places (healthy public policy), builds walking trails (supportive environments), and funds community health worker programs (community action) is implementing the Ottawa Charter's multi-pronged approach.

A psychological model that predicts health behavior by focusing on an individual's perceived susceptibility to a condition, perceived severity of the condition, perceived benefits of taking action, perceived barriers to action, cues to action, and self-efficacy.

Example

A person is more likely to get a flu vaccine if they believe they are susceptible to influenza (perceived susceptibility), that the flu could be serious (perceived severity), that the vaccine is effective (perceived benefit), and that the vaccination is convenient and affordable (low perceived barriers).

A framework for understanding the multifaceted and interactive effects of personal and environmental factors that determine health behaviors. It identifies five nested levels of influence: individual, interpersonal, organizational, community, and public policy.

Example

A comprehensive anti-smoking intervention works at the individual level (nicotine replacement therapy), interpersonal level (peer support groups), organizational level (smoke-free workplace policies), community level (local cessation programs), and policy level (tobacco taxes and advertising bans).

A model of intentional behavior change that describes five stages individuals move through: precontemplation, contemplation, preparation, action, and maintenance. It recognizes that change is a process, not an event, and that relapse is a normal part of the cycle.

Example

A sedentary person first becomes aware that they need to exercise (contemplation), then starts planning by buying running shoes and joining a gym (preparation), begins a regular exercise routine (action), and sustains it for over six months (maintenance).

The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Low health literacy is associated with poorer health outcomes and higher healthcare costs.

Example

A patient with low health literacy may misunderstand prescription instructions such as 'take twice daily with food,' leading to incorrect dosing and reduced medication effectiveness.

The attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally, addressing avoidable inequalities, and eliminating disparities in health and its determinants caused by historical and contemporary injustices.

Example

A public health department that provides free mobile vaccination clinics in underserved communities, offers materials in multiple languages, and schedules clinics during evenings and weekends is working toward health equity by reducing access barriers.

In health promotion, the process through which people gain greater control over the decisions and actions affecting their health. Empowerment can occur at individual, organizational, and community levels and is both a process and an outcome of effective health promotion.

Example

A community health program trains local residents to become peer health educators who then lead diabetes prevention workshops in their own neighborhoods, giving the community ownership over its health improvement efforts.

An approach introduced by Aaron Antonovsky that focuses on factors supporting health and well-being rather than on factors causing disease. The core concept is the 'sense of coherence,' which describes a person's ability to comprehend, manage, and find meaning in life experiences.

Example

Instead of asking only 'What causes heart disease?' a salutogenic approach also asks 'What keeps people healthy despite exposure to risk factors?' and then designs programs that strengthen those protective factors such as social connection and stress management.

A client-centered, directive counseling technique that enhances motivation for change by helping people explore and resolve ambivalence. It employs open-ended questions, affirmations, reflective listening, and summarizing (OARS) to support behavior change.

Example

A health coach working with a patient reluctant to quit smoking uses reflective listening to explore the patient's own reasons for wanting to quit, rather than lecturing about health risks, helping the patient find internal motivation for change.

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Curriculum alignment— Standards-aligned

Grade level

College+

Learning objectives

•Apply the Health Belief Model and Social Cognitive Theory to design targeted behavior change interventions
•Evaluate community-based health promotion programs using process, impact, and outcome evaluation methodologies
•Design culturally responsive health communication campaigns that address literacy levels and audience segmentation
•Analyze social determinants of health and their influence on population-level wellness outcomes and disparities

Recommended Resources

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Books

Health Promotion: Planning & Strategies

by Keith Tones & Jackie Green

Health Behavior and Health Education: Theory, Research, and Practice

by Karen Glanz, Barbara K. Rimer & K. Viswanath

Health Promotion in Practice

by Carolyn Chambers Clark

Promoting Health: A Practical Guide

by Angela Scriven

Courses

Health Promotion: An Introduction

CourseraEnroll

Foundations of Global Health

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Health and Society

edXEnroll

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Medicine & Health

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Intermediate

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Epidemiology

The study of disease distribution and determinants in populations, forming the scientific foundation of public health practice and policy.

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Social Sciences

Behavioral Economics

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Beginner

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Mental Health

The study of emotional, psychological, and social well-being, including the understanding, prevention, and treatment of mental health conditions.

Intermediate

Health Promotion

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Adaptive Learn

Flashcards

Cheat Sheet

Glossary

Learning Roadmap

Book

Key Concepts

Social Determinants of Health

Ottawa Charter for Health Promotion

Health Belief Model

Social-Ecological Model

Transtheoretical Model (Stages of Change)

Health Literacy

Health Equity

Empowerment

Salutogenesis

Motivational Interviewing

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Grade level

Learning objectives

Recommended Resources

Books

Health Promotion: Planning & Strategies

Health Behavior and Health Education: Theory, Research, and Practice

Health Promotion in Practice

Promoting Health: A Practical Guide

Courses

Health Promotion: An Introduction

Foundations of Global Health

Health and Society

Related Topics

Public Health

Epidemiology

Behavioral Economics

Nutrition

Mental Health