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The 4th International Conference on Health Promotion

This special feature on the 4th International Conference on Health Promotion is provided in OHPE, because we believe that health promotion in Ontario will continue to have an integral link to the international scene, to influence and be shaped by events in other parts of Canada, North America and throughout the world. Many of the resources noted here have appeared in other places such as CLICK4HP list serv. However, repetition and broad distribution of these ideas and resources can only

help contribute to a needed debate and discussion of the future of health promotion. Concerns about partnerships with the private sector (see issues raised on CLICK4HP about pharmaceutical companies involved in this international conference), about participation of developing countries and minority populations in shaping health promotion and representation in policy-making - all are issues that are being raised in Ontario. We have much to learn and to share.

A. Background [from the conference website]:

New Players for a New Era: Leading Health Promotion into the 21st Century comes at a critical moment in the development of international strategies for health. It is almost 20 years after the World Health Organisation member states made an ambitious commitment to a global strategy of Health for All, and to the principles of primary health care through the Alma-Ata Declaration. It is ten years after the 1st International Conference on Health Promotion was held in Ottawa, Canada. That conference resulted in publication of the Ottawa Charter for Health Promotion which has been a source of guidance and inspiration for health promotion since that time. Subsequent international conferences and meetings have further clarified the relevance and meaning of key strategies in health promotion including healthy public policy (In Adelaide, 1988), and supportive environments for health (in Sundsvall, 1991).

The Jakarta Declaration on Health Promotion into the 21st Century

The 4th International Conference on Health promotion in Jakarta is the first to be held in a developing country, and the first to involve the private sector in supporting health promotion. It provides an opportunity to reflect on what has been learned about effective health promotion, to re-examine determinants of health, and to identify the directions and strategies which are required to address the challenges of promoting health in the 21st Century.

[the following is an edited synopsis of the major points of the declaration - for the full document see]


Health is a basic human right and essential for social and economic development. Increasingly, health promotion is being recognised as an essential element of health development. It is a process of enabling people to increase control over and to improve their health. Health promotion, through investments and actions, acts on the determinants of health to create the greatest health gain for people, to contribute significantly to the reduction of inequities in health, to ensure human rights, and to build social capital.


It is vital that health promotion evolve to meet changes in the determinants of health.

Demographic trends such as urbanisation, an increase in the number of older people and the prevalence of chronic diseases, increased sedentary behaviour, resistance to antibiotics and other commonly available drugs, increased drug abuse and civil and domestic violence, threaten the health and well-being of hundreds of millions of people. New and re-emerging infectious diseases, and greater recognition of mental health problems require an urgent response.

Transnational factors also have a significant impact on health. These include the integration of the global economy, financial markets and trade, access to media and communication technology, as well as environmental degradation due to the irresponsible use of resources.

Some [of these changes] have great potential for health, such as the development of communications technology, others such as international trade in tobacco, have a major negative impact.


Research and case studies from around the world provide convincing evidence that health promotion works.

There is now clear evidence that:

* comprehensive approaches to health development are the most effective.

* settings offer practical opportunities for the implementation of comprehensive strategies.

* participation is essential to sustain efforts.

* health learning fosters participation. Access to education and information is essential to achieving effective participation and the empowerment of people and communities

New responses are needed

To address emerging threats to health, new forms of action are needed.

There is a clear need to break through traditional boundaries within government sectors, between government and non-government organisations, and between the public and private sector. Co-operation on equal ground between the different sectors is essential.


1. Promote social responsibility for health

2.Increase investments for health development

3. Consolidate and expand partnerships for health

4. Increase community capacity and empower the individual

5. Secure an infrastructure for health promotion


Participants endorse the formation of a global health promotion alliance. The goal of this alliance is to advance the action priorities for health promotion expressed in this declaration.

Priorities for the alliance include:

* raising awareness about the changing determinants of health

* supporting the development of collaboration and networks for health development

* mobilisation of resources for health promotion

* accumulating knowledge on best practice

* enabling shared learning

* promoting solidarity in action

* fostering transparency and public accountability in health promotion

National governments are called to take initiative in fostering and sponsoring networks for health promotion both within and between their countries.


The New Public Health: A collection of video conversations with people who shape our thinking about health and health care

The 4th International Conference on Health Promotion in Jakarta hosted the World Premiere of the series entitled "The New Public Health: A collection of video conversations with people who shape our thinking about health and health care".

Dr. Robert Perreault of Canada's McGill University and Universite de Montreal meets with the world's foremost authors, thinkers and leaders in public health and health promotion and engages in informal conversations with them about the role of Public Health in the context of the transformation of health care systems everywhere.

The 1997 release comprises six video conversations designed to stimulate the reading of scientific literature and to promote the circulation of ideas across continents. They further aim to support continuing education, professional development and university teaching.

The six tapes present conversations with:

Ilona Kickbusch, WHO - Geneva, on The Future of Public Health

Michael Marmot, London, on The Whitehall Studies

Jean-Pierre Deschamps, Nancy, on Poverty and Health

Jean Rochon, Quebec, on Going from Words to Action

Spencer Hagard, London, on Revisiting the Ottawa Charter

Irving Rootman, Toronto, on Evaluation and Health Promotion

All six videos exist in English or French versions. They will be made available worldwide in all VHS formats .The Web address is:

To be released in 1998 are conversations with:

Heather MacLean, University of Toronto and Women's College Hospital

Lawrence Green, University of British Columbia

Marc Danzon, WHO - Copenhagen

Alexandre Berlin, European Commission, Brussels

James Rohrer, University of Iowa, Iowa City

Fred Paccaud, Univ. Institute for Social & Preventive Medicine, Lausanne

Felix Gutzwiller, Univ. Institute for Social & Preventive Medicine, Zurich

This independent project is being supported by the Government of Quebec, and the Government of Canada among others.

Information from: Steven Sacks [ssacks@INTERLINK.NET]

Les Services Organon

Information services in occupational and environmental health

4842, av. de l'Esplanade Montreal (QC) H2T 2Y7

Telephone/fax: (514) 278-9173

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The International Health Promotion Indicators Project

Suzanne Jackson presented the work to date on the International Health Promotion Indicators Project at the Fourth International Conference on Health Promotion in Jakarta, Indonesia July 21 - 25, 1997. This project, which was carried out under her direction at the request of WHO-Geneva, in collaboration with Irv Rootman, Michael Goodstadt and Rick Edwards, is designed to develop a set of national level indicators of the implementation of health promotion. It uses the five action areas of the Ottawa Charter for Health Promotion as the organizing framework.

The presentation was very well received by the participants in the session and it was recommended that the project be continued by conducting pilot tests in selected countries over the next year.

For more information, contact Suzanne Jackson or Irv Rootman at

e-mail: .

submitted by Irving Rootman