(introduction...)

The first formal commitment to health promotion at an international level was made at the First International Conference on Health Promotion held in Ottawa, Canada in 1986. This conference resulted in the Ottawa Charter. This milestone document enshrines the idea of health creation as the cornerstone of the health promotion approach: “Health is created where people live, love, work and play”.

The Ottawa Charter defined health promotion as “the process of enabling people to increase control over and to improve their health” and it identified five priority action areas:

* Build healthy public policy;
* Create supportive environments;
* Strengthen community action;
* Develop personal skills; and
* Reorient health services.

In the wake of the Charter’s adoption, a new approach to improving and promoting public health was developed: Settings for Health.

Settings for Health emphasizes practical networks and projects to create healthy environments such as healthy schools, health-promoting hospitals, healthy workplaces and healthy cities. Settings for Health builds on the premise that there is a health development potential in practically every organization and/or community.

The health of an organization or community, the Settings for Health approach argues, is thus much more than the aggregate health of its citizens. The presence of environmental stress can predict the likelihood of people becoming sick, but not which disease they might contract. The appropriate public health response is thus to promote and build the potential for good health before it becomes a question of combating a specific disease or other health problem.

Settings for Health projects have come to have the following elements in common which can be fostered through a series of defined strategies:

* Policy/Strategic objectives;

* Action at both political and technical levels;

* Focus on organizational development and institutional change;

* Building alliances and collaboration between sectors, disciplines and political/executive decision-makers;

* Community involvement and community empowerment.