Health promotion, as defined by the World Health Organization, is the process of enabling people to increase control over, and to improve, their health. That definition, established at the first Global Conference on Health Promotion in Ottawa in 1986, has guided public health policy worldwide for nearly four decades. Rather than focusing solely on treating disease, WHO’s approach targets the conditions that shape health in the first place: where people live, what they eat, how they work, and whether they can access the information and services they need.
The Ottawa Charter: Where It Started
The 1986 Ottawa Charter remains the foundational document for health promotion globally. It established three core approaches: advocate for the political, economic, social, and environmental conditions that support good health; enable all people to reach their full health potential by reducing inequities; and mediate between the different interests in society to pursue health goals. These aren’t abstract principles. They translate into specific expectations for governments, communities, and organizations to actively shape healthier environments rather than placing the burden entirely on individuals to make better choices.
Five Action Areas
The Ottawa Charter laid out five areas where health promotion should operate. Building healthy public policy means embedding health considerations into decisions across all government sectors, not just healthcare. Creating supportive environments focuses on the places where people live and work. Strengthening community action puts local populations at the center of setting priorities and making decisions. Developing personal skills involves education and health literacy so people can manage their own well-being. And reorienting health services pushes healthcare systems to look beyond treatment toward prevention.
These five areas still form the backbone of WHO’s health promotion strategy, though the specifics have evolved considerably as new threats have emerged.
The 2021 Geneva Charter and Well-Being Societies
The most recent major update came from the 10th Global Conference on Health Promotion in 2021, which produced the Geneva Charter for Well-being. It broadened the conversation significantly, framing the goal as creating “sustainable well-being societies” that achieve equitable health without harming the planet.
The Charter’s vision is societal well-being that enables all people to flourish and reach their full physical and mental health potential throughout their lives and across generations. To get there, it identifies four strategic directions:
- Nurturing planetary ecosystems, recognizing that environmental degradation directly undermines human health.
- Designing social protection systems built on equity, inclusion, and solidarity.
- Supporting equitable economies that serve human development rather than concentrating wealth.
- Promoting universal health coverage through primary care, health promotion, and preventive services.
The Geneva Charter also highlights digital transformation as a key challenge, calling for stronger health promotion capacity to manage emerging public health issues in an increasingly online world. It pushes for collaboration with international financial institutions to create sustainable funding for well-being policies across all countries, not just wealthy ones.
Health in All Policies
One of WHO’s most practical frameworks is Health in All Policies, or HiAP. The idea is straightforward: decisions made in transport, housing, urban planning, education, agriculture, finance, and taxation all affect health outcomes, so health considerations should be part of those decisions from the start. A city’s transportation plan shapes how much people walk and cycle. Agricultural subsidies influence what food is affordable. Tax policy determines who can access healthcare.
HiAP is about integrated governance, where health and equity objectives are pursued alongside the goals of whichever sector is making the decision, creating mutual benefits rather than competing priorities. WHO supports countries in implementing this approach through training resources, a global network of practitioners, and technical advice for policymakers trying to improve coordination across government departments. The emphasis falls particularly on disadvantaged groups, whose health is most affected by policy decisions outside the health sector.
Tackling Commercial Determinants of Health
A growing area of WHO’s health promotion work addresses what it calls commercial determinants of health: the ways private sector activities, both products and business practices, affect public health. This includes not just harmful products like tobacco and ultra-processed foods but also market strategies, working conditions, production-related pollution, and political activities like lobbying, misinformation campaigns, and donations that influence regulation.
WHO urges governments to use taxation, fiscal policies, and meaningful regulation of advertising and sponsorship for harmful products. But it also calls for deeper structural change: repositioning social outcomes ahead of profit through alternative economic models, reforming governance around lobbying and conflicts of interest, and ensuring that commercial products and services promoting health are equitably available. Civil society organizations play a key role here, enhancing transparency and accountability and using citizen power to push for progressive regulation.
Preventing Noncommunicable Diseases
Noncommunicable diseases like heart disease, cancer, diabetes, and chronic respiratory conditions are the leading causes of death globally, and the most effective prevention strategy is one that changes everyday habits around diet, physical activity, smoking, and alcohol use. These four risk factors drive the vast majority of preventable chronic disease.
In practice, WHO’s health promotion approach to these diseases looks like setting high standards for food and beverages, increasing opportunities for physical activity in schools and workplaces, monitoring air quality, and creating smoke-free environments. A healthy dietary pattern means reducing red and processed meat, sugar-sweetened drinks, alcohol, salt, sugar, and saturated fats while increasing whole grains. Most cardiovascular disease can be prevented by addressing seven controllable risk factors: diet, physical activity, tobacco avoidance, healthy weight, and keeping blood pressure, cholesterol, and blood sugar in check. Cancer prevention overlaps heavily, adding sun protection, safe sex practices, and control of cancer-causing viruses.
WHO provides direct support for tobacco cessation and advocates for smoke-free environments, recognizing tobacco as a common risk factor across all four major categories of noncommunicable disease.
Health Literacy as a Foundation
Health literacy is central to WHO’s promotion strategy, but the organization defines it more broadly than just reading ability. It represents the personal knowledge and competencies that accumulate through daily activities, social interactions, and across generations. Critically, it includes the ability to think critically about health information and to express personal and societal needs.
WHO also distinguishes organizational health literacy, the structures and resources that enable people to access, understand, evaluate, and use health information and services. A hospital with confusing intake forms or a public health campaign written at a graduate reading level creates barriers regardless of individual skill. Improving organizational health literacy means better communication, stronger support for informed decision-making, and culturally and linguistically appropriate information and services. WHO supports countries in assessing the extent of limited health literacy in their populations, adapting measurement tools to local contexts, and using that data to guide policy.
Measuring Impact
WHO uses health impact assessment to evaluate whether policies, programs, and projects are actually improving health outcomes. This process produces recommendations for decision-makers along with monitoring frameworks to track changes over time. Specific tools include software for quantifying the health burden of air pollution, tools for assessing the outcomes of climate-driven policies, and a web-based tool that estimates the health and economic benefits of increased walking and cycling in communities.
At the broadest level, WHO’s current strategic plan for 2025 to 2028, the Fourteenth General Programme of Work, sets targets for 6 billion people to enjoy better health and well-being, 5 billion to benefit from universal health coverage without financial hardship, and 7 billion to be better protected from health emergencies. The plan identifies six strategic objectives, including responding to climate change as a health threat, addressing root causes of ill health across policy sectors, advancing primary healthcare, improving health service coverage and financial protection, and strengthening emergency preparedness and response.
Healthy Cities: Promotion at the Local Level
One of the longest-running examples of WHO health promotion in action is the European Healthy Cities Network. Cities that join commit to developing detailed city health profiles and city health development plans, essentially mapping the health landscape of their population and creating strategies to improve it. The network provides a practical model for how health promotion principles translate into local government action, from urban planning decisions to community health services, grounding global frameworks in the specific needs of neighborhoods and residents.