The Re-Imagined Ottawa Charter for Health Promotion

The Ottawa Charter is a seminal document in Health Promotion that was birthed at the First International Conference on Health Promotion twenty-five years ago in Ottawa, Ontario, Canada, November 1986.

The Charter was a way of legitimizing the vision for health promotion, describing key concepts, the prerequisites for health (conditions and resources needed for health), and outlining strategies and actions in order to achieve ‘Health for All’. The Charter highlighted individuals, communities, organizations, and systems as key players in improving health and wellbeing and frames the value systems and practices of health promotion. For the field, it represented the “move towards a new public health”. An original image of the charter can be found here — it is basically the same as the image you see above on the left (sans the Francais and colour).

While the state of health promotion and public health has evolved since 1986, the Ottawa Charter still remains a highly relevant, powerful, and inspirational document in the world of health promotion. This has been important in informing my own work as a health promoter, but I find it interesting that in 25 years, the logo has remained unchanged. Certainly, subsequent health promotion conferences have reinforced their support for the Charter and noted new and evolving issues for health promotion to take into consideration in this day and age (e.g., acknowledging rapid globalization and the role of information technologies in transforming our world) but no visuals have been created to reflect these considerations or even simply try to re-imagine different ways of visualizing these fundamental concepts in health promotion.

The original description of the Charter logo is here. I’ll just bring up a few points from this text so you have a bit of context:

The logo represents a circle with 3 wings. It incorporates five key action areas in Health Promotion (build healthy public policy, create supportive environments for health, strengthen community action for health, develop personal skills, and re-orient health services) and three basic HP strategies (to enable, mediate, and advocate).

The outside circle, originally in red colour, is representing the goal of “Building Healthy Public Policies”, therefore symbolising the need for policies to “hold things together”. This circle is encompassing the three wings, symbolising the need to address all five key action areas of health promotion identified in the Ottawa Charter in an integrated and complementary manner.

The round spot within the circle stands for the three basic strategies for health promotion, “enabling, mediating, and advocacy “, which are needed and applied to all health promotion action areas.

[The upper] wing is breaking the circle to symbolise that society and communities as well as individuals are constantly changing and, therefore, the policy sphere has to constantly react and develop to reflect these changes: a “Healthy Public Policy” is needed;

Based on this original explanation, I thought it might be a useful exercise to re-imagine the Charter. In doing so, my point is to play with these concepts, particularly since I see so much dynamism, synergy, and relationships amongst them that I do not think is currently expressed in the logo. I also wonder if policies are the binding concept that “hold things together” as suggested above — policy is powerful, but I think about it as another component of the greater Health Promotion (HP) system. To me, there are two main ways I’d like to change the logo: (1) visualize the HP concepts to demonstrate how they are constantly reacting, responding and adapting to one another and (2) illustrate the forces that shape, design, and manipulate these concepts (aka the Health Promoter).

So allow me to throw out some alternative visuals. And yes, they are all very nerdy (I think in very scientific ways), so please bear with me.

1. The Health Promotion Molecule: I have been talking about elements and molecules a lot lately, so I tried making a health promotion (HP) molecule using the five action areas. I changed the language of these actions slightly but I like this visual because it implies that HP must function as a whole and is comprised of several integral concepts. This was a start, but I didn’t really like the linear connectivity using the chemical bonds between the atoms. I think that the concepts relate to one another in dynamic and complex ways, and this is not illustrated here. Also, it’s not clear where the health promoter fits into this picture.

2. Health Promotion molecules: Based on the last logo, I thought it might be helpful to break off the action areas into different molecules to show that they can freely move around and interact with one another in different ways (if you can imagine, in a 3D space). Inspired by H2O molecules, you can think of the action areas having an attraction for one another (e.g., H2O polar bonds), enough so that together they have fluid qualities (highly interweaved). The dotted lines can represent motion (molecules are in constant motion and vibrate) and may even indicate the level of intensity of a particular action area depending on whether it is located closer to the centre or to the outer rings. Again, it’s not clear where the health promoter fits into this logo.

3. The Health Promotion Atom: I like the idea of orbitals and putting concepts into orbit around some sort of central component that brings all the concepts together, and so, I give you the atom. The atom here shows the HP concepts along different pathways of orbit. Like electrons orbiting a nucleus, the HP concepts occupy and move within a particular space (or energy cloud if you will). There are different ways these HP concepts can relate to each other or their central “nucleus” (they can be drawn closer together or repelled further away), a quality I like about this logo. The nucleus represents the health promoter who can act upon these various action areas/concepts.

4. The Health Promotion Galaxy: This logo is inspired by the original Charter as the formation of the wings in the Charter remind me of a galaxy. The “wings” here start to swirl into each other and gravitate around the centre. The wings also appear to originate from the same central space that the health promoter occupies. This is a gravitationally bound system.

So, does design fit anywhere in these re-imaginations?

I think so. The action areas outlined in the Charter are inherently designed: We design environments to be supportive, interventions to help people build personal skills, public policy, health services, opportunities and processes for community action, and the greater system in which these operate. It seems that the health promoter is akin to a designer: someone who is aiming to change an existing situation into a healthy or preferred one, and essentially designing health.  The designer/health promoter is centralized in the last two logos, suggesting their importance and power (e.g., gravitational pull) within the greater health promotion system.

These may not be the best visual representations of health promotion, but it’s nice to have alternatives and options that can stimulate new or different thinking and ways of understanding the field. I wonder if we (as a field) will test out some new visualizations in the future, but in the meantime, I hope this is a starting point!

***

NOTE: I should also mention that after chatting with some of my health promotion professors and consulting Google, I had a difficult time finding any versions of the Ottawa Charter that had been visually modified. Other than the logo for the Jakarta Declaration (which is really more of an artful than conceptual representation), I could not find much out there…if you can point me in the direction of any others, I’d appreciate it!

5 thoughts on “The Re-Imagined Ottawa Charter for Health Promotion

  1. What a billiant, creative and enlightening way of portraying the interdependent and systemic concept of health promotion. It illustrates movement, fludiity and the balance of the system. While one can focus on one aspect of healt promotion intervention, we will constantly be appreciative of the forces of other influences…A picture is worth a thousand words!!

    Have you thought of presenting this model in a health promotion conference?

  2. Hi Andrea:
    I thin k this is brilliant – nerdy or not!! I love it. The re-imagining allows for more indepth understanding of health and healing. It links it to funbdamental life forces. Thank you so much for this. Do you happen to have this in a PDFormat. Have you copyrighted this? You really should and the previous comment about presenting should be taken seriously.

    Best regards and God bless

    Vuyiswa

    1. @Rosanna Thanks for this comment. I always appreciate your supportive words.

      @Vuyiswa Thanks for your comment. I have publicly shared a lot of my content up to this point and appreciate your note about copyright. I don’t have a PDF yet but can send you something separately if you’re interested 🙂 I think you and Rosanna have brought up a great point — I would love to present/talk about this more widely with others.

  3. Hi, Andrea! Your work is both beautiful and thought-provoking. I loved it.
    While working on a translation of the description of the PA logo, I’ve found the images linked to the 5th, 6th, 7th and 8th Conferences: http://goo.gl/ivSdAQ but I guess they were made for purposes narrower than the ones you put forward.
    I intend to translate the words of this post into Portuguese to share with my fellow public health workers here in Southern Brazil. Is it ok?
    :o)

    1. Thanks so much!

      I appreciate you sharing the link with me, the images themselves are quite interesting. Clearly the Charter visual has stood the test of time.

      Please feel free to share the post. I appreciate the kind words and would love to hear what others have to think! 🙂

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