Health promotion based on the five action areas of the Ottawa Charter: developing personal skills, creating supportive environments, strengthening community action, reorienting health services, building healthy public policy

The Ottawa Charter for Health Promotion, adopted by the World Health Organization in 1986, is the central framework HSC PDHPE expects you to know. Almost every Core 1 extended response asks you to apply it to a priority issue. Strong responses do not just name the five action areas; they use the Charter as the spine of the argument.

The five action areas

1. Developing personal skills

Building individual knowledge and skills so people can make informed health decisions and take action on their own health.

Australian examples:

• School PDHPE (the course you are sitting). Statewide curriculum teaching health literacy.
• Heart Foundation Walking groups - teach pacing, goal-setting, group accountability.
• Quitline - teaches behavioural strategies to quit smoking.
• MoodGYM, Beyond Blue's online programs - teach cognitive behavioural skills for managing anxiety and depression.

This action area is necessary but rarely sufficient on its own. Skills without supportive environments fail because the environment pushes people back toward unhealthy choices.

2. Creating supportive environments

Making the healthy choice the easy choice through changes to physical and social environments.

Australian examples:

• The Health Star Rating system on packaged food, making nutritional information visible at point of sale.
• Smoke-free public spaces - pubs, restaurants, beaches, university campuses. NSW smoke-free laws apply to indoor public places, commercial outdoor dining, and within 10 metres of children's play equipment.
• Active urban design - separated cycling infrastructure (Sydney George Street, Melbourne CBD bike lanes), pedestrian-friendly precincts.
• Workplace wellness programs - subsidised gym, healthy canteens, walking meetings.

The strongest CVD prevention examples come from this area: smoke-free environments and food environment changes together produced sustained behaviour change at the population level.

3. Strengthening community action

Empowering communities to identify and act on their own health priorities. The key word is empowerment - communities decide and drive, government supports.

Australian examples:

• Aboriginal Community Controlled Health Organisations (ACCHOs) - the strongest Australian example of community-led health. Communities own and run primary care designed by and for them.
• Heart Foundation community fundraising and advocacy.
• Local mental health and suicide prevention coalitions funded under the Primary Health Networks program.
• R U OK? Day - community-organised conversations about mental health.

Community action is particularly effective where mainstream services have failed to reach a group. The evidence base for ACCHOs is one of the strongest in Australian public health.

4. Reorienting health services

Shifting health services from acute treatment toward prevention and from siloed care toward integrated care. The action area most often misunderstood by students.

Australian examples:

• Medicare's Chronic Disease Management Plans (GP Management Plans, Team Care Arrangements) - pay GPs to coordinate care across allied health for chronic conditions.
• The 715 Aboriginal and Torres Strait Islander Health Check - dedicated Medicare item for annual preventive screening.
• Statin and antihypertensive prescribing guidelines updated to focus on absolute cardiovascular risk rather than single risk factors.
• National Bowel Cancer Screening Program - mailed faecal occult blood tests to all Australians aged 50-74, free, opt-out.

This action area is what shifted age-standardised CVD mortality so significantly: a combination of statin uptake, blood-pressure treatment guidelines, and emergency cardiac care.

5. Building healthy public policy

Government-level policy that makes health a consideration in every sector, not just health portfolios.

Australian examples:

• Tobacco plain packaging legislation (2012) - world-first, copied by 20+ countries since.
• Tobacco excise - annual increases keep cigarette pricing high. The single most effective tobacco control measure by evidence.
• Sugar-sweetened beverage discussions - Australia has discussed but not yet implemented a sugar tax; the UK, Mexico, and South Africa have.
• The Health Star Rating system as a regulated framework (sits in this area as well as supportive environments).
• Mandatory bicycle helmet laws (Australian-wide since 1990s).
• Safe drinking water and food regulation through state and federal food authorities.
• National Preventive Health Strategy 2021-2030 - the umbrella strategy across all preventable conditions.

This is the action area with the strongest evidence base because it shifts the default behaviour for everyone, regardless of individual capacity.

How to use the Charter in an extended response

The mistake most students make is to list the five action areas without picking a priority issue, or to pick a priority issue without consistently applying the Charter throughout. Strong responses do both.

A template that works:

1. Define health promotion and name the Charter as the central WHO framework.
2. Identify the priority issue (e.g., CVD, mental health, obesity, Indigenous health).
3. Work through all five action areas in order, with one specific Australian example per area linked to the priority issue.
4. Make a judgment if the question asks "evaluate" or "assess" - is the Charter effective for this priority? Why or why not?

The single largest mark-improver in PDHPE extended responses is naming specific Australian programs (Heart Foundation Walking, plain packaging, the 715 check, ACCHOs) rather than describing the action area in the abstract.