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The Ottawa Charter for Health Promotion action areas and the role of health promotion for VCE Health and Human Development Unit 3 AoS 2

Syllabus dot point

“The Ottawa Charter for Health Promotion as part of the social model of health, and the role of health promotion (through its five action areas) in improving population health”

VCEHealth and Human DevelopmentUnit 3: Australia's health in a…14 min read

Quick answer

The Ottawa Charter for Health Promotion (World Health Organization, Ottawa, 1986) is the framework that puts the social model of health into action. It defines health promotion as "the process of enabling people to increase control over, and to improve, their health", and sets out five action areas: build healthy public policy, create supportive environments, strengthen community action, develop personal skills and reorient health services. Health promotion improves population health by acting on the causes of ill health across whole communities, not just treating individuals. Exam questions give you a program or a health issue and ask you to name an action area, describe it, and link it to a specific improvement in health status.

Jump to a section
  1. What this dot point is asking
  2. The Ottawa Charter in brief
  3. The five action areas
  4. The role of health promotion in improving population health
  5. Applying the action areas: three worked examples
  6. Command terms and how to answer them
  7. How this dot point appears in the VCE exam
  8. Exam-style questions

What this dot point is asking

The 2025 study design places the Ottawa Charter inside the key knowledge on "reasons for improvements in Australia's health status since 1900", as "the concept of the social model of health and the Ottawa Charter for Health Promotion (not including the principles of the social model of health)". A separate key knowledge point is "the role of health promotion in improving population health". The matching key skills are to:

  • explain how initiatives reflecting action areas of the Ottawa Charter could lead to improved health outcomes;
  • analyse a range of data, case studies and examples of health promotion programs in relation to the use of the action areas.

The VCAA FAQ (updated February 2026) says students are not required to focus on one specific health promotion program; they should be able to apply the action areas to a range of programs and data, and should see the Ottawa Charter as an example of the social model of health in action. It was examined as a 6-mark question in 2022, 2023 and 2025, and as a 3-mark question in 2024.

The Ottawa Charter in brief

The Charter was adopted at the First International Conference on Health Promotion in Ottawa, Canada, in November 1986. It built on the WHO's goal of health for all and shifted the focus of public health from individual behaviour and treatment towards the conditions in which people live.

Prerequisites for health. The Charter lists the fundamental conditions and resources for health: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity. The VCAA FAQ notes that the prerequisites are not an explicit Unit 3 and 4 concept but are implicitly present, for example in social justice and equity.

Strategies. The Charter describes three strategies: advocate (argue for the conditions that support health), enable (reduce differences in health status by giving people the opportunities and resources to reach their full health potential) and mediate (coordinate governments, health, social and economic sectors, industry, media and communities). The exam focus in the 2025 study design is on the action areas.

The five action areas

Action area What it means Australian examples
Build healthy public policy Decision makers in all sectors (not just health) create laws, regulations, taxes and policies that make healthy choices easier Tobacco excise, plain packaging, smoke-free laws; compulsory seatbelts and random breath testing; bans on commercial solariums; school canteen policies
Create supportive environments Making the physical, social and cultural settings where people live, work and play safer and more supportive of health Shade structures, bike paths, parks and playgrounds; smoke-free venues; culturally safe services; workplaces with healthy food
Strengthen community action Communities set their own priorities, make decisions and act together to improve health Community-led programs such as the NSW Knockout Health Challenge; Aboriginal Community Controlled Health Organisations; local sporting clubs and councils partnering on activity programs
Develop personal skills Information, education and skill-building so people can make healthy decisions and cope with life's challenges Quit and SunSmart campaigns; school health education; cooking classes; mental health literacy resources
Reorient health services Moving the health system from treatment towards prevention and health promotion, and making services culturally appropriate GPs asking about smoking, activity and diet and referring patients; health checks and screening; Aboriginal health workers in services
Telling the action areas apart
  • Individual knowledge or skills? Develop personal skills.
  • A community group deciding and acting together? Strengthen community action.
  • A law, tax, rule or official policy? Build healthy public policy.
  • A change to a physical, social or cultural setting? Create supportive environments.
  • A change to what health services and professionals do? Reorient health services.

The 2024 examiners noted that create supportive environments must be linked to a physical or social environment that is safe, inclusive, culturally appropriate or supportive of healthy choices, not just "support".

The role of health promotion in improving population health

Health promotion differs from treatment. It works before illness occurs, targets whole populations or groups rather than one patient, and addresses the determinants of health (sociocultural, environmental and biological factors) as well as behaviour. Its role in improving population health includes:

  1. Reducing risk factors across the population. A small change in a risk factor across millions of people prevents a large amount of disease.
  2. Reducing inequities. Programs can direct extra effort to groups with the greatest need (equity).
  3. Empowering people and communities to take control of their own health (enable, strengthen community action).
  4. Being cost-effective and sustainable. Preventing disease reduces future demand on the health system.

Evidence: tobacco control. Australia's layered tobacco control uses all five action areas. Daily smoking among people aged 14 and over fell from 19.5 per cent in 2001 to 5.6 per cent in 2025 (AIHW National Drug Strategy Household Survey), and the age-standardised burden of disease attributable to tobacco fell 41 per cent between 2003 and 2024 (AIHW). Tobacco still caused 7.6 per cent of the total burden of disease in 2024, which shows health promotion's gains take decades and must be sustained. See tobacco health promotion for the full case study.

Evidence of need: physical activity. In 2022, 83 per cent of young people aged 15 to 17 did not meet the guideline of at least 60 minutes of moderate to vigorous physical activity a day (AIHW, Australia's health 2024: in brief, as quoted in the 2025 exam). Low activity is exactly the kind of population-wide, behaviour-and-environment problem the action areas are designed for.

Applying the action areas: three worked examples

Skin cancer (SunSmart).

  • Build healthy public policy: school sun protection policies; laws banning commercial solariums.
  • Create supportive environments: shade over playgrounds and pools; hats as part of school uniforms.
  • Develop personal skills: "slip, slop, slap, seek, slide" education and checking your own skin.
  • Reorient health services: GPs and pharmacists giving sun protection advice and skin checks.
  • Health outcome: less ultraviolet exposure, lower incidence of skin cancer, and earlier detection lowering mortality from melanoma.

Physical activity among young people.

  • Strengthen community action: councils, schools and local clubs running free, youth-designed activity sessions.
  • Create supportive environments: safe bike paths, lit parks, skate parks and school grounds open after hours.
  • Build healthy public policy: required physical education time in schools; funding for active travel.
  • Develop personal skills: programs that build fundamental movement skills and confidence.
  • Health outcome: more young people meeting the guideline, lower prevalence of overweight and obesity, better mental health and wellbeing.

Aboriginal and Torres Strait Islander healthy lifestyles (NSW Knockout Health Challenge).

  • Strengthen community action: community-led and -owned teams choose their own activities; yarning circles shape the program's future.
  • Develop personal skills: group cooking classes and nutrition and physical activity education.
  • Create supportive environments: a culturally safe social setting where healthy choices are supported by peers and family.

Command terms and how to answer them

  • Identify an action area: name it exactly as the Charter does.
  • Describe it: say what the action area involves in general terms.
  • Explain how it is evident or how it could lead to improved health outcomes: link a specific feature of the program to the action area, then to a behaviour or environment change, then to a named health outcome with a direction (for example "reducing the incidence of melanoma").
  • Discuss (2025 Q12): for each action area, give a realistic, specific health promotion action and show how it would change the target behaviour; do not write about what an individual could do.
  • Analyse (2023 Q6b): break the program into action areas and show how each contributes to changes in health status data, quoting the stimulus.
A 6-mark "discuss two action areas" answer

Question: Referring to two action areas of the Ottawa Charter, discuss how health promotion could reduce harmful alcohol use among young adults.

Step 1: Choose two genuinely different action areas

Build healthy public policy and create supportive environments.

Step 2: Action area 1 with a specific action and link (3 marks)

Build healthy public policy involves governments creating laws and regulations that support health. Governments could restrict alcohol advertising on social media and at sport, and limit late-night trading hours for bottle shops. With less exposure and availability, young adults are less likely to binge drink, reducing alcohol-related injuries and the incidence of alcohol use disorders.

Step 3: Action area 2 with a specific action and link (3 marks)

Create supportive environments involves making physical and social settings support healthy choices. Universities and sporting clubs could run alcohol-free social events and provide free water and safe transport home, so socialising does not depend on drinking. This lowers the pressure to drink heavily, reducing injuries and risky behaviour.

Step 4: Check

Each action area is named, described, applied to a specific action and linked to a change in behaviour and a health outcome.

Develop personal skills is not strengthen community action

These are the most confused pair. Develop personal skills builds an individual's knowledge and skills (education, classes, information). Strengthen community action is a community collectively setting priorities and acting (community-led programs, local partnerships). Read whether the action targets a person's skills or a group's collective effort.

Naming an action area that is not in the stimulus

In 2024, build healthy public policy was not accepted for the Knockout Health Challenge because the case study contained no law or policy. Only choose an action area you can point to in the evidence.

Talking about the Charter in general

The 2023 report's main criticism was answers that discussed the Ottawa Charter without linking to the selected condition. Every point needs the specific issue (for example lung cancer), a specific action and a specific change in health status.

How this dot point appears in the VCE exam

  • Short answer (2 to 3 marks): identify and describe one action area in a case study (2024 Q2).
  • Extended short answer (6 marks): two action areas applied to a stimulus program or health issue (2022 Q10b, 2025 Q12), or an analysis of how health promotion improved health status using data (2023 Q6b).
  • Extended response (10 marks): the Ottawa Charter as one of the approaches explaining improvements in Australia's health status since 1900, alongside old public health and the biomedical approach (2024 Q14).

Exam-style questions

Questions in the style of VCAA exam questions on this dot point, each with a worked answer. They are written by ExamExplained unless tagged "Past paper"; the year shows the paper a question is modelled on.

2025 VCAA Q12Past paper6 marks
According to the Australian Institute of Health and Welfare (2024), at least 60 minutes of moderate to vigorous physical activity daily is recommended for children aged 5-17 years, yet 83% of young people aged 15-17 did not meet this guideline in 2022. Referring to two action areas of the Ottawa Charter, discuss how health promotion could address the low levels of physical activity among young Australians.
Show worked answer →

Average 3.1 out of 6 (2025 examiners' report).

What was needed (report): correctly refer to two action areas; show how each could be implemented to increase physical activity, with specific examples; and show a meaningful link between each action area and increasing the physical activity of young Australians.

Why students lost marks
Writing about what "an individual could do" rather than how the action area (health promotion) could be used, and not linking the action to a specific increase in physical activity.
High-scoring extracts (report, summarised)
Strengthen community action: a partnership between local gyms, schools and local government offers young people a series of fun, free physical activity sessions for their age group, making exercise enjoyable so they are more likely to be active and keep it up. Create supportive environments: changing the physical environment by building more parks, walkways and playgrounds gives young people more places to be active, increasing the likelihood that they exercise.
Other valid choices
Build healthy public policy (for example compulsory weekly physical education in schools), develop personal skills (programs that build young people's skills and confidence in a range of sports), reorient health services (GPs asking adolescents about activity and referring them to programs).
2023 VCAA Q6bPast paper6 marks
[Stimulus: a graph of age-standardised DALY per 1,000 population, 2003-2018, for melanoma of the skin, road traffic injuries (motor vehicle occupants) and lung cancer (AIHW Burden of Disease Study 2022).] Select one of the conditions shown in the graph. Referring to the information provided and your own understanding of the action areas of the Ottawa Charter for Health Promotion, analyse the ways in which health promotion might bring about improvements in health status in Australia for your selected condition.
Show worked answer →

Average 2.7 out of 6 (2023 examiners' report); 14 per cent scored zero.

What was needed
Use both the graph and your own knowledge of the action areas to analyse how health promotion improved health status for the chosen condition. The report's main criticism: some students discussed the Ottawa Charter in general and did not link it to the selected condition.
High-scoring response (report, summarised, lung cancer)
Build healthy public policy: tobacco taxes and bans on smoking in public places reduce smoking, reducing the prevalence of lung cancer. Develop personal skills: the Quit campaign's mass media advertising and online information gives people the knowledge to quit, reducing lung cancer mortality. Reorient health services: health professionals include prevention (encouraging patients to stop smoking) in consultations. This helps explain the fall in lung cancer burden from about 6.8 DALY per 1,000 in 2003 to about 5.4 in 2018 and fewer years of life lost.
Tip
Quote the graph data, name the indicator (DALY, YLL, prevalence, mortality) and state the direction of change.
2022 VCAA Q10bPast paper6 marks
[Stimulus: headspace's 'Take a Step' campaign, which encourages Aboriginal and Torres Strait Islander young people to recognise the signs that something is not right and take small, practical steps towards feeling better, thinks about wellbeing holistically (culture, identity, place and spirituality), and offers national TV and radio advertisements plus print and online resources, including a community-based chat feature, videos and culturally appropriate fact sheets for young people and their family and friends.] Identify and describe two action areas of the Ottawa Charter for Health Promotion that are reflected in the 'Take a Step' campaign and explain how they are evident.
Show worked answer →

Average 2.8 out of 6 (2022 examiners' report).

Why students lost marks. Many did not describe each action area, so they could only receive a maximum of four marks. Each action area needs three parts: name it, describe what it means, and show where it appears in the stimulus.

High-scoring response (report, summarised). Develop personal skills means providing education and building skills so people can improve their health; 'Take a Step' gives Aboriginal and Torres Strait Islander young people "practical steps" and teaches them to recognise signs of declining mental health and ways to feel better. Strengthen community action means connecting individuals and communities to work together towards a common goal; the community-based chat feature, videos and fact sheets for young people and for their family and friends involve the whole community in supporting young people's mental health, so they do not feel alone.

Practise this

Sources & how we know this

Based on the official VCAA study design and published VCAA past papers and marking guidelines. Not yet individually reviewed by a person; always check VCAA and your school's materials for current rules.

ExamExplained