Health promotion and the Ottawa Charter: WACE Year 12 Health Studies Unit 3
“Apply the action areas and the enable, mediate and advocate strategies of the Ottawa Charter to plan health promotion that improves community health outcomes”
The Ottawa Charter is a health promotion framework built on five action areas (build healthy public policy, create supportive environments, strengthen community action, develop personal skills, reorient health services) and three strategies (enable, mediate, advocate). WACE asks you to apply these to a real issue: choose action areas that match the determinants of the problem and justify why they would reduce inequities, rather than just naming them.
What this dot point is asking
WACE wants you to use the Charter as a planning tool. A strong answer selects action areas that fit the health issue in the stimulus, explains a specific action for each, and links it back to the determinants driving the problem. Marks reward matched, justified application, not a memorised list.
The five action areas
Build healthy public policy means using laws, regulations, taxes and organisational rules to make the healthy option the easier option. Examples include tobacco taxes, mandatory food labelling and smoke-free venues.
Create supportive environments means shaping the physical and social surroundings so health is supported by default, such as building footpaths and parks, providing healthy food in canteens, or creating safe workplaces.
Strengthen community action means empowering communities to identify their own priorities and act on them, so solutions are owned locally and are more likely to last.
Develop personal skills means building the knowledge, health literacy and life skills that let individuals make informed decisions, often through education and skill-building programs.
Reorient health services means shifting the focus of the health system from treatment toward prevention, early intervention and health promotion, and making services accessible and culturally appropriate.
The Charter is designed so the action areas reinforce one another. A single education program (develop personal skills) has limited effect if the environment and policy still push people toward the unhealthy choice. Combining action areas, for example pairing a school education program with a healthy canteen policy and a supportive built environment, produces a more durable change than any one area alone.
The three strategies: enable, mediate, advocate
Enabling means giving people and communities the resources, skills and opportunities to take control of their own health, reducing the gap between groups. Mediating means bringing together different sectors and interests, such as government, industry, schools and community groups, to coordinate action, because no single sector can address health alone. Advocating means speaking and acting publicly to make health a priority, influencing decision-makers and challenging the conditions that damage health. These three strategies cut across all five action areas and are especially important for reducing inequities, because they target the groups and structures where disadvantage is concentrated.
Applying the Charter to reduce inequities
Good application starts with the determinants. Identify what is driving the issue, then choose action areas and strategies that address those drivers for the disadvantaged group. If cost is the barrier, healthy public policy (subsidies) and enabling strategies fit. If a community feels powerless, strengthening community action and enabling fit. The justification should explain why the chosen action will work for that specific group, not just that it relates to the issue.
How this maps to the exam
Expect a stimulus describing a health issue or a proposed program. You may be asked to classify actions into the correct action area, to plan a multi-area response, or to evaluate how well a program uses the Charter. Always tie each action area to a determinant and to the group experiencing the problem.
A stimulus gives a health issue and asks you to plan using the Charter. The top-band move is to start from the determinants, then map action areas onto them.
Identify the determinants in the stimulus
For high rates of youth vaping in a town: social (peer norms and marketing), economic (cheap, accessible products), and personal skills (low refusal skills). List these first so each action area has a target.
Map each action area to a determinant
Build healthy public policy: enforce retail age limits and restrict nearby sales (targets accessibility). Create supportive environments: vape-free school grounds and venues (targets the social norm). Develop personal skills: refusal-skills and critical-marketing lessons (targets skills and the marketing influence).
Add a strategy layer
Use advocate to push decision-makers for the retail policy, and enable by giving the school and community the resources to run the skills program. Naming the strategy alongside the action shows command of the framework.
Justify and link the areas
Explain that policy and environment reduce supply and normalisation while personal skills build resistance, and that combining them is more durable than education alone. End by linking back to the disadvantaged group most affected, which secures the application and justification marks.
Students often list the five action areas and add a generic sentence for each. The marks come from a specific, justified action that fits the stimulus and addresses the determinants of the issue. For each action area you use, state the concrete action and explain how it reduces the health problem for the group described.
Exam-style questions
Questions in the style of SCSA 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.
WACE 2022-style8 marksA regional community has high rates of overweight and physical inactivity. Using three action areas of the Ottawa Charter, plan a health promotion response and justify how each action would improve outcomes.Show worked answer →
An 8 mark plan-and-justify response needs three matched action areas, a concrete action for each, and a determinant link.
- Build healthy public policy
- The local council adopts a policy requiring healthy options in council facilities and subsidises a community pool. Justification: this addresses the economic and environmental barrier (cost and availability of active options) so the healthy choice becomes the easier choice.
- Create supportive environments
- Build footpaths, cycleways and lighting so walking and cycling are safe and convenient. Justification: it changes the built environment determinant, making activity part of daily life rather than a deliberate effort.
- Strengthen community action
- Support a community group to run free local sport and walking groups it designs itself. Justification: local ownership fits the community's needs and lasts, and builds the capacity to sustain change.
- Tie together
- Note the areas reinforce one another: policy and environment make the skills and community programs effective.
Markers reward three correctly named areas, a specific justified action for each, and links to the determinants driving the issue.
WACE 2023-style4 marksExplain the difference between the enable, mediate and advocate strategies of the Ottawa Charter.Show worked answer →
A 4 mark response needs all three strategies distinguished.
- Enable
- Give people and communities the resources, skills and opportunities to take control of their own health, reducing the gap between groups.
- Mediate
- Bring together different sectors and interests (government, industry, schools, community) to coordinate action, because no single sector can address health alone.
- Advocate
- Speak and act publicly to make health a priority, influencing decision-makers and challenging the conditions that damage health.
Markers reward a clear, correct distinction between all three strategies.