Emerging health issues

The widening challenge for population health promotion

Bibliographic Data

ID22945255
AuthorsAnthony J Mcmichael (Australian National University), Colin D Butler (0000-0002-2942-5294, Australian National University, corresponding author)
Year2006
Volume21
Issuesuppl_1
Pages15-24
Publication date2006-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Promotion International (JOURNAL)
Journal identifiersISSN: 0957-4824 • E-ISSN: 1460-2245
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapro/dal047
PMID17307953
OpenAlexW2121411386
LanguageEN
Citations received13
References cited27

The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the development, human rights and environmental movements. The big task is to promote sustainable environmental and social conditions that bring enduring and equitable health gains.

Development economics · Economic growth · Economics · Environmental health · Global health · Health care · Life expectancy · Political science · Population · Population growth · Population health · Poverty · Public health · Reproductive health · Social determinants of health · Sustainability · Child Nutrition and Water Access · Ecology · Food Security and Health in Diverse Populations · Global Public Health Policies and Epidemiology · Medicine · Health Policy