Enable, mediate, advocate

Abstract

The authors of the Ottawa Charter selected the words enable, mediate and advocate to describe the core activities in what was, in 1986, the new Public Health. This article considers these concepts and the values and ideas upon which they were based. We discuss their relevance in the current context within which health promotion is being conducted, and discuss the implications of changes in the health agenda, media and globalization for practice. We consider developments within health promotion since 1986: its central role in policy rhetoric, the increasing understanding of complexities and the interlinkage with many other societal processes. So the three core activities are reviewed: they still fit well with the main health promotion challenges, but should be refreshed by new ideas and values. As the role of health promotion in the political arena has grown we have become part of the policy establishment and that is a mixed blessing. Making way for community advocates is now our challenge. Enabling requires greater sensitivity to power relations involved and an understanding of the role of health literacy. Mediating keeps its central role as it bridges vital interests of parties. We conclude that these core concepts in the Ottawa Charter need no serious revision. There are, however, lessons from the last 25 years that point to ways to address present and future challenges with greater sensitivity and effectiveness. We invite the next generation to avoid canonizing this text: as is true of every heritage, the heirs must decide on its use.

Oral Health

“…To overcome opposition, it is the responsibility of scientists not only to provide empirical evidence, but also to communicate with society [39,41]. In the Ottawa Charter on health promotion, "Enable," "Mediate," and "Advocate" were described as the core activities [42][43][44]. Scientists need to advocate evidence to mediate conflict among groups to enable public health interventions.…”

Enable, mediate … but don’t advocate!

“…The Ottawa Charter on Health Promotion lists “peace, shelter, education, food, income, stable eco‐system and social justice” as conditions required for good health 1 . As Saan and Wise 2 note, political, economic, social, cultural, environmental, behavioural and biological factors all influence health, be it positively or adversely. Saan and Wise also state that health promotion action aims to ensure that the conditions listed in the Ottawa Charter are satisfied: this can be and often is achieved through advocacy 2 …”

Healthy dying: time for health promotion to get serious

“…In a reflections article in Health Promotion International Hans Saan and Marilyn Wise discuss the 'enable, mediate, advocate' components of the Ottawa Charter. They encourage us to prepare for the ultimate project-Healthy Dying-'as to embrace our own death is to celebrate the health we enjoyed' (Saan and Wise, 2011).…”