We need a comprehensive approach to health promotion

Health promotion has been evolving since the pioneering work of Professor Lawrence Green and colleagues in the USA more than 35 years ago and the Ottawa Charter in 1986. This evolution has included shifts in philosophies based on the best available evidence. Early in the development of health promotion the recognition of individual health behaviour or lifestyle as a major cause of ill health led to a call for individuals to take responsibility for their own health (i.e. health promotion for self-responsibility or for behavioural perspectives). However, there is strong evidence that social, economic and environmental factors are significant determinants of behaviours and health status (structural perspectives or structural factors) and that addressing individual responsibility, without due consideration of the structural factors, can be viewed as a naive approach...

Some people use the evidence of ‘self-inflicted illness’ to recommend that individuals whose lifestyles cause their own ill-health should bear a substantial cost of the medical care they require. This may be in the form of imposing additional taxes, for example on cigarettes, alcohol, junk foods and other unhealthy products, to cover the cost of treating the health-related problems they cause or even charging those people who practise unhealthy lifestyles higher health insurance premiums or suggesting that those of a larger size pay more for plane flights.,,