Content area
Full Text
Key words
ecology; health promotion; holistic; place; settings; sustainable; systems
Abstract
Highlighting the need for holistic and sustainable health improvement, this paper starts by reviewing the origins, history and conceptualization of the settings approach to health promotion. It then takes stock of current practice both internationally and nationally, noting its continuing importance worldwide and its inconsistent profile and utilization across the four UK countries. It goes on to explore the applicability and future development of settings-based health promotion in relation to three key issues: inequalities and inclusion; place-shaping and systems-based responses to complex problems. Concluding that the settings approach remains highly relevant to 21st century public health, the paper calls on the new "Royal" to provide much-needed leadership, thereby placing settings-based health promotion firmly on the national agenda across the whole of the UK.
INTRODUCTION
As multidisciplinary public health continues to take shape within the UK, facing both familiar and new challenges, the need for an holistic vision and approach to sustainable health improvement has never been more evident. Settings-based health promotion adopts an explicitly holistic model and, more than 20 years after its inception, continues to be widely used throughout the world as both an approach and infrastructure for health improvement. In the UK, although the healthy settings model retains a certain level of popularity and influence, there is considerable variation not only in local and regional practice, but also between countries in terms of policy commitments and supporting infrastructures. It is timely, therefore, to review the settings approach and to consider its relevance, applicability and future evolution in the context of key influences on public health policy and practice - tackling inequalities and promoting inclusion; place-shaping; and making effective systems-based responses to 21st century issues. Furthermore, following the recent merger, it is appropriate to consider how the new "Royal" can provide the vision, voice and national-level leadership necessary to place settings-based health promotion firmly on the national agenda across the UK - thereby supporting holistic and sustainable health improvement practice.
HEALTHY SETTINGS: OVERVIEW
The settings approach to health promotion emerged following the 1986 launch of the Ottawa Charter,1 which stated that "health is created and lived by people within the settings of their everyday life; where they learn, work, play and love"....