The relevance POSITIONING HEALTH PROMOTION FOR THE TWENTY-FIRST CENTURY depends on the way in which health promotion is positioned both as a field of research and as an influence on policy. In the Regional Office for Europe, the World Health Organization is attempting to position health promotion as an ‘investment strategy’; a strategy which pays social and health dividends, both short and long term.
This is a strategy which is integral to social and economic development, framed within the development criteria of equity, sustainability, empowerment (see Ziglio, 1993; see also WHO, 1995).
If health promotion is to move to a broad political and policy level of action, there must be an informed strategic plan which places multiple theory-based interventions in the correct juxtaposition to yield maximum health benefits for a population.
Hence the importance for health promotion not to be confined merely to behaviour modification programmes, but to address and influence policies in a wide range of sectors.
The credibility of health promotion is linked to its capacity to influence policies within and outside the health sector (see Ziglio, 1993). Conversely, naively conceived and essentially co health promotion (Kelleher, 1995).
If one wants to evaluate health promotion programmes, one needs not only robust methods of evaluation, ones need, first and foremost, robust programmes and supportive policies to evaluate!
Health promotion must be linked to wider public policy initiatives to enhance its impact on processes that enable people and to gain control over and improve their health (Milio, 1981; WHO/EURO, 1995a).
Health promotion cannot stand alone as either a discipline or an enterprise. What health promotion brings to bear is knowledge and skills involved in analyzing and appraising clues to those aspects of personal, social, economic, political and organizational behaviour that perform as resources or barriers to improving the health of a population. It is not the lack of a single, general theory that slows progress in promoting population health. It is more the lack of common sense and good judgment in appreciating the complex realities of the human condition and identifying what, where and when interventions are appropriate, preferred and possible.