Visioning the future of health promotion: learning from the past, shaping the future: learning from the past, shaping the future”

EDITORIAL It is my honour to serve as guest editor for this special publication to mark 70years since the foundation of the International Union for Health Promotion and Education (IUHPE). This anniversary special issue provides an opportunity to critically reflect on the evolution and future development of health promotion and to consider IUHPEs role in advancing the field now and into the future. The `International Union for Health Education was officially launched in 1951. This international non-governmental agency was founded by Professor Jacques Parisot, Professor of Public Health in the Medical School in Nancy, France, and Mr Lucien Viborel, Director of the National Centre for Health Education at the Ministry of Public Health in France. The French Government promoted the organization of the Constitutive Assembly of the Union in May 1951 at an international conference in Paris. This was a time of great change in the aftermath of the Second World War, which highlighted the urgent need for global cooperation. The United Nations was founded in 1945, including setting up the World Health Organization as a specialized agency responsible for international public health with the aim of promoting and protecting the health of all peoples. The establishment of the International Union just a few years later was a long-sighted and strategic development, with the realization that a global movement of people and organizations committed to promoting population health was needed to accompany the vision and work of global agencies such as the World Health Organization. Over the last 70years the International Union has grown and developed its core mission, embracing Health Promotion in its title in 1993 to become IUHPE. Since then it has developed and expanded its role as an independent global professional association dedicated to advancing health promotion and health equity. As a unique membership-based NGO, IUHPE remains strongly committed to its founding principles while also keeping a strategic focus on the innovation and transformation that is needed to advance global health promotion over the next 70years. To mark the 70th anniversary, this special publication brings together a collection of papers, commentaries and perspectives on the past, present and future of health promotion. Critical insights are exchanged on health promotions role as a key transformative strategy for advancing human health, wellbeing, equity, and sustainable development in the face of global challenges. The papers also critically consider IUHPEs role in strengthening health promotion globally, working with members and partner agencies in advancing policies, practices, structures, capacities and research that will promote population health, health equity and wellbeing and a healthier and sustainable future for all. The first set of papers provide critical reflections on the current state and development of health promotion from a policy, research and practice perspective. In my own paper (Barry), I consider how transformative health promotion can be advanced, and critically reflect on what progress needs to be made and the structures and processes that are required to strengthen health promotion at a systems level. The enabling mechanisms that are needed at a conceptual, policy and implementation level to strengthen health promotion systems are discussed and the critical role of IUHPE in this endeavour is outlined. The paper by De Leeuw and colleagues charts the development of policy in health promotion and introduces the concept of a health political science for health promotion. Case studies are presented to illustrate the value of applying health political science theorizing to health promotion. The authors call for a greater appreciation of the political nature of the field and for deeper insights into the conceptual grounding of health promotion policy processes. Potvin and Jourdan consider the state of development of health promotion research. They argue that while health promotion research is a distinct field of research, it currently lacks a unifying framework to structure its knowledge base. They propose three structuring pillars that build on existing health promotion research practice the object, purpose and nature of the knowledge generated from health promotion research and outline current work that offers a direction for the structuring process. Van den Brouckes paper addresses the continuing development of health promotion practice as a transdisciplinary field within public health. This paper outlines the unique contribution of health promotion to public health and discusses the importance of workforce development based on core competencies for health promotion practice. Van den Broucke considers how health promotion capacity development can be strengthened in the context of integrating health promotion within the practice of public health. The focus on workforce capacity development is continued in a commentary from Battel-Kirk and colleagues, where they report on the development and implementation of the competency-based IUHPE Accreditation System as a quality assurance system for global health promotion practice, education and training. An overview is provided of how the Accreditation System works and its current status, and research on its impact on workforce development is presented and future plans discussed. The next set of papers consider future directions and priorities for health promotion in the 21st century, taking into account current and future challenges. A series of papers and commentaries discuss new approaches and emerging ideas to re-envision health promotions role. Nutbeams commentary considers the relationship between health education and health promotion and, applying the lens of health literacy, considers how building on the past can shape the future. Nutbeam outlines the challenges and opportunities presented by new digital health technologies in enabling people to access and engage with health information and set health goals. The paper discusses the role of skills-focused health education and the importance of interactive and critical health literacy in engaging with digital media, supporting empowerment, community development and social activism for health. Kickbusch in her commentary on visioning the future of health promotion outlines transformative approaches to promoting health and wellbeing. She argues that the way forward for health promotion must be framed to address the challenges of our time, including inequality, climate crisis, pandemics, digitalization and a weakening democracy. She considers new models and approaches and discusses how embracing complexity, the transformative metrics of wellbeing, and the design of supportive environments will allow societies to benefit from integrated policies that promote health, wellbeing and sustainability. Baums paper considers how health promotion can be reframed to address the current crises of growing inequities, a warming planet, the pandemic and a fracturing of trust and solidarity in societies. The paper discusses the need to take planetary health more seriously, including the importance of using systems thinking; determining the role of health promotion in governing for health and health equity; and how to balance health promotion as a profession with being a social movement. Baum calls for a more radical health promotion agenda that can achieve the goal of a healthy, equitable and sustainable planet in which all humans can flourish. The theme of planetary health is further detailed in a paper by Tuitahi and colleagues which addresses the question: `how do we improve the health of the population especially the health of the most disadvantaged and vulnerable while making peace with the Earth?. This paper provides an overview of global ecological changes being driven by social and economic forces and considers their health implications. The Legacy Statements of the IUHPE 2019 World Conference on Health Promotion are discussed and the authors call on health promoters to provide leadership in promoting a new set of values that are compatible with planetary health, drawing on Indigenous and spiritual perspectives, and addressing both the ecological and social determinants of health. The commentary that follows from Magistretti and colleagues discusses the role of grassroots movements in planetary health and considers how the discourse on grassroots activism can be reframed as a global salutogenic process of change. The People-Planet-Health project is presented as a novel knowledge exchange initiative, which aims to give voice and visibility to grassroots groups. The authors call on health promotion practitioners and global policymakers to recognize and value the contribution of grassroots movements in the creation of planetary health. Ottemöller and colleagues from the IUHPE International Student and Early Career Network address health equity and explore how the theory of salutogenesis can re-envision health promotion with marginalized communities. The paper outlines the need to acknowledge the deep-rooted and historical causes of health inequities, including the influence of colonial and Western ideologies. A radical change in current approaches is proposed with a shift in focus from pathologizing traditionally oppressed communities to a community engagement and participation approach, building on traditional and indigenous knowledge, that promotes the resilience and wellbeing of marginalized communities. We conclude this section with two commentaries on progressing the Sustainable Development Goals (SDGs) in the African and South-East Asian regions. Munodawafa and colleagues consider health promotion in the African continent, outlining current regional strategies and developments in respect of progressing the SDGs. The specific challenges and opportunities for health promotion, including addressing the current COVID-19 pandemic, are discussed and recommendations are made for strengthening health promotion policy and practice, placing it at the centre of the development agenda in order to achieve the SDGs in the region. Mukhopadhyay and Kaur outline the situation in South-East Asia and consider the importance of investing in health promotion to achieve the SDGs. They discuss the development of health promotion in the region and the overriding importance of addressing the social determinants of health, especially for populations living in conditions of economic and social deprivation. We close the special issue with a series of perspectives from five of the past Presidents of IUHPE, who share their personal reflections and provide fascinating insights on the development of health promotion and IUHPE over the last 20years and consider future developments. I am extremely grateful to all the authors and reviewers who contributed to this special issue and to the Editor-in-Chief, Professor Erica Di Ruggiero, and IUHPE Head of Scientific Affairs, Dr Ana Gherghel, for their work in making this possible. I also wish to acknowledge the contribution of all the staff and members of IUHPE, past and present, and all who have supported the work of the organization since its foundation. IUHPE has been a consistent voice for health promotion across the years and has provided a vital platform for unifying the global network of people and agencies dedicated to advancing the field. We are at a critical time in marking this 70th anniversary, as we navigate our way through the pandemic, aiming to build back better and fairer, and plan for a healthier future for all. Health promotion has to be at the forefront of this endeavour, placing the promotion of health equity at the centre of the health, wellbeing and sustainable development agendas. The full potential of health promotion has yet to be realized and now, more than ever, transformative health promotion actions need to be put in place. We know what works and now is the time to put effective strategies into action. IUHPE will continue to support this global effort, advocating for health equity and supporting the global community of health promoters to unite in strengthening health promotion and its implementation in practice over the next 70years. I hope you enjoy reading this special issue and that you will join us in celebrating the 70th anniversary. May IUHPE stay forever young!