PHO Webinar: Health Promotion: Celebrating the Past and Looking to the Future

Main ideas, concepts, and lessons

• Health promotion is both values-based and action-oriented

  • Grounded in ethical commitments to equity and social justice.
  • Requires aligning professed values with practical work, not just “naming” them.
  • Examples of values emphasized:
    • Love as intention and action (linked to socially connected communities where everyone is cared for).
    • Curiosity about why conditions and health outcomes happen (dig deeper, understand root causes).

• Health promotion focuses on “conditions” across sectors and settings

  • Health promotion aims to improve social conditions in which people live, learn, work, and play.
  • It goes beyond physical conditions to include social constructs and policy-related levers.
  • Core principle: meaningful change often requires cross-sector collaboration because key determinants sit outside public health jurisdiction.

• How health promotion has evolved over time

  • Shift from:
    • Mostly health education / brochures / health fairs (information-only approaches)
    • Toward upstream strategies aligned with the Ottawa Charter (policy, supportive environments, community action, reorienting health services).
  • Expanded focus from:
    • Built/physical environment
    • To social determinants, initially often framed around poverty
    • To broader attention in recent years including colonialism, racism, sexism, heterosexism, and increasing interest in sustainability.
  • Persistent gap: discourse changes faster than implementation—often a “lifestyle drift” back to individual behavior change.

• Persistent challenges

  • Underinvestment in prevention (and consequently in health promotion).
  • Measurement and evaluation difficulties:
    • Health promotion is harder to quantify than tasks like inspections.
    • “What gets measured gets done,” creating a negative feedback loop for funding.
    • More complex issues (e.g., racism, homelessness, drug poisoning crisis) are especially difficult to evaluate.
  • Tendency to default to health behaviorism (“telling people what to do”) even when the broader determinants are recognized.
  • Political backlash and election-era retrenchment:
    • Progressive gains can be reversed.
    • Health promotion must engage politically, but organizations may lack the skills for productive dialogue.
  • Information environment problems:
    • Social media can amplify confirmatory bias and non-validated information (notably discussed in the context of COVID).

• What health promotion “looks like” in practice

  • The panel repeatedly argued that health promotion isn’t just one “program”—it can be:
    • Applying a health promotion lens/framework
    • Using values-based partnership and action to change conditions
    • Implementing “finite” initiatives that contribute to longer-term upstream change

• Examples highlighted

  • Radon initiative (Kingston, Frontenac, Lennox & Addington)

    • Problem: radon is an underappreciated lung cancer risk.
    • Approach:
      • Studied local radon levels using Health Canada methodologies.
      • Used models like the Health Belief Model (perceived risk/efficacy).
      • Considered factors influencing testing/mitigation via the Precaution Adoption Process Model.
    • Outcomes:
      • Found significant proportions of homes exceed health thresholds.
      • Supported a policy change: municipalities updated building codes to require soil/gas control measures in new builds/expansions after Aug 2019.
      • Equity angle: partnership and engagement extended to social housing, recognizing different populations may be affected differently.

  • Purpose Built Communities (US)

    • Large-scale community redevelopment through public-private partnerships.
    • Deep investment in disadvantaged communities leading to improvements across health-relevant areas (education, housing quality, crime reduction).

  • Toronto Crisis Response Unit (police diversion during mental health crises)

    • Mobile unit with trained mental health professionals instead of default police response.
    • Immediate impact goal: reduce the chance of injury/violence.
    • Framed as resulting from community organizing and activism.

  • Curriculum transformation / Black health and anti-Black racism education

    • Noted lack of substantial anti-Black racism content in many public health education programs.
    • Aims to improve skills and knowledge so practitioners can better address racism and its health impacts.

  • Residential facility healthy eating menu assessment tool (local scale)

    • A structured tool to help facilities build healthy menus and healthy eating environments.
    • Emphasized partnership, involvement of residents, small changes, and progress over perfection.

• Future of health promotion (panel “excitements”)

  • Infusing health promotion into other sectors and tables where decisions are made
    • Health promotion should be present in:
      • Racism-related tables
      • Anti-violence tables
      • Broader public health issues beyond chronic disease and substance use prevention
      • Climate change conversations (health promotion as “health” not just “hazard”)
  • Next generation of practitioners
    • Students trained in health promotion ask tougher questions and push organizations further.
    • Emphasis on moving from awareness to action and “shaking up” reliance on frameworks-only implementation.
  • The launch of Health Promotion Essentials is positioned as a strong foundation and refresher.

Q&A takeaways

• Health promoters everywhere (not just public health units)

  • Panel strongly supported health promotion capacity across all organizations/sectors.
  • Highlighted need for leadership recognition so competencies are valued and supported.
  • Suggested partnership approaches that allow public health to provide contacts/resources and experiment.

• How to convey health promotion value when it’s hard to count

  • Use a blend of:
    • Qualitative evidence and storytelling
    • Concrete examples of policy adoption and large-scale impact
    • Framing discussions around community need and impact rather than only counting outputs
  • COVID was cited as an example of how health promotion competence shows up when priorities shift.

• Leveraging community/nonprofit third sector for poverty and health promotion

  • Recognized that much equity-relevant leadership and work happens in nonprofits/community health centers.
  • Public health credibility (as government) can be an asset when used to amplify community efforts and build productive partnerships.

• Practical anti-racism engagement for health units

  • Start with internal capacity building—but don’t stop there.
  • Move toward implementation through learning, trying, failing safely, and evolving.
  • Use existing public health standards/requirements as leverage (e.g., race-based data expectations).
  • Center community voices and leadership (internal and external).
  • Address the reality of white supremacy foundations without getting stuck in defensiveness.
  • Emphasize that anti-racism is intellectual and emotional work, including approaches like centering Black joy.

---

Methodology / instruction-like elements (detailed bullet points)

1) Turning values into practical work (dialogical approach)

• Name and acknowledge guiding values (e.g., equity, social justice, and even love as intention/action).
• Use a dialogical tool (described via the panelist’s work) to move from:
  • “We believe in equity” → “What does equity require in our concrete decisions and actions?”
• Translate values into community design and real operational choices:
  • design socially connected communities
  • ensure people are cared for, not merely informed

2) Health promotion “change pathways” emphasized in practice

• Focus on upstream levers:
  • policy changes
  • supportive environments
  • community action
  • reorienting services
• Use cross-sector partnerships because key determinants are outside public health jurisdiction.
• Combine awareness/education with structural changes:
  • not only raising perceived risk, but also enabling action through policy and environment redesign.

3) Example workflow: radon initiative approach

• Identify an underappreciated risk with clear health consequences.
• Diagnose local need/levels:
  • collaborate with relevant federal bodies (Health Canada mentioned)
  • conduct a local study and evaluation
• Plan communication and uptake strategy:
  • use behavioral/decision models (Health Belief Model mentioned)
  • address perceived risk and perceived efficacy
• Assess factors influencing precaution behaviors:
  • use precaution adoption framing (Precaution Adoption Process Model mentioned)
• Implement measurable outcomes with policy support:
  • partner with municipalities/city
  • advocate/support building code changes
• Apply equity lens to affected groups:
  • expand to social housing/community-facing contexts

4) Anti-racism engagement in health units (practical steps)

• Start with internal capacity building to address knowledge/skills gaps.
• Continue with implementation:
  • learn → try → adjust (including the ability to fail and evolve)
• Use standards and mandates as leverage (e.g., race-based data expectations).
• Ensure community engagement/leadership:
  • center community voices inside and outside the health unit
• Create spaces for dialogue rather than positional defensiveness.
• Recognize the emotional component:
  • acknowledge the lived impacts of racism
  • include approaches that sustain well-being (e.g., centering Black joy)

---

Speakers / sources featured (as named in subtitles)

• Monica Nunes (moderator; Knowledge Exchange Specialist, Public Health Ontario)
• Andrea Bodkin (senior program specialist in health promotion, Public Health Ontario)
• Sume Ndumbe Eyoh (Executive Director, Black Health Education Collaborative; Assistant Professor, University of Toronto Dalla Lana School of Public Health)
• Susan Stewart (Director, Community Health and Wellbeing Portfolio, Kingston, Frontenac and Lennox & Addington Public Health; chair roles listed in subtitles)
• Jessica Lefebvre (Health Promotion Specialist, Eastern Ontario Health Unit)
• Mentimeter (platform used during the webinar)
• Pema Ziemer (mentioned as a colleague involved in developing the dialogical tool)
• Pema Ziemer / Martin Luther King / bell hooks (named references used to frame “love” as intention and action)
• Ottawa Charter (1986) (source/framework referenced)
• Lalonde report (1970s) (source/framework referenced)
• Lalonde at 50 (conference referenced)
• Health Belief Model (used in the radon example)
• Precaution Adoption Process Model (used in the radon example)
• Health Canada (partner referenced in the radon work)
• WHO (World Health Organization) (threshold referenced in the radon example)
• Toronto Crisis Response Unit (example referenced)
• Purpose Built Communities (initiative referenced)
• Black Public Health Collective (study referenced regarding anti-Black racism content in courses)
• Health Promotion Ontario (organization referenced; white paper mentioned)
• Office of the Chief Medical Officer of Health / Ministry of Health (referenced as audience for a white paper)
• Toronto Purchase Treaty 13; Toronto Carrying Place Trail; various Indigenous nations/territories (land acknowledgements referenced)
• Dr. Gina Watson Cree (mentioned in the Q&A about experimentation/partner contact)