Global Health Journal 8 (2024) 91–96

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Global Health Journal

journal homepage: https://www.keaipublishing.com/en/journals/global-health-journal/

RESEARCH ARTICLE

Shaping global health promotion: a comprehensive analysis of the 10

Global Conferences on Health Promotion Conferences (1986‒2021)
Shiyu Liu a,ˆ, Meichen Sun a,ˆ, Na Zhang b, Zhaozhang Sun c, Xiangyang Tian d, Liming Li e,
Youfa Wang a,∗
a Global Health Institute, School of Public Health, Xi’an Jiaotong University, Xi’an, Shaanxi, China
b
School of Nursing, Health Science Center, Xi’an Jiaotong University, Xi’an, Shaanxi, China
c
Department of Culture, Media and Creative Industries, King’s College London, London, United Kingdom
d
Chinese Center for Health Education, Beijing, China
e
School of Public Health, Peking University, Beijing, China

a r t i c l e i n f o a b s t r a c t
Article history: Objective: This study analyzed how the 10 Global Conferences on Health Promotion have played a significant
Received 8 February 2024 role in shaping and promoting a worldwide consensus and actions on health promotion, effectively addressing
Received in revised form 13 May 2024
diverse health challenges that evolved over different periods.
Accepted 22 May 2024
Methods: The textual analysis method was used in this study and text encoding was conducted to systematically
Available online 28 May 2024
examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during
Keywords: 1986‒2021. We summarized the themes and key achievements, and key vocabulary in the conference declarations
Global conference on health promotion was extracted and analyzed to construct the global health promotion consensus and actions.
Health promotion
Results: The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of
Consensus and actions
health promotion on a global scale. The primary purpose and goal are to promote health from regional to global.
Significantly, our findings highlight a transition in the primary actors driving health promotion. It underscores
a shift in health promotion from being driven primarily by organizations like the World Health Organization,
governments, and international bodies, to a more inclusive approach involving non-governmental organizations
and the general public. This development implies that health promotion has evolved into a collective global en-
deavor, demanding the proactive involvement of various stakeholders, and forging new alliances in public health.
Meanwhile, the coronavirus disease 2019 (COVID-19) pandemic has further shaped the landscape of health pro-
motion, underscoring the need for intensified focus on areas including disease prevention, health education, and
the integration of digital health technologies, and emphasizing the importance of a multidimensional, responsive
approach in public health initiatives.
Conclusions: Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally.
Countries, together with public and private entities, should intensify cooperation. Multisectoral collaboration
among partners such as healthcare, education, social security, and the industry is vital for health promotion and
achieving global health goals.

1. Introduction proving their overall health outcomes.1 Broadly defined, health pro-
motion not only underpins primary healthcare systems but also forms
Health promotion is a multifaced social and political process that the core of public health initiatives. By addressing these determinants,
encompasses actions aimed at both enhancing individual skills and ca- health promotion works to optimize their positive effects on both public
pabilities, and transforming the social, environmental, and economic and personal health, underscoring its critical role in the health sector.
determinants that impact health outcomes. This process is fundamen- The advent of modern health promotion can be traced back to the
tally about empowering people—both as individuals and as a collec- first International Conference on Health Promotion, held in Ottawa
tive—to take greater control over these health determinants, thus im- in 1986.2 This pivotal event marked the beginning of a global effort

∗
Corresponding author.
E-mail address: [email protected] (Y. Wang).
ˆ
Joint first authors.

https://doi.org/10.1016/j.glohj.2024.05.002
2414-6447/Copyright © 2024 People’s Medical Publishing House Co. Ltd. Publishing service by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an
open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
S. Liu, M. Sun, N. Zhang et al. Global Health Journal 8 (2024) 91–96

aimed at addressing public health challenges and achieving the vision put forth in each conference document. Microsoft Excel was used for de-
of “Health for all” by the turn of the millennium and beyond. The strate- scriptive statistical analysis and data visualization.
gies advocated in the Ottawa Charter for Health Promotion (Ottawa Char-
ter), such as enhancing health-promoting factors, ensuring health eq-
uity through empowerment, and fostering collaborations across sectors, 3. Results
laid the foundation for subsequent global health promotion efforts. The
World Health Organization (WHO) Global Health Promotion Confer- 3.1. Characteristics of the 10 Global Conferences on Health Promotion
ences have since continued to refine these strategies and established key
action areas for health promotion worldwide. The conference in Shang- Table 1 highlights the historical timeline and key achievements of
hai in 2016,3 themed “Promoting health in the sustainable development the 10 Global Conferences on Health Promotion. The first conference
goals (SDGs): health for all and all for health”, underscored the vital con- was held in Ottawa, Canada in 1986,4 primarily responding to growing
nection between health promotion and the 2030 Agenda for Sustainable expectations for a new public health movement around the world. No-
Development. The Shanghai Declaration on promoting health in the 2030 tably, the most recent installment of the conference, held in 2021, was
Agenda for Sustainable Development (Shanghai Declaration) called for ro- conducted online, adapting to the challenges posed by the coronavirus
bust political interventions to expedite progress on the SDGs, offering disease 2019 (COVID-19) pandemic.5 Over more than 30 years, and
a strategic framework for governments to harness the transformative throughout these 10 conferences, the fundamental principles of health
power of health promotion. promotion have remained resolute. These conferences have consistently
Since 1986, the WHO has convened 10 Global Conferences on Health demonstrated an unwavering commitment to fostering consensus and
Promotion with the overarching goal of fostering the understanding, initiating actions in the realm of health promotion on a global scale.
agreement, and implementation of health promotion principles on a Their dedication to this cause has yielded remarkable progress and tan-
worldwide scale. These conferences have served as an important plat- gible outcomes.
form for worldwide exchanging best practices, developing evidence- The developmental process and evolution of the themes from the 10
based strategies, and fostering international cooperation. They high- Global Conferences on Health Promotion from 1986 to 2021 provides
lighted that health promotion is not solely the responsibility of indi- a high-level overview of how the focus of global health promotion has
vidual nations but also a collective global commitment that requires shifted over time to remain responsive to changing needs and priori-
joint efforts from governments, civil society, academia, and the private ties. The first conference, named the International Conference on Health
sectors. Promotion, was held in Ottawa, Canada in 1986. This conference was
This study provides a comprehensive review of the declarations and convened in response to growing expectations for a new public health
reports presented in the 10 Global Conferences on Health Promotion, movement around the world, building on the progress made through
summarizing their developmental processes and outcomes. Through a the Declaration of Alma-Ata and the debates at the World Health As-
thorough investigation of the content and outcomes of these confer- sembly on intersectoral action for health.4 This conference built on the
ences, this study offers valuable insights and guidance for future health progress made through the Declaration of Alma-Ata, and the recent de-
promotion globally. It not only sheds light on the historical develop- bate at the World Health Assembly on intersectoral action for health,
ment and progression of global health promotion conferences but also focusing on the needs of industrialized countries, but considering simi-
provides a roadmap for policymakers, non-governmental organizations lar concerns in all other regions. The Ottawa Charter on health promo-
(NGOs), and healthcare providers engaged in the global public health tion, released during this first conference, identified five key action ar-
arena. This contributes to the broader goal of creating a healthier, more eas: Building Healthy Public Policy, Creating Supportive Environments,
interconnected world, united in the pursuit of optimal Health for All. Strengthening Community Actions, Developing Personal Skills, and Re-
orienting Health Services.4 These action areas formed the foundational
2. Methods and materials framework that guided the subsequent development of global health
promotion.6
This study employed a textual analysis approach to systematically Each successive conference theme was chosen to address the evolv-
examine the declarations, statements, and reports from the 10 Global ing needs, challenges, and priorities in global health promotion at the
Conferences on Health Promotion held from 1986 to 2021. All relevant time. For example, the second conference in Adelaide, Australia in
documents were sourced from the WHO’s official website (https://www. 1988 focused on “Healthy Public Policy”,7 recognizing the importance
who.int/teams/health-promotion). of policy-level interventions in creating supportive environments for
To perform the textual analysis, two graduate students indepen- health. The third conference in Sundsvall, Sweden in 1991 built on this
dently conducted close readings of the texts. A pre-defined coding by emphasizing “Supportive Environments for Health” across physical,
scheme was developed based on a preliminary literature review and social, economic, and political dimensions.8
foundational concepts from the Ottawa Charter. This scheme included As the world entered a new millennium, the 5th conference in Mexico
variables such as key themes, action areas, and stakeholders mentioned City in 2000 brought attention to “Bridging the Equity Gap”, acknowl-
in each conference document. Each text was coded using these variables edging the persistent health inequalities within and between countries.9
to categorize information systematically. Discrepancies in coding were The 6th Global Conference on Health Promotion was held in Bangkok,
resolved through discussion, and when necessary, a senior researcher Thailand in 2005. The conference theme was “Policy and Partnership
was consulted to reach a consensus. for Action: Addressing the Determinants of Health”. It emphasized the
The evolution of conference themes was traced through a chrono- importance of multi-sectoral collaboration and policy coherence in tack-
logical analysis of the stated themes and focus areas of each successive ling the underlying social, economic, and environmental determinants
conference. This allowed for the identification of shifting priorities and of health.10 The 7th conference in Nairobi, Kenya in 2009, with its
emerging challenges in global health promotion over time. “Impact” was theme of “Promoting Health and Development: Closing the Implemen-
defined as the tangible outcomes, commitments, and actions resulting tation Gap”, highlighted the need to translate knowledge and commit-
from each conference, as evident in their respective declarations and ments into action.11 The 8th Global Conference on Health Promotion
statements. Specific attention was paid to how these impacts aligned was held in Helsinki, Finland, in June 2013, with the theme “Health
with and advanced the central tenets of the Ottawa Charter established in All Policies: Framework for Country Action”. This conference empha-
in the first conference. To understand how the conferences shaped and sized the importance of integrating health into all public policy decisions
promoted global health promotion consensus and actions, we conducted and called for collaboration among governments, civil society, and the
a thematic analysis of the key strategies, frameworks, and calls to action private sector to promote health for all.12

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Table 1
Key information and achievements of the 10 Global Health Promotion Conferences Held during 1986‒2021.

Session Year Location Conference theme Background Key content Key achievements

1st 1986 Canada, Ottawa The Ottawa Charter for The 1978 Alma-Ata Declaration on Set the theoretical basis The Ottawa Charter
Health Promotion Primary Health Care, the World Health of health promotion
Organization’s Targets for Health for
All document, and the recent debate
at the World Health Assembly on
intersectoral action for health
2nd 1988 Australia, Adelaide Adelaide Inheriting the spirit of the Alma-Ata Four key areas as The Adelaide
Recommendations on and Ottawa conferences and taking priorities for health Recommendations
Healthy Public Policy this as an opportunity public policy for
immediate action
3rd 1991 Sweden, Stockholm Supportive Environments The UNICEF/WHO International Four dimensions of The Sundsvall
for Health Conference on Primary Health Care, action on supportive Statement
in Alma-Ata (1978), and the First environments for health
International Conference on Health
Promotion in Industrialized Countries
(Ottawa 1986)
4th 1997 Indonesia, Jakarta New players for a new The critical moment in the Define effective health The Jakarta
era - leading health development of international promotion, re-examine Declaration
promotion into the 21st strategies for health. It is almost 20 the determinants of
century years since the World Health health, identify strategic
Organization’s Member States made directions, and formulate
an ambitious commitment to a global actionable strategies.
strategy for Health for All and the
principles of primary health care
through the Declaration of Alma-Ata
5th 2000 Mexico, Mexico City Health Promotion: The advances of the previous four The importance of The Mexico
Bridging the Equity Gap International Health Promotion addressing health Ministerial Statement
Conferences, particularly taking inequalities among
forward the priorities of the last different population
International Conference on Health groups through health
Promotion held in Jakarta, Indonesia promotion efforts.
in 1997
6th 2005 Thailand, Bangkok Policy and Partnership To meet the challenges including the Commitments and The Bangkok Charter
for Action: Addressing impact of globalization, the internet, pledges required to
the Determinants of greater moves towards private sector address the determinants
Health involvement in public health, and to of health in a globalized
better exploit the opportunities world through health
presented for health promotion in the promotion
21st Century
7th 2009 Uganda, Nairobi Promoting health and As the aspirations of global health are Closing implementation The Nairobi Call to
development: closing the falling short of the achievable, the gaps in health and Action
implementation gap burden of ill-health is increasingly development through
recognized to be inequitably health promotion
distributed, between and within
countries
8th 2013 Finland, Helsinki Health in All Policies Builds on a rich heritage of ideas, Health for All is a major The Helsinki
(HiAP) actions and evidence that have societal goal of Statement
emerged since the Alma Ata governments, and the
Declaration on Primary Health Care cornerstone of
(1978) and the Ottawa Charter for sustainable development
Health Promotion (1986)
9th 2016 China, Shanghai Promoting Health in the The SDG agenda is a new context and Health and The Shanghai
Sustainable Development renewed urgency for health well-beingessential to Declaration on
Goals promotion and an opportunity for achieving sustainable Promoting Health;
WHO and its partners development, promoting The Shanghai
health through action on Consensus On Healthy
all the SDGs and making Cities
bold political choices for
health.
10th 2021 Online Conference Health Promotion for The world faces complex and Outlines the necessary The Geneva Charter
Well-being, Equity and interrelated crises, but they impact elements of a “well-being for Well-Being
Sustainable Development countries in different ways, require society” and what needs
investments that integrate planetary, to be done in order to
societal, community and individual better prevent and
health and well-being, as well as respond to the multiple
changes in social structures to health and ecological
support people to take control of their crises we face globally
lives and health

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The 9th conference in Shanghai, China in 2016 focused on “Pro- In conclusion, these keywords reflect the concern of the Global Con-
moting Health in the Sustainable Development Goals”, recognizing the ference on Health Promotion to build global cooperation, drive policy
integral role of health promotion in achieving the United Nations’ 2030 change, and promote social equity and sustainable development.
Agenda for Sustainable Development. The 10th conference, held vir-
tually in 2021 due to the COVID-19 pandemic, emphasized “Health 3.3. Progress in constructing the global health promotion consensus and
Promotion for Well-being, Equity and Sustainable Development”, un- actions
derscoring the importance of health promotion in building societal re-
silience and addressing global inequities. Over the past three decades of dedicated efforts, the conferences
have strengthened consensus on global health promotion, and taken
proactive measures to translate this consensus into global actions and
3.2. Key terminology in the 10 conferences initiatives. The primary purpose and goal of these conferences are to
promote health from regional to global. There has been a transition
Through the extraction and analysis of key vocabulary in the confer- from emphasizing the WHO, international organizations, and govern-
ence declarations. “Health Promotion” is the most frequently used word, ments as the main actors, to acknowledging the vital contributions of
indicating that the Conference Declaration emphasizes the importance non-governmental organizations, civil society, academia, the business
of health promotion and its close relevance for global development. It sector, private enterprises, communities, and the general public.
is essential for global health, public health, and social health develop- Initially, the conferences primarily centered on regional health is-
ment. Fig. 1 shows the key vocabulary in the declarations of the 10 con- sues and diseases, such as specific outbreaks of infectious diseases. How-
ferences. The words “sustainable” and “policy” suggest that sustainable ever, as health challenges increasingly took on a global dimension, the
development and policy formulation are key priorities in the Conference scope of discussion expanded to include topics like health inequality,
Declaration, including formulating sustainable policies in the health sec- disease burden, non-communicable diseases, the repercussions of cli-
tor to drive global health. The presence of “global” and “action” indi- mate change on health, and global health security. The inaugural con-
cates a focus on global action and collaboration, emphasizing collabo- ference focused on the health challenges faced by industrialized nations
rative efforts among countries to address global health challenges. while taking into account other regions, especially developing countries.
Furthermore, the terms “social”, “equity”, and “community” indicate As globalization advances, health concerns in developing countries have
a concern for social equity and community engagement. This implies increasingly taken center stage. Notably, the 4th conference, held for
that the conference declaration emphasizes eliminating health dispari- the first time in a developing country, underscored the growing atten-
ties in global health promotion and encourages community-level partici- tion to health disparities between developing and developed nations.13
pation. The occurrence of “policy”, “public”, and “goals” shows that the The fifth conference, the first conference of the new century, transi-
conference declaration is concerned with policy formulation and goal tioned its name from “international” to “global”,9 distinctly reflecting
achievement. This may involve advocating for the development of poli- the conference’s fundamental mission of fostering global health promo-
cies supporting health promotion at various levels of government and tion. The Mexico Ministerial Statement, signed by 89 countries during the
setting relevant goals. The words “agenda”, “charter”, and “partnership” 5th conference, further accentuated the profound global focus on health
suggest that the conference declaration emphasizes alignment with the promotion.
global agenda, involving partnerships with different organizations and The subsequent conferences have persistently worked towards con-
institutions to collectively advance health promotion. structing a global consensus on health promotion. In terms of health

Fig. 1. Key vocabulary in the declarations of the 10 global health conferences held during 1986‒2021.

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determinants, the consensus places the highest emphasis on socioeco- According to the World Health Statistics 2023 released by the WHO,14
nomic factors because of their profound influence on health. The Ot- non-communicable diseases (NCDs) continue to prevail and affect all
tawa Charter on health promotion identified five principal areas of ac- countries worldwide, with diseases such as obesity, cardiovascular dis-
tion to steer global health promotion endeavors. These areas encom- eases, diabetes, and cancers on the rise worldwide related to changes
pass: Build Healthy Public Policy, Create Supportive Environments, in lifestyles and environmental factors. Health promotion needs to pay
Strengthen Community Actions, Develop Personal Skills, and Reori- more attention to the prevention and management of these diseases.
ent Health Services.6 These domains are interdependent; the estab- Concurrently, mental health issues are becoming increasingly promi-
lishment of public health policies facilitates the remaining four ac- nent,14 especially in the face of global pandemics such as COVID-19,
tions. The creation of supportive environments is intrinsically tied to and societal stressors. Addressing mental health has become an urgent
health outcomes, necessitating environments, including material, so- and indispensable matter. Health promotion must be proactive and re-
cioeconomic, and political factors, that contribute positively to health. sponsive to the broader environmental, commercial, and political deter-
Given the vast social determinants of health, integrating health into minants that frequently underlie poor health and well-being.15
all policies extends the scope of health service adjustments. Health is Furthermore, health inequalities are growing more evident, since in
an integral aspect of sustainable development, and health promotion many countries, health disparities persist, with vulnerable populations
needs to fundamentally adapt to align with the overarching goals of enduring higher health risks. Directly targeting these disparities is im-
the 2030 Agenda for Sustainable Development. Health promotion has perative for health promotion efforts. Additionally, the negative health
evolved into a collective global endeavor, demanding the proactive in- impacts of extreme weather events and environmental changes from cli-
volvement of various stakeholders, and forging new alliances in public mate change are expected to be far-reaching. All such global and local
health. challenges need global efforts and cooperation to be addressed.
In the post-COVID-19 pandemic era, the emphasis placed by the con-
ference on health promotion infrastructure development and related ex-
4. Discussion periences will play a crucial role in future health-related crises. Geopo-
litical crises and economic recessions highlight the importance of main-
The 10 Global Conferences on Health Promotion have played a piv- taining global stability and social equity. The themes of the confer-
otal role in shaping the global health promotion agenda over the past ence centered on fairness, bridging gaps, and equitable distribution of
three decades. The WHO has continuously implemented and expanded healthcare resources are poised to sculpt a more egalitarian and just
the key principles of health promotion, from placing it within the society. We suggest that for forthcoming global health promotion en-
broader context of globalization to connecting it with the Sustainable deavors, several pivotal areas can be further fortified: (1) Disease pre-
Development Goals.3 , 10 Reviewing these conferences provides valuable vention and health education: Adhering to the adage that prevention
lessons and insights for the future of global health promotion, particu- is superior to cure, an effective preventive strategy demands a holis-
larly in the post-COVID-19 era. tic approach that underscores a salubrious lifestyle and tackles all sig-
One of the key lessons learned is the importance of adapting health nificant risk vectors.19 Strengthening health education, raising aware-
promotion strategies to address evolving global challenges. The 9th con- ness, encouraging healthy diets, and lifestyles can effectively curb the
ference in Shanghai signaled a crucial shift towards aligning health pro- prevalence of numerous chronic non-communicable diseases. (2) Digital
motion with the SDGs, underscoring the need to update the Ottawa Char- health and technological innovation: The swift strides in digital health
ter’s action areas to effectively drive sustainable development. The 10th and medicinal technology herald novel avenues for health enhancement.
conference further emphasized the urgent need to build a “well-being so- Such advancements are instrumental in furnishing healthcare services
ciety” that balances health and ecological sustainability.5 These lessons to the vulnerable and immunocompromised globally. Harnessing digi-
highlight the necessity of a flexible and responsive approach to health tal health innovations, such as the proliferation of telemedicine, health
promotion that can tackle emerging issues. surveillance, and data scrutiny, can elevate the efficacy and reach of
Despite progress made, significant health challenges remain and health services. (3) Environmental health: Global environmental shifts
new ones have emerged. Non-communicable diseases continue to bur- are set to shape the well-being of present and future generations. The
den countries worldwide, with rising rates of obesity, cardiovascular consequences manifest directly - as seen with escalated frequencies and
diseases, diabetes, and cancers linked to lifestyle and environmental intensities of extreme weather phenomena - and indirectly, channeled
changes.14 Mental health issues are also increasingly prominent, ex- through ecological and societal frameworks, such as water-transmitted
acerbated by global crises like the COVID-19 pandemic.14 Moreover, and vector-linked diseases, migration, and discord.20 Fusing health pro-
persistent health inequalities, climate change impacts, and geopolitical motion with environmental conservation, acting against climatic shifts,
instability pose further challenges to global health.15 mitigating pollution, and ensuring access to pristine water and air can
To address these issues, health promotion must build on past lessons profoundly ameliorate health standards. And (4) social health equity:
while embracing new approaches. Reviewing these conferences can pro- Reducing health disparities is important and is a priority supported by
vide some useful insights into the future of global health promotion in the United Nations in the developmental goals, but this faces numerous
the post-COVID-19 pandemic era, when global health faces unprece- challenges. It is essential to ensure that individuals, irrespective of their
dented challenges and opportunities. More than ever, the critical impor- socioeconomic positioning, can avail themselves of elementary health-
tance of health promotion and close international collaboration is unde- care services. Relevant government agencies need to provide related
niable. The COVID-19 pandemic has affected and challenged mankind support for the efforts.
greatly, both in personal lives and in health promotion endeavors. A Looking ahead, the success of global health promotion will depend
reactive approach to health crises is untenable; instead, health promo- on sustained cooperation and innovative strategies. International and
tion must be proactive, and have the capacity to respond effectively and multisectoral partnerships, engaging governments, NGOs, businesses,
rapidly to emerging crises.16 The COVID-19 pandemic has demonstrated and communities, will be instrumental in tackling complex health chal-
the limitations of focusing solely on individual responsibility and behav- lenges. To actualize this vision, enduring collaboration and inventive
ioral interventions when addressing multifaceted public health issues.17 strategies are essential. Cooperation is fundamental to achieving this
As we navigate this new era, it is imperative that we cultivate a renewed ambitious goal. On one hand, international cooperation is paramount.
generation of public health leadership, one that is well-equipped, es- The emergence of public-private partnerships in global health is piv-
teemed, and effectively managed. The lessons learned from this pan- otal for advancing sustainable growth and fortifying health systems in
demic should propel us towards a more holistic, integrated, and antici- developing nations. Countries, together with public and private enti-
patory approach to public health.18 ties, should intensify cooperation on global health issues, sharing ex-

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periences and jointly tackling transnational diseases and other health Formal analysis. Na Zhang: Writing – original draft. Zhaozhang Sun:
challenges. On the other hand, multisectoral collaboration is crucial. Writing – review & editing. Xiangyang Tian: Writing – review & editing.
Recognizing the significance of a structured and systemic approach to Liming Li: Writing – review & editing, Conceptualization. Youfa Wang:
health-promotion interventions paves the way for successful intersec- Writing – review & editing, Conceptualization, Methodology, Project ad-
toral collaborations. Engaging various sectors, such as healthcare, ed- ministration, Funding acquisition.
ucation, social security, and the economy, is indispensable given the
intricate nature of health challenges. Competing interest

5. Conclusion The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
The comprehensive review and analysis presented in this research the work reported in this paper.
underline the significant strides made by the 10 Global Conferences on
Health Promotion from 1986 to 2021 in shaping and steering global Availability of data and materials
health promotion. This study elucidates the evolution of health promo-
tion, marking its transition from a series of regional initiatives to a co- The data that support the findings of this study are available on re-
hesive global commitment with profound implications for public health quest from the corresponding author.
policy and practice worldwide.
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