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Social inequalities in health from Ottawa to Vancouver: action for fair equality of opportunity

International Health Unit, Faculty of Medicine, University of Montreal, Montreal, Canada, valery.ridde{at}umontreal.ca

Anne Guichard

Institut National de Prévention et d'Éducation pour la Santé, Paris, France

David Houeto

Université Catholique de Louvain, École de santé publique, Bruxelles, Belgique

The authors set out to show that the Ottawa Charter of 1986 has not been sufficiently accepted over the past twenty years, even by those who use it as a strategic tool to guide interventions for reducing social inequalities in health. Although some public health policies do emphasize the reduction of social inequalities in health, only the Ottawa Charter appears to possess the status of an international declaration on the matter. Social inequalities in health are the systematic, avoidable, and unjust differences in health that persist between individuals and sub-groups of a population. Four examples from the field of health promotion serve to show that forgetting to combat social inequalities in health is not exclusive to the domain of public health. However, taking action against social inequalities in health does not equal tackling poverty. Moreover, intervening on the principle of equality of opportunity, on the basis of an ideology of meritocracy, or for the benefit of the population as a whole, without regard to sub-groups, only tends, at best, to reproduce inequalities. Although evidence is insufficient, there are studies that show that reducing social inequalities in health is not an aporia. Three explanations are advanced as to why social inequalities in health have been ignored by health promotion professionals. The Ottawa Charter had the merit of highlighting the struggle against social inequalities in health. Now, moving beyond the declarations, from the strategic framework provided by the Ottawa Charter and in accordance with the Bangkok Charter, it is time to show proof of voluntarism. Several priorities for the future are suggested and the International Union for Health Promotion and Education (IUHPE) should be responsible for advocating for them. (Promotion & Education, 2007, Supplement (2): pp 12-16).

Key Words: Ottawa Charter • IUHPE • public policies

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Promotion & Education, Vol. 14, No. 2 suppl, 12-16 (2007)
DOI: 10.1177/10253823070140020601x


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ridde, V. Articles by Houeto, D. Search for Related Content PubMed PubMed Citation Articles by Ridde, V. Articles by Houeto, D. Pubmed/NCBI databases Medline Plus Health Information Exercise for Children Exercise and Physical Fitness Social Bookmarking                         What's this?