To advocate and promote better health for everyone is a bit like favouring world peace or, in the American idiom, loving mom and apple pie. Few can argue against it and very few are critical. Over the past few decades, at least in the wealthier nations on this planet, the activity of health promotion has developed into a discernible and increasingly co-ordinated movement, beginning to develop its own jargon and its own institutions. But the impact of health promotion on the healthiness of individuals and whole communities is seldom dramatic, and its beneficial effects are not easily susceptible to proof.
The publication yesterday by the Minister for Health and Children of a new five-year strategy for the promotion of health is not likely, therefore, to capture the national imagination or provoke either enthusiasm or controversy. But there has been some structural progress since the publication of the State's first health promotion strategy in 1995. There has been a significant development of health promotion units in all the regional health boards to implement whatever policies are developed by the unit within the Department of Health, and there seems also to have been a developing recognition of the need to involve communities and the general public directly in such strategies as those developed by the various local drugs task forces.
There may be some comfort to be drawn from the Minister's acknowledgment that it is "an inescapable reality that poverty is now recognised as having a seriously detrimental effect on health", but this is a fact that has been acknowledged since Victorian times at least. It may also be encouraging that there is to be something called "health proofing" so that developments initiated by Government departments other than Health can be screened before their implementation. The need to have such inter-departmental liaison was mooted at least a quarter of a century ago, but better late than never. The promised establishment of a body to be called the National Health Promotion Forum, to be chaired by the Minister for Health himself, its members to be widely representative, sounds encouraging, but the proof will be in the meeting or, more significantly, in the actions implemented after the Forum's meetings.
The health promotion movement, statutory and voluntary, still has many challenges before it which have not been met in recent decades. Why are immunisation levels still so low here against the common infectious diseases? How come there is a measles epidemic at the moment? Why are smoking levels increasing among some sectors, notably young women, when a general and steady decline in the number of smokers had started some decades ago? Why is it becoming evident that young children need to be taught the dangers of drink? Do parents need to be targeted in health promotion campaigns and, if so, how?
There is, in the newly published, elegantly presented and expensively printed Health Promotion Strategy booklet, an encouraging graph showing a persuasive parallel decline in the prevalence of heart disease and other vascular disorders and this decline must be to some extent the result of earlier health promotion campaigns. So the continuance of health promotion activities is essential. Better targeting of groups at risk of ill-health should help further and more health-focused executive action by the Government in all departments to reduce environmental hazards and other health risks over which individuals have no control would be most welcome.