Health promotion, the Ottawa Charter and 'developing personal skills': a compact history of 25 years.

The challenge of understanding what has happened in the 25 years since the Ottawa Charter would be difficult enough if there had been no Charter. However, our task is to interpret to what extent the Charter has influenced the world of health promotion as it is today. The task here is to consider what has happened regarding one action component of the Charter, notably developing personal skills. In taking only one of the five components, we are deconstructing the holistic approach that was implied in the Ottawa Charter and it is somewhat strange to isolate this action area from the others, and perhaps outside the 'spirit' of the Charter. Nonetheless, the approach will be to interpret this area broadly while still being restrictive and not venturing into discussions of the other action areas except where the connection is so strong that to isolate personal skills from the other area would be unproductive. The Ottawa Charter brought to the table, for health promotion and education, a growing recognition that health was a broad concept in its own right. It made explicit that ties to disease approaches were highly related to health education and promotion, but that health promotion had to go well beyond a narrow interpretation of the field. It recognized that active participation by people, to directly affect their health and the broader determinants of it, was paramount.