Health promotion: can it redress the health effects of social disadvantage?

Social disadvantage is an entrenched feature of contemporary New Zealand society and has a deleterious influence on health. Traditional health promotion activities, with their focus on the individual, have had only a limited impact. The World Health Organization is fostering a new approach to health promotion based on the Ottawa Charter, the two most important strategies being: building healthy public policy and strengthening community action. The new health promotion has great potential, especially with its emphasis on 'empowerment', but as yet only indirect evidence supports the effectiveness of this approach. Several current New Zealand community-based initiatives hold promise for the future and three of these are discussed. The greatest challenge is to ensure that the 'empowering' approach to health promotion continues to be developed by Area Health Boards and that this type of health promotion becomes a major priority at all levels of society. As social scientists, we need to support this approach and assist in the production of evidence to show whether it is capable of redressing the health effects of social disadvantage.