Recently I have had a few conversations with teachers about the principles of social justice that are promoted by using the actions areas of the Ottawa Charter. The difficulty comes with the fact that the principles mentioned in Preliminary PDHPE – equity, diversity, and supportive environments – do not match up with those mentioned by the Department of Health who identify: participation, access, equity and rights (PEAR) as the principles of social justice.
For the Department of Health, participation refers to the person’s ability to participate in the decisions around their health. Access is about improving access to education, health products and services, basic resources and more. Equity is concerned with overcoming unfairness caused by unequal access, power and socioeconomic status. And rights refers to a person’s legal, industrial and political rights.
I should note, before we go further, that these principles are not found explicitly on the WHO website let alone mentioned in the Ottawa Charter specifically. The three social justice principles from Preliminary PDHPE, however, can be found more easily (and have written about here). I would suggest this article as an extension from the basic 3 principles covered in Prelim.
When we seek to find these in the five (5) action areas of the Ottawa Charter this is what we see.
Developing Personal Skills
When we look at these social justice principles in developing personal skills, the most obvious are access and equity.Much skill development comes through accessing educational resources (both formal and non-formal) and in order to ensure everyone has equal access the issues of equity arise as education and its resources are expensive, which could limit access. To address this we have free mandatory education for all in Australia, as well as grants to help improve access and equity for those who are less fortunate, or suffer from a disability. Of course in people will achieve higher levels of health related skills if they have a voice and choice in their education (participation) and education has also been established as a right for all Australians.
Creating Supportive Environments
For this action area of the Ottawa Charter participation is fundamental. As the involvement of communities in health promotion strategies helps to create the supportive environment. Here we also see rights get involved as people have a right to a safe working environment for example. Supportive environments is also about equity and acces. We see this as we seek to improve the environments people live in to ensure they have access to basic needs such as clean water and sanitation, as well as safe parks, ovals and other health facilities and services. Equity of access is also achieved by creating a supportive environment because it is creating supportive environments for all, not just those with money and power.
Strengthening Community Action
This action area most clearly aligns with the issue of participation. The goal of both participation and community action is to help individuals and communities be involved in the decision making, development and execution of health promotion initiatives. But strengthening community action also allows people to execute their right to speak and protest against particular decisions around health. it can help ensure people have access and equity as well because the people and community are involved in the decisions and planning, meaning it will help overcome the barriers to access and promote equity to the community.
Reorienting Health Services
This action area helps to promote the rights of the individual, providing them with access not just to treatment, but also to preventative measures. Equity and access are also improved by providing free or subsidised services/products to those who need it.
Build Healthy Public Policy
The social justice principle from the Department of Health that lines up really well with public policy is rights. Policies are used to establish rights and to help provide people with their rights. So we have laws and policies around education to provide everyone in Australia with an education and develop their personal skills. We also have laws around funding of access to health care services and products, which helps to improve the equity of health through health promotion. We also have a say in the development of policies and laws through voting and communicating with our local members and other members of parliament, but also through the use of strengthening community action in the development of policies. All of which promotes the principle of participation.
