Health promotion in public health : philosophical analysis

Health promotion can reasonably be viewed as a major element in public health work. The latter was defined around a century ago as “the science and art of preventing disease, prolonging life and promoting health through the organized efforts of society.” Health promotion involves (i) health education, such as advertising; (ii) illness prevention, such as screening; and (iii) legislation, such as banning smoking in public places. Although it has older roots, it is largely a phenomenon of the mid-twentieth century and beyond. Three factors stimulated its development. The first was the development of epidemiology and in particular the work showing the link between smoking and illness followed by success in reducing smoking in the population. The second was the increased cost of health care in its standard form of illness treatment. And the third was a concern that despite improvements in health and, in the UK, the inception of a National Health Service, the inequality in health status between rich and poor remained and even grew. The philosophical questions concerning health promotion fall into three categories: the philosophy of science, ethics, and political philosophy.