Implementation of the Bangkok Charter's health promotion strategies in Korean health promotion efforts at the municipality level

Myoung-Soon Lee; Jang-Rak Kim; Min-Jung Kang

doi:10.5124/jkma.2011.54.10.1081

J Korean Med Assoc > Volume 54(10); 2011 > Article

Lee, Kim, and Kang: Implementation of the Bangkok Charter's health promotion strategies in Korean health promotion efforts at the municipality level

Healthcare Policy

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(10): 1081-1100.

Published online: October 12, 2011

DOI: http://dx.doi.org/10.5124/jkma.2011.54.10.1081

Implementation of the Bangkok Charter's health promotion strategies in Korean health promotion efforts at the municipality level

Myoung-Soon Lee, MD¹, Jang-Rak Kim, MD², Min-Jung Kang, MSW¹

¹Department of Social and Preventive Medicine, Sungkunkwan University School of Medicine, Suwon, Korea.

²Department of Preventive Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.

Corresponding author: Myoung-Soon Lee, msnlee@skku.edu

Received September 01, 2011 Accepted September 16, 2011

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To address effectively health determinants and challenges in the rapidly changing global context of the 21st century, the Bangkok Charter for Health Promotion was adopted at the Sixth Global Conference for Health Promotion in 2005. According to the Bangkok Charter, all sectors and settings of society are required to implement five strategies for health promotion: they must be advocates for health and health promotion, make strategic investments in their policies and programs, build capacity, regulate and enact appropriate legislation, and build partner alliances with other actors for health promotion. The purpose of this study is to assess the extent to which Korea has implemented the health promotion strategies of the Bangkok Charter. To facilitate more effective approaches to promote health in Korea, we sent survey questionnaires to 224 local public health centers throughout the country. We received responses from 384 professionals in 145 of these public health centers. Our analysis of these surveys indicates that basic concepts of health promotion as well as important approaches and health promotion strategies have not been effectively utilized in the Korean context. This is particularly true of efforts to regulate and legislate in the public health field, and to partner and build alliances for health promotion. Efforts in these areas have been inadequate and not given enough priority within the field as a whole. With a concerted effort to implement these strategies for health promotion in all sectors and all settings of Korean society, we can expect more effective interventions and approaches for promoting health and to achieve a higher level of overall societal health.

Bangkok Charter; Health promotion; Health promotion strategies; Korea

Acknowledgment

The authors would like to thank Gong-Hyun Kim, Chong-Hee Cho, Hye-Kyung Hwang, Min-Soo Park, Steven Hugh Lee, and all the participating health officials from local public health centers across Korea. This study was supported by a grant from National Health Promotion Fund, Ministry of Health and Welfare, Republic of Korea.

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Figure 1

Local public health center directors' perceived importance and perceived implementation of the Bangkok Charter's health promotion strategies at the municipality level in Korea (n=118). As measured using Likert 5 scales.

Figure 2

Local public health center middle managers and frontline workers' perceived implementation of the Bangkok Charter's health promotion strategies in four health promotion programs at the municipality level in Korea (n=250). As measured using Likert 5 scales.

Table 1

The social demography of survey participants (N=384)

^a)( ) No. of participating local public health centers.

Table 2

The survey instrument

( ) presented as no. of items.

NA: not applicable.

^a)As measured using Likert 5 scales.

^b)The directors of local public health centers (PHCs) assessed the extent to which the Bangkok Charter's health promotion strategies had been implemented at the municipality level in Korea in the decade after 1995; the middle managers and the frontline workers of PHCs focused their assessment on four health promotion programs over the year of 2005-2006: tobacco control, alcohol use, physical activity, and diet.

^c)Cronbach's α was calculated in each group of directors, middle managers and frontline workers.

Table 3

Public health centers (PHCs) implementation of the Ottawa Charter's health promotion concepts and approaches at the municipality level in Korea

^a)We measured PHC health officials' responses by using Likert 5 scales (1: not implemented at all, 2: very little effort made to implement, 3: some effort made to implement, 4: partly implemented, 5: thoroughly implemented).

^b)Difference of the perceived extent of implementation of the Ottawa Charter, according to different positions in the division of labor (directors, middle managers, or frontline workers) amongst health officials by ANOVA test was statistically significant (p<0.05).

Table 4

The perceived importance of the Bangkok Charter's health promotion strategies, by various levels of health officials at local public health centers in Korea

Values are presented as mean (SD). As measured using Likert 5 scales (1, not important at all; 2, little important; 3, somewhat important; 4, important; 5, very important). p-value by ANOVA test.

Table 5

Health officials'perceived implementation of the Bangkok Charter's health promotion strategies at the municipality level in Korea

Values are presented as mean (SD). As measured using Likert 5 scales (1, not important at all; 2, little important; 3, somewhat important; 4, important; 5, very important).

^a)The directors of local public health centers (PHCs) assessed the extent to which the Bangkok Charter's health promotion strategies had been implemented at the municipality level in Korea in the decade after 1995.

^b)The middle managers and the frontline workers of PHCs focused their assessment on four health promotion programs over the year of 2005-2006: tobacco control, alcohol use, physical activity, and diet.