The implications of the professionalization of health promotion in Canada: a response to JR Graham's letter to the editor - HPCDP: Volume 37-5, May 2017

Volume 37 · Number 5 · May 2017

Letter to the Editor
The implications of the professionalization of health promotion in Canada: a response to JR Graham's letter to the editor

Thierry Gagné, MScauthor note 1,author note 2; Josée Lapalme, MAauthor note 1,author note 2; Janette Leroux, MScauthor note 3,author note 4

Author references:

Correspondence: Thierry Gagné, 7101 ave du Parc, office 3139, Montréal, QC H3N 1X9; Email:


  • Health promotion represents two related concepts: a discourse on the place of health in societies and a specialized field of intervention within the broader field of public health.
  • A singular focus on professionalizing health promotion may impede the capacity of its discourse to permeate other public health professional bodies.
  • Initiatives that include and go beyond the development of professional resources are needed to help sustain its dedicated workforce and institutionalization.

Health promotion is often understood through two related definitions: a discourse on the place of health in societies and a specialized field of intervention (e.g. practice) within the broader field of public health.Footnote 1 To strengthen health promotion practice in Canada, starting in 2006, Health Promotion Ontario (HPO) members conducted literature reviews and developed the first set of discipline-specific competencies in line with the Public Health Agency of Canada's (PHAC) 2005 Core Competencies for Public Health in Canada. Following this work, a Pan-Canadian Network for Health Promoter Competencies (PCNHPC) was consolidated and conducted practitioner consultations across Canada that culminated in the publication of the national Health Promoter Competencies in November 2015.Footnote 2

JR Graham recently questioned whether this focus on competencies will lead to a narrowed "professionalization" of health promotion, which may in turn hinder the capacity of its discourse to influence other public health professional bodies.Footnote 3 Critics may further question any attempt to professionalize health promotion: how can health promotion proponents advocate for an independent profession when they also promote moving beyond professional cleavages and working collaboratively with other sectors? Such critiques may also find an echo in keeping with the fledgling state of the health promotion discourse in Canada today, which has endured repeated downfalls since its modern inception with the 1986 WHO Ottawa Charter for Health Promotion and its ensuing "Golden Age" in the late eighties and nineties among Canadian governmental and academic institutions.Footnote 4

We argue that such critiques miss the diversified and often precarious nature of health promotion practice in Canada today. Unlike Graham suggests, health promoters are no longer "the new kids on the block" and represent instead an increasingly marginalized fringe in the public health workforce in keeping with narrowing budget priorities and strict mandate orientations. In this context, health promotion competencies that contribute to the legitimization of their work become vital resources. The function of creating a distinct professional space for health promoters is not to turn health promotion into the next public health, but to create an identity and space for people who are doing important health promotion work but who are rarely professionally represented in the many diverse settings and sectors in which they work.

Sustaining health promotion may involve its joint development as both a discourse and a field of practice. Unbeknownst to Graham at the time of his publication, members of the PCNHPC continued working together after November 2015 towards a new organization, Health Promotion Canada (HPC), with the intention of promoting a broader mandate related to health promotion.Footnote 5 Building on its earlier achievements, HPC aims to facilitate the development of provincial chapters dedicated to health promotion professionals with an overarching national infrastructure. While championing a core professional mandate, HPC broadened its strategy by integrating senior and junior academics as executive members. In addition, it is now planning to foster a larger space for academic and professional exchange and knowledge transfer as well as integrate other regional, national and international organizations already devoted to advancing health promotion.

We thank JR Graham and the HPCDP journal for engaging in a challenging debate on the development of health promotion in Canada. Professionalization indeed fits into broader problematic trends of neoliberalism, to which the health sector is not immune, and a critical stance is essential to ensure that any professionalizing actions do not detract or distract from the core efforts of promoting health. We argue here that the Competencies and the formation of HPC contribute to the development and sustainability of the field, but we invite others to join and continue in this discussion.


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