The final chapter brings together the contributions from all chapters, highlighting how
effective health promotion depends on reaching the settings in which people live, and understanding the
processes of human interaction in these settings. The chapter starts with an analysis of how international
conventions and agreements about health actions (such as those mentioned in chapter 5 and 7) may
influence national policies, and how these are implemented in settings at local levels as discussed in
chapters 3, 4, 6 and 7. The chapter goes on to analyse how implementation of such actions at national
and international level influences the significant social processes in these settings, and why this
influence may result in positive changes in health behaviour and health. The chapter concludes with a
discussion of how systems theory may help to understand how social processes and settings at different
societal levels are linked, proposing an ecological systems model of health promotion including all five
principles of health promotion action as outlined in the Ottawa Health Promotion Charter.
Keywords: Health promotion, health, well-being, Ottawa Health Promotion Charter, settings, social
processes, ecological approach, community approach, international conventions, national policies,
implementation, system theory, ecological systems model.
