Opportunities and challenges for promoting health in a changing world

Issue addressed: A recent review of priorities for the Western Australian Health Promotion Foundation's (Healthway) strategic plan provided us with an opportunity to consider the global context within which health promotion practitioners and policy makers are now operating and implications for current policy and practice in Australia. Methods: Literature review (1998-2003). Results: With some minor modification, risk factors and major causes of death and disability have, by and large, remained much the same since 1998. However, promoting health at the beginning of the 21st century is not the same as promoting health five years ago. A number of global events and trends have practical implications for health promotion policy and practice. Conclusion: This was not meant to be a comprehensive review, but rather an overview to stimulate debate and discussion. We conclude that since our earlier review of health priorities in 1998, "nothing has changed, but everything has changed". In a changing global context, there needs to be: greater emphasis on advocacy to create supportive environments, healthy public policy and legislation; partnerships with sectors outside of health to tackle social determinants of health; and leadership development to facilitate individuals and groups to address these important issues.