Health promotion is not often associated with the health needs of people with disabilities, because disability is usually viewed as a unchangeable health problem. A person with paraplegia as a result of spinal cord injury, for example, might not be considered a good candidate for health promotion, since her or his health has already been affected by injury.

But all people with disabilities have as much need for health promotion as the general population, if not more. The person with a spinal cord injury needs to understand how to care for herself/himself, get enough exercise and eat healthy meals. People with disabilities are at risk of the same health conditions as others; and they may also have additional health problems due to greater susceptibility (related or not to their disabilities).

Often, people with disabilities and their family members have very little awareness of how they can achieve or maintain good health.

People with disabilities often experience poorer levels of health than the general population, both because of their impairments and because of the many barriers they face when trying to improve their health.

Many people with disabilities require support from others, particularly family members, who may as a result experience stress-related physical and emotional illness, reduced ability to care for other family members, reduced time and energy for work or reduced social interaction and stigmatization.

Maintaining the health of family members is essential. (To learn more, see the Social module.)

The Ottawa Charter for Health Promotion outlines five areas for action which can be used to help develop and implement health promotion strategies.

1. Build healthy public policy – develop legislation and regulations across all sectors which protect the health of communities by ensuring safer and healthier goods and services, healthier public services and cleaner and more enjoyable environments.
2. Create supportive environments for health – make changes in the physical and social environments to ensure that living and working conditions are safe, stimulating, satisfying and enjoyable.
3. Strengthen communities – adopt community approaches to address those health problems that have strong environmental, socioeconomic and political components. Empower communities to set priorities, make decisions and plan and implement strategies to achieve better health.
4. Develop personal skills – develop people’s skills by providing information and health education to enable them to exercise more control over their health and environment and make better choices to improve their health status.
5. Reorient health services – the health sector must move increasingly towards health promotion, beyond its responsibility of providing clinical and curative services. Health promotion strategies can be applied to different:
   • population groups such as children, adolescents or older adults
   • risk factors such as smoking, physical inactivity, poor diet or unsafe sex
   • health or disease priorities such as diabetes, HIV/AIDS, heart disease or oral health
   • settings such as community centres, clinics, hospitals, schools or workplaces.

Individuals have enormous potential to influence their own health outcomes; and participatory approaches in health promotion are important, as they allow people to exert greater control over the factors which affect their health. Health issues need to be addressed through working with others rather than by doing things for them.