The year in review—Health Promotion International 2023 Free

A YEAR OF TRANSFORMATION FOR HEALTH PROMOTION INTERNATIONAL

In 2023, we embarked on an exciting new era of Health Promotion International to which we were appointed as the new Editorial team. Our first editorial in February 2023 argued that we faced a critical time for both people and planet, with the need for bold and transformational thinking from the health promotion community that would challenge the status quo, while embracing core principles of human rights, social justice, health equity and collective responsibility (Thomas and Daube, 2023).

We welcomed eight new Associate Editors from six countries to the team, as well as two new social media coordinators, and new Advisory and Editorial Board members from ten countries, joining our journal founders Professor Ilona Kickbusch and Emeritus Professor John Catford. In 2024, we look forward to further strengthening representation from lower- and middle-income countries (LMICs), practitioners and First Nations communities. We are particularly proud of the appointment of ten Early Career Researchers (ECRs) who have helped to guide all aspects of the journal. Our ECRs are innovative thinkers and were instrumental in developing the new Mike Daube Early Career Advocacy Series - a series designed to support ECRs to publish innovative review and perspective pieces on contemporary public health and health promotion issues (Daube, 2023). Our ECRs also participated in writing editorials for the journal and supported the launch of our new author video page, where researchers have the opportunity to create a video abstract to showcase important findings from their papers. We also released special themed collections on the Commercial Determinants of Health (CDoH), Health Literacy, the Digital Determinants of Health (DDoH), and Participatory Approaches in Health Promotion.

We established a range of priority areas for the journal to reflect important health promotion and public health priorities. Health policy, advocacy, the commercial and political determinants of health, and the climate crisis have joined well established areas of health promotion such as health literacy, public messaging campaigns, health promotion in sports settings and schools, and mental health promotion. We launched a call for papers on special issues about the CDoH and DDoH which will be published in 2024, as well as a new section focusing on a broad range of review articles. It has been encouraging to see some manuscripts submitted to the journal on the climate crisis and planetary health, and we would like to see an increased focus on these issues in 2024. Research published in 2023 demonstrates the vital role of health promotion in improving health and equity for populations.

One of our central aims in 2023 was to ensure that the journal published perspectives from a wide range of voices across the globe. While we are delighted to have seen a substantial increase in the number of manuscripts submitted to the journal, we recognize there is still much work to do in providing equitable publishing opportunities for LMIC and First Nations scholars and practitioners. We also aimed for speedy and responsive review times for our authors. We are pleased to report that we have seen a significant decrease in our peer review times. Our median speed to first decision is 5 days (for all papers, including those which are rejected following initial assessment) and 46 days (for those papers which are sent for peer review). The median speed for days in review is 121 days, and we will continue to work on these times. Special thanks go out to those who have so generously supported the journal’s robust peer review process.

Impact of course is about much more than citations. We were pleased to see many of our papers contributing to global conversations about contemporary public health and health promotion issues, gaining attention on social media platforms, in the media and commentaries (Table 1).

EDITORIALS CALLED FOR ACTION ON CONTEMPORARY HEALTH PROMOTION ISSUES

In 2023 we re-established the publication of editorials. Kickbusch and Holly (2023) outlined the importance of a focus on the DDoH and provided a roadmap for ‘the shifts required in our management of health promotion in the digital age’ (p. 2) in order to shape better health futures. Issues highlighted in editorials also included the role of health promotion in responding to the CDoH, noting how commercial production and consumption, and corporate social responsibility (CSR) practices influence inequity for women (McCarthy et al., 2023), and the need for global public health action on the commercial gambling industry (calling for clear prohibited partnership policies to prevent industry influence on research and policy) (Thomas et al., 2023a). Two of our editorials highlighted the important roles children and young people play in influencing policies and action relating to harmful commercial marketing (Soraghan et al., 2023), and as political actors engaged in the climate crisis (Arnot et al., 2023a). We were also reminded through the case study of e-cigarettes in Australia (Freeman et al., 2023) and tobacco in the United Kingdom (Frazer et al., 2023) that with sufficient political will, action on harmful industries can protect the health and well-being of populations for generations to come — although the newly elected New Zealand government’s immediate decision to backflip on world-leading tobacco policies is a disturbing reminder of the need for constant vigilance. We ended 2023 on a lighter note. In his editorial exhorting us to ‘Stop blaming the industry and follow the science’, Maani (2023) used humour to show up the arguments all too many harmful industries use in defence of their activities, encouraging us to ‘bazooka responsibly’.

THE COMMERCIAL AND POLITICAL DETERMINANTS OF HEALTH ARE GLOBAL HEALTH PRIORITIES

Research on the activities of and responses towards harmful industry actors, activities and products featured strongly in the journal in 2023. Papers covered a range of commercial and harmful industry practices across the globe including harmful marketing (Soraghan et al., 2023; Thomas et al., 2023b; Thow et al., 2023); product development (Pitt et al., 2023); lobbying (Lacy-Nichols et al., 2023); managing vested interests (Haklar et al., 2023); and industry funding of health charities (Petticrew et al., 2023); as well as the advocacy skills needed to respond (Daube 2023; Sykes et al., 2023). Jongenelis et al. (2023) documented the hidden extent of industry influence, finding that a quarter of submissions to a regulatory inquiry relating to vaping contained text provided by an industry-led astroturfing campaign. There was also a strong focus on the impact of the CDoH on youth, including the contemporary marketing of gambling (Thomas et al., 2023b) and unhealthy food marketing in Costa Rica and Guatemala (Morales-Juárez et al., 2023). Arnot et al. (2023b) documented that young people understand and are critical of the practices of the fossil fuel industry and their influence on government policies, arguing for broader structural changes to protect planetary health over economic interests. In 2024, we hope to see more integrated approaches to the CDoH, which highlight themes and practices across industries, documenting how these industries may seek to exploit new markets, particularly through targeting children and young people, and in LMICs which often lack robust regulatory frameworks to respond. This includes manuscripts that explore appropriate interventions, consider the broader range of strategies that commercial actors use to influence health and equity, and show the links between the social, commercial and political determinants of health.

FIRST NATIONS HEALTH

We implemented reporting guidelines developed by Advisory Board member Associate Professor Raglan Maddox [Bagumani (Modewa) Clans, Papua New Guinea] and colleagues (Maddox et al., 2023), in relation to how Indigenous peoples are engaged in each stage of the research process. Scholarship on First Nations health continued to highlight the need to decolonize health care systems, and the important role that health promotion can play in achieving this goal, with a number of frameworks proposed. For example, Percival et al. (2023) highlighted the need for transformative approaches to Indigenous health service delivery models, including reorientation towards health promotion. Reweti (2023) (Ngāpuhi nui tonu), winner of the 2023 Ilona Kickbusch Award for Early Career Research, showed the importance of ‘prioritising Indigenous voices and knowledge systems’ in Westernised healthcare, ‘using whānau-centred initiatives (a concept that encompasses the broader family and community) as a foundation for health promotion within an Indigenous context’ (p. 1). Through the KāHOLO hula project in Hawaii, Look et al. (2023) demonstrated the importance of culturally responsive health promotion initiatives for Indigenous communities in relation to hypertension management, including maintaining cultural integrity, with one participant commenting: ‘I think we are creating the pathway, not just for the future, but also for our kūpuna [elders and ancestors] who are still with us’ (p. 5).

HEALTH LITERACY

Health literacy continues to be an important focus for the health promotion community, with research focusing on a range of topics including mental health (Kuroda et al., 2023; Mo et al., 2023) and infectious diseases (Ishikawa and Kato, 2023; Park and Chung, 2023), as well as in different population groups such as youth (Jenkins et al., 2023; Ribeiro et al., 2023) and older adults (Kuo and Liang, 2023; Lim et al., 2023b). Research also highlighted the range of methodological approaches that are being used to investigate the association between health literacy and various health and social indicators, including qualitative (Johnsen et al., 2023), quantitative (Dolezel and Hewitt, 2023), mixed methods (Shaw et al., 2023b), conceptual (Lim et al., 2023b), longitudinal (Ishikawa and Kato, 2023), and questionnaire validation studies (Awwad et al., 2023).

Studies published in the journal showed that health literacy can have health and social benefits, including as a protective factor against tobacco consumption (Wang et al., 2023), for better health status (Dolezel and Hewitt, 2023), for better social functioning (Gutierrez et al., 2023; Shaw et al., 2023b) and for the adoption of healthy and protective prevention behaviours during the Covid-19 pandemic (Ishikawa and Kato, 2023; Kuroda et al., 2023). For example, Kuroda et al. (2023) found that while there was public anxiety associated with the Covid-19 pandemic, when critical and communicative health literacy increases, people are more informed about risks and hazards and ultimately may take more appropriate preventive actions. The review by McDonald et al. (2023) highlighted the important role of information provided in health service waiting areas in promoting the health literacy of patients. However, although the study showed the positive benefits of waiting room information, it showed that not all consumers access this information, with the need for future studies to examine the long-term effectiveness of such interventions.

MENTAL HEALTH PROMOTION

Supporting and responding to concerns about mental health remains a clear priority for health promotion communities and practitioners (Craik et al., 2023). Studies reported on some of the complexities of providing appropriate mental health care and support for refugee and asylum seeker communities (Klapprott et al., 2023), but also the difficulties asylum seekers face in accessing appropriate mental health care (Mengesha et al., 2023). Qualitative studies showed the role that new approaches such as engaging the arts and creativity can play in supporting men with their mental health, building social connectedness and self-esteem - ‘See as soon as you walk through that door? You are accepted … something I never had before’ (O’Donnell et al., 2023) (p. 4). Participatory methodologies supported the powerful voice of young people in school mental health and suicide prevention interventions, including their lived experiences and their views about how such programs could be improved and delivered differently in schools (Walsh et al., 2023).

HEALTHY FOOD PROGRAMS AND EATING PRACTICES

Researchers exploring the uptake of healthy food programmes and the practices of engaging with meals and ‘commensality’ now increasingly focus on sociopolitical contexts in their analyses. This reflects the growing awareness of the root causes of unhealthy diets among the general population. For example, Middleton et al. (2023) scrutinized the discourse that ‘traditional family meals’ used to be better and more achievable in the past, showing that gendered challenges and pressures to live up to this ideal have proven stable over time. Gupta et al. (2023) demonstrated the widespread support among the Australian population for policy interventions targeted at the food industry to address unhealthy diets. The systematic review conducted by Lofton et al. (2023) emphasized the need for a food sovereignty framework to assess the food environment intervention. Youth featured prominently in these studies. For example, Shaw et al. (2023a) and Everitt et al. (2023) both highlighted the social determinants of young people’s food choices; Lalchandani et al. (2023) explored the intersection between health and environment of school lunchboxes; and McKelvie-Sebileau et al. (2023) showed the importance of cultural appropriateness of free school meal programmes in New Zealand. In particular, these studies demonstrated the importance of listening and responding to local community needs and opinions about the issues that matter to them, and using these to influence policy reform.

HEALTH PROMOTION THROUGH SPORTS BASED SETTINGS

Sporting clubs and spaces continue to be a setting for a range of health promotion interventions and can have an impact from individual health through to social and community capital (Van Hoye et al., 2023). This includes mental health, social connection and physical activity (Jackman et al., 2023), as well as supporting healthy eating and healthy food environments (Prowse et al., 2023). However, there are also clear inequities in who has access to the benefits of sporting environments. For example, McDonough and Knight (2023) found that there is inequitable access to sports in juvenile justice in the USA, with girls generally having less opportunity to access sports programs in these settings than boys. While sports based settings can be health promoting, we are also keenly aware that harmful industries are increasingly aligning themselves with sports in their commercial marketing and public relations strategies (Thomas et al., 2023b). In 2024, we welcome manuscripts that critically analyse the use of sports by these industries, particularly in CSR activities.

HEALTH PROMOTION IN LMICS

Strategies to respond to communicable (including neglected tropical diseases) and non-communicable diseases remains a focus in LMICs. Researchers are increasingly applying broader social, commercial, and political determinants of health lenses to investigate the complex issues that may drive inequity for different population subgroups in LMICs, and the range of strategies to respond (McCarthy et al., 2023; Thow et al., 2023; Touray et al., 2023). Qualitative research provided powerful reminders of the tensions between socio-economic circumstances and access to healthcare — with a particular focus in 2023 on the challenges associated with diabetes. Research with people living with type 2 diabetes highlighted the tensions between blanket dietary advice, and the role of the changing food environment and poverty in the Gambia, with one 70-year-old participant commenting: ‘Because of poverty…I eat whatever I have…All the things I have been advised to stop eating, eh, if I had stopped them, I would have been dead by now’ (Touray et al., 2023) (p. 7). Similarly, a study using photovoice in Liberia showed the impact of social and economic inequities on poor health outcomes for people living with diabetes, with shared challenges in accessing food, diabetes medications and supplies, and diabetes education (Bleah et al., 2023). Lubaki et al. (2023) documented that access to affordable medication remains a clear challenge for those living with diabetes in the Democratic Republic of Congo—‘Due to economic reasons, sometimes I don’t have to take the medicine exactly as prescribed to avoid a lot of expenses’ (p. 6). There were however positive signs about the implementation of successful programs and interventions relating to sanitation promotion using national-scale approaches in Tanzania, with researchers stressing the importance of government support, theory, innovation, and the use of mass media to increase the reach of messages (Aunger et al., 2023; Czerniewska et al., 2023). In 2024, we continue to welcome research led by researchers and practitioners from LMICs which focus on the prevention of communicable and non-communicable diseases in LMICs. We would also encourage the submissions of manuscripts relating to new areas of focus for the journal, including the climate crisis and planetary health, and the CDoH in LMICs.

REVIEWS

Reviews published in 2023 had a strong focus on diet, nutrition and physical activity; mental health; and health literacy through a range of settings, including schools (Abu Shihab et al., 2023; Lalchandani et al., 2023), sports settings (Lim et al., 2023a; McVinnie et al., 2023), workplaces (Damen et al., 2023; Gullestrup et al., 2023) and health organizations (Ayre et al., 2023). It was encouraging to see critical reviews related to these topics. For example, Jenkins et al. (2023) highlighted that the action-oriented dimensions of critical health literacy are rarely supported in schools. After reviewing the role of the state in dietary policy-making, Karreman et al. (2023) issued a clear call to public health researchers and practitioners to ‘avoid unreflexively embracing framings that draw on the languages and logics of free market economics’ (p. 1). In 2024, we would welcome reviews on a broader range of topics, including those related to the climate crisis and planetary health, the CDoH and DDoH, and those with a specific focus on LMICs.

PARTICIPATORY APPROACHES ARE INTEGRAL TO HEALTH PROMOTION

Participatory approaches are central to health promotion, and can maximize impacts on policy and practice by involving people in issues that affect them. Papers highlighted the importance of valuing the expertise of people with lived experience (Phipps et al., 2023) to transform and reimagine health promotion approaches informed by the Ottawa Charter (Neely and Reed, 2023). Photovoice is a methodological approach that is increasingly being used across a range of studies (Gallego et al., 2023; Walsh et al., 2023), enabling people to share their views, consider contextual and structural factors, connect with people with shared lived experiences and advocate for change (Bleah et al., 2023). Participatory approaches are particularly important in youth engagement strategies. Ingman et al. (2023) emphasized the importance of building trusting relationships with youth, attending to equity and using multiple types of engagement strategies. However, as highlighted by Laird et al. (2023) and English et al. (2023), we must continue to advocate for the resources needed to enhance our recruitment and engagement strategies, acknowledge differences in professional and cultural knowledge systems and act ethically in the design and implementation of participatory projects. In 2024, we would like to see a continued focus on participatory methods and would encourage the submission of perspective pieces which consider how we can best engage and empower communities to be involved in all stages of research (Arnot et al., 2023a).

COVID-19

Finally, we could not end this year in review without acknowledging that Covid-19 has a continuing impact on individuals and communities around the globe and that some groups, including children and young people, continue to experience more severe impacts and inequities associated with the pandemic (Gallego et al., 2023; Koshy et al., 2023; Richard et al., 2023; Trask et al., 2023; van der Kamp et al., 2023). Information from trusted sources will be important in ensuring evidence-based decision making while responding to issues such as vaccine hesitancy (Jones and Neely, 2023), as well as mis- and disinformation, which can spread so rapidly via social media platforms (Wirtz et al., 2023). However, while social media platforms can be a source of misinformation, Taba et al. (2023) highlighted that social media platforms will be crucial in communicating messages about Covid-19 to groups such as young people. We welcome further contributions in this area as the challenges posed by Covid-19 continue. The past four years have demonstrated that health emergencies require a systemic public health and health promotion approach, including policy and interventions implemented at a societal scale and in people’s everyday life.

NEXT STEPS

The journal’s first editorial in 1986 noted the dynamic nature of health promotion and public health, and the challenge entailed in "enabling individuals and communities to develop their health potential" (Mahler, 1986). In 2024, the journal will continue to identify and respond to the challenges we all face. We wish to thank all those who supported Health Promotion International in 2023 and look forward to further contributions from colleagues across a range of health promotion issues, interests and concerns, presenting robust evidence, embracing complexity, addressing both global and local questions and calling for increased levels of action that will benefit the health of all our communities.

REFERENCES