[Promoting instead of controlling health--lessons learned, lessons to learn]

Health promotion, as laid down in the Ottawa Charta by the World Health Organisation, embraces the call for self-responsibility. Self-responsibility, however, is not merely directed towards apparently personal risk factors. The Ottawa Charta clearly puts health in a wider societal context and follows the line of early social medicine, which, as Virchow put it, understood politics as medicine on a large scale. With the increasing dominance of neoliberal thinking during the 1990s, this view of health in its societal context was pushed aside to make way for an individualistic understanding of self-responsibility. At the same time a resurgence of expert-led prevention strategies could be observed. Recently, however, the discussion on self-responsibility appears to be regaining societal aspects. The task on hand is, to support this societal approach to health whilst at the same time to ensure the field of health promotion does not overstretch itself.