During the first part of the 20th century, the state of public health is generally described in terms of the presence or absence of diseases, and controlling diseases is the primary focus of the Organization's work. Before the century reaches its midpoint, however, a modern understanding of health emerges, as enshrined in the Constitution of the World Health Organization: "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."
In 1946 the Organization creates the Institute of Nutrition of Central America and Panama in Guatemala City "to foster the development of nutrition science"; three years later, it establishes a Nutrition Section at its headquarters in Washington, D.C.; and, in 1967, it sets up the Caribbean Food and Nutrition Institute in Kingston to promote and provide training, technical assistance, research, information dissemination, and policies as they relate to food and nutrition.
Family health is an increasingly important component of the Organization's work. The 1953-1956 edition of Health Conditions in the Americas notes that: "nearly all the countries and other areas of the Americas have very young populations, and health programs would be directed principally to the problems of infancy, childhood, and young adult life. In many of these areas, more than 40% of the population is under 5 years of age." Twenty years later, the 1973-1976 edition of that title warns that: "Although the birth rate has been dropping since 1960 in most countries, the percentage of high-risk births is significant."
The historic Ottawa Charter of 1986 declares: "Health promotion is the process of enabling people to increase control over, and to improve, their health." That same year, who endorses the Charter, shifting the principal thrust of its work from disease-oriented medical interventions to the promotion of health. In 1987, PAHO's director, Dr. Carlyle Guerra de Macedo, states priorities: "Health promotion in the pursuit of well-being represents the primary objective of development and the primordial justification for any social policy." In 1990 the Pan American Sanitary Conference clarifies that "health promotion is increasingly perceived as the sum activity of the population, the health services, the health authorities, and other productive and social services aimed at improving the status of individual and collective health."
Today, we recognize that active application of the strategies of health promotion is essential for preventing much of the disease that still burdens the Americas as well as for maintaining a healthy mind in a healthy body.
