Dispute, dissent and the place of health promotion in a "disrupted tradition" of health improvement

Dispute over the nature and purpose of health promotion has characterized the development of this field of activity in recent times. This paper explores such disputes and offers an explanation for them. I argue that health promotion and related fields (such as public health and health education) share in a "disrupted tradition." I assert that "health promotion" can be seen as the term presently favored by some to represent an extensive "tradition of protecting and improving the health of the public." Its relative favor and currency can be ascribed to a degree of power shift between competing groups operating with separate conceptions of health, away from biomedicine and towards more socially rooted understanding. Relative degrees of power and influence po ssessed by these groups at different historical times have contributed to the "disruption" of the tradition. Understanding this disruption helps explain a number of historiographical and theoretical problems besetting the field.pb