According to Kickbush in 1997, health is created through an interrelation between people and their environment during their everyday life, especially where they live, love, learn, work and play. In this context, health promotion (HP) is the process that allows people to increase the control on their health to improve it ^⁽¹⁾; therefore, in this process life health conditions and social determinants will have a fundamental role when it comes to understanding the health of the people.

From the Ottawa letter for the HP of 1986, where health promotion, requirements and actions were defined, many changes and transformations that someway affect the health of the people and communities were implemented, namely, globalization, climate change, transborder crises, increase of inequalities between territories and the recent COVID-19 pandemic. Understand the inter-connections between the climate change, the health of the people and that of the planet is key for the transformation of the HP strategies ^⁽²⁾.

HP is based considering health as a right that has to be sustained by the society and it has to be understood that people have an active role in their health, and that health is created along the life from a positive approximation -of health- where the key question is what creates this health. This salutogenic model for health promotion, along with the social determinants of health and the approach of rights weave the conceptual framework of the HP from which public policies should be created, along with healthy environments, reinforcement of community action, development of personal skills, and reroute health services.

The recent COVID-19 pandemic has disrupted the world changing day-to-day life of people and communities. Strategies, programs and health policies have focused in preventing infections and reducing risks associated to the illness through restrictions, leaving societies and people in limit situations and pauperisation, and to the health systems and services stressed and weakened. In this context, some of the HP values have been ignored because they do not look valid or efficient in a pandemic context, but the challenge is to demonstrate how HP is efficient in changing conditions.

In times of pandemic is more necessary than ever to increase the control people have over their health, when favoring social cohesion, solidarity and trust among the people, in addition to increase the collective responsibility to build a base for HP response ^⁽³⁾. Community participation and digital transformation have been key to face COVID-19.

Work with our sight set on HP to respond in times of contingency or uncertainty implies, among other actions, an cross-sectorial action based in the collaboration between all the sections and the community; guarantee the sustainability of health services regarding environmental resources, but also the strengthening of primary care and empowerment of community services; train the community and commitment toward public health; prioritize equality as guide for all the actions in order to include everybody, working to have a more fair distribution of the resources and not lose sight of health perspective throughout life ^⁽³⁾.

A good management of health is essential to advance HP strategies and programs in this changing world. This proposal appears in the 13th General Work Program of the World Health Organization (WHO) (2019-2023) where HP is acknowledged as strategy to improve health and well-being of the people. Also, in the Geneva Charter for Well-being, a declaration that resulted from the 10th Health Promotion World Conference of the WHO held on December 2021, where the need to join efforts in the creation of sustainable wellbeing associations, committed to health, is asserted, and that is egalitarian and include future generations and ecological limits ^⁽⁴⁾. This stands as an authentic declaration of intentions from the signatory countries of such charter, which will act as a compass for the HP in the years to come.

If we focus on the goal of improving the health of the people, the creation of HP and well-being policies. This would have to be one of the main responsibilities of the governments. As well as HP has to direct the design of guidelines for health and well-being management ^⁽⁵⁾. In this case, HP provides us an opportunity to weave strategies addressed to the improvement of the health of the people based on a positive approach toward health, focused on specific social determinants regarding health, and health in all of the policies, addressed to communities and care of the health of the planet. The COVID-19 pandemic has taught us that HP is an efficient strategy to move the community in times of uncertainty and has revealed the need to incorporate the governance that acknowledges and includes the relationship between health and social, environmental, and economical factors, while focusing on equality and well-being ^⁽⁶⁾.