The role of health promotion: between global thinking and local action.

ISSUE ADDRESSED The persistence of health inequities provides an ongoing challenge for health promotion. The dictum 'think globally, act locally' fails to recognise the significance of infrastructure and policy in linking global issues and local practices as a means of addressing health inequities. METHODS Commentary and opinion. RESULTS Through analytic tools and methods, health promotion has much to contribute to facilitating health-improving changes in social, economic and physical environments. Local actions provide excellent illustrations of organisational change and intersectoral action, and present the possibility that such actions could be widely implemented. While this has occurred on some issues, this is not usually the case. Political support, policy and infrastructure are required to link global ideas and local actions and overcome the impasse. Media advocacy is one example of an approach with potential to make these links and mobilise political support. CONCLUSIONS Reframing media and political discussion, away from the dichotomy of individual responsibility and government intervention and towards acknowledging the social context of human behaviour, could contribute to policy and social environments with greater capacity to address inequities.