A structural health promotion approach focuses on structural aspects of health and wellbeing. In other words, it addresses policies and practices that affect health at a broader community level, such as systemic discrimination. For example, structural health promotion strategies may include advocating for access to traditional Indigenous healing options in healthcare, campaigning government for publicly accessible addiction services, and creating a transportation program for underserviced communities.

This approach to health promotion recognizes that broader social structures play an important role in health, and that one’s participation and access within a community are shaped by one’s social location. The goal is to dismantle the (often hidden) social processes that contribute to the maintenance of social exclusion and to actively promote health equity. In addition, this involves advocating for and promoting healthy public policy. Healthy public policy has a primary focus on health and health equity. These policies can “improve the physical, social, economic and environmental conditions in which people live, learn, work and play” (Public Health Ontario, 2026).

Example

A Street Nurse implements a mailbox program for clients with no fixed address and actively advocates for more subsidized housing locally. This is considered a structural approach because it attends to the broader needs of the community while advocating for systemic change.

Discussion questions

1. How can a nurse draw upon healthy public policy to support their practice in the context of supporting adolescent growth?
2. How can a nurse draw upon healthy public policy to support healthy living with aging populations?

References

Public Health Ontario (2026). Policy development. https://www.publichealthontario.ca/en/Health-Topics/Public-Health-Practice/Policy-Development