Challenges for health promotion research and action across the globe

The editors have been very excited to see an increase in submissions to the Health Promotion International (HPI) journal from researchers living in non-English-speaking countries and a commensurate increase in reviewers from such countries. For example, this issue contains articles by authors from Japan (Aihara 2011), Ecuador (Orozco 2011), the Republic of Korea (Moon 2011) and Zimbabwe (Simmons 2011) as well as Australia, Ireland and Canada (Gagnon 2011). Many of the articles published in the journal have had at least one reviewer from outside the English-speaking world. The contributors, and their areas of research, emanate from not only the high-income sector of the nonEnglish-speaking world (Japan, Austria and the Republic of Korea) but also represent lowand middle-income countries (Ecuador and Zimbabwe). The challenge for health promotion theorists, activists, practitioners and researchers, who take a global perspective, is incorporating the eclectic mix of health priorities among countries into a coherent framework for study and action. It is vital to ensure that all voices are heard and varying perspectives and priorities are respected. Projections of the global burden of disease for the rest of the twenty-first century suggest a convergence towards chronic illness as the dominant health issue for all countries. For example, a recent retrospective epidemiological study of 187 countries by Forouzanfar et al. (Forouzanfar et al., 2011) predicts that by 2025, breast and cervical cancer will surpass maternal mortality as the major cause of female mortality in the developing world, thus mirroring the realities of the developed world. However, we are not there yet! Currently, the developing world still struggles with a massive burden of disease from acute and infectious health conditions. The lack of progress in meeting many of the Millennium Development Goals in middleand low-income countries highlights the need for a creative multi-pronged health promotion approach (UN, 2011). Furthermore the persistence, emergence and re-emergence of drug-resistant infectious diseases in both the developed and developing worlds demonstrate that as health promoters we can never become complacent and unidimensional in our approach (Heymann, 2006). The major changes in health status in the last century, in some countries of the world, have been a shift from high infant and maternal mortality and morbidity to low levels on these indicators and a dramatic increase in life expectancy at all ages. The world population trends of the late twentieth century are often characterized as the second wave of a demographic transition which began in the mid-nineteenth century. The first wave saw continuing high fertility rates alongside sharp increases in life expectancy at all ages. The second wave is characterized by a lowering of fertility to replacement, or less than replacement rates, further reductions in mortality rates (including infant and maternal mortality) and a compression of morbidity into the very old age cohort. The trend towards reduced fertility rates and the ageing of the population has dramatically altered the demographic profile of countries such as Japan, Korea, Singapore and China (Eggleston and Tuljapurkar, 2010). However, the major demographic transitions of the twentieth century have left many countries untouched. For example, in many parts of sub-Saharan Africa, Southern Asia, Oceania and Indo-china, maternal and infant mortality rates and fertility rates remain high while life expectancy (at all ages) remains low Health Promotion International, Vol. 26 No. 4 doi:10.1093/heapro/dar082 # The Author (2011). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com