In times of global warming and related environmental and social problems the concept of sustainable development is gaining in importance. The 'Agenda 21', created at the United Nations Conference on Environment and Development in Rio de Janeiro in 1992, is a comprehensive blueprint for action to secure the earth's ecological resources, taking into account aspects of justice and economic prosperity. It is important to differentiate between 'sustainable development' and 'sustainability' in the sense of measures that achieve long-term effects - this being another key challenge in health promotion. The concept of sustainable development is primarily aimed at achieving a balance between resource consumption and resource regeneration to secure the viability of a just society with a functioning economy in an intact ecological environment.
The concepts of health promotion / prevention and sustainable development have far more similarities than differences. Although the focus of sustainable development is primarily on environmental issues, it emphasizes equal opportunities, good physical and mental health and health-enhancing social integration just as much as prevention/health promotion underlines the importance of ecological living conditions and social equity. Basically, the two disciplines focus on a careful and fair use of ecological, physical, mental and social resources.
Once the goals of both health promotion/prevention and sustainable development are both formulated in global terms, their complexity is such that they appear almost impossible to achieve. To achieve 'health for all' seems as unrealistic as the goal to leave an ecologically sound world to future generations - a world where the consumption and regeneration of resources are balanced and where everybody has equal access to these resources.
Given the strong internal dynamics of economic processes, national policy making and individual behaviour, proponents of health promotion / prevention and sustainable development are well advised to act pragmatically and to seek changes at various levels. The sectors involved will embrace a combination of measures - aimed at individuals and orientated towards the setting. A careful and responsible use of ecological, mental, physical and social resources by individuals is indeed essential but is not sufficient to achieve the ambitious goals. Projects in health promotion / prevention and sustainable development must also aim at influencing policy decisions in favour of their objectives and persuading organizations to take more responsibility for people's health and the ecological environment. Educational activities and awareness-raising measures via the mass media must therefore be supplemented by strategies of influencing policy-making processes and organizational development. That this is already being implemented in practice is demonstrated by the increasing importance of concepts such as 'health impact assessment', 'environmental impact assessment', 'workplace health management," corporate social responsibility' or 'sustainability management'.
Given the largely identical goals, challenges and strategies of health promotion / prevention and sustainable development it seems obvious that cooperation between the two disciplines should be reinforced at all levels and that common approaches should be developed. Thus, scarce resources will be pooled and it will become more likely that sustainable changes can be achieved.