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Background <p>Since the World Health Organization emphasized in the Ottawa Charter for Health Promotion that health is created in the everyday environments of people’s lives, the settings approach has become a&#xa0;cornerstone of health promotion. However, the concept of space itself often remains implicit and undertheorized. Terms such as setting or neighborhood are widely used, yet rarely examined in terms of how spaces are produced, how they shape health opportunities, and how they can be intentionally designed to promote health.</p> Objective <p>This article aims to address this conceptual gap by developing a&#xa0;relational understanding of space and introducing the St. Gallen model of social space-oriented practice, developed in St. Gallen, as an analytical and practice-oriented framework for area-based health promotion.</p> Methods <p>This conceptual paper draws on relational theories of space and professional approaches to social space-oriented practice. Through theoretical analysis and conceptual synthesis, it reconstructs three complementary heuristic perspectives of sociospatial intervention: the design of places, work with people, and the shaping of structures and organizations.</p> Results <p>The model conceptualizes space as an actively produced enabling environment shaped by material conditions, social relations, and institutional arrangements. This perspective makes professional spatial logics visible and provides a&#xa0;structured framework for analyzing and shaping health-relevant living conditions. Health opportunities thus become understandable as outcomes of sociospatial configurations that can be intentionally influenced.</p> Conclusion <p>Advancing health promotion requires a&#xa0;consistent relational spatial turn. The St. Gallen model offers a&#xa0;theoretically grounded and practically applicable framework for designing more integrated, reflective, and equity-oriented health promotion strategies, thereby strengthening the effectiveness and sustainability of area-based health promotion.</p>

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Gesundheit ist immer räumlich. Sozialräumliche Gesundheitsförderung und der „spatial turn“ im Setting-Ansatz mit dem St. Galler Modell

  • 期刊论文

  • 发表日期：

    2026年5月21日

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  • Christian Reutlinger

摘要

Background

Since the World Health Organization emphasized in the Ottawa Charter for Health Promotion that health is created in the everyday environments of people’s lives, the settings approach has become a cornerstone of health promotion. However, the concept of space itself often remains implicit and undertheorized. Terms such as setting or neighborhood are widely used, yet rarely examined in terms of how spaces are produced, how they shape health opportunities, and how they can be intentionally designed to promote health.

Objective

This article aims to address this conceptual gap by developing a relational understanding of space and introducing the St. Gallen model of social space-oriented practice, developed in St. Gallen, as an analytical and practice-oriented framework for area-based health promotion.

Methods

This conceptual paper draws on relational theories of space and professional approaches to social space-oriented practice. Through theoretical analysis and conceptual synthesis, it reconstructs three complementary heuristic perspectives of sociospatial intervention: the design of places, work with people, and the shaping of structures and organizations.

Results

The model conceptualizes space as an actively produced enabling environment shaped by material conditions, social relations, and institutional arrangements. This perspective makes professional spatial logics visible and provides a structured framework for analyzing and shaping health-relevant living conditions. Health opportunities thus become understandable as outcomes of sociospatial configurations that can be intentionally influenced.

Conclusion

Advancing health promotion requires a consistent relational spatial turn. The St. Gallen model offers a theoretically grounded and practically applicable framework for designing more integrated, reflective, and equity-oriented health promotion strategies, thereby strengthening the effectiveness and sustainability of area-based health promotion.