Expert voices for change: Bridging the silos-towards healthy and sustainable settings for the 21st century

The settings approach to health promotion, first advocated in the 1986 Ottawa Charter for Health Promotion, was introduced as an expression of the new public health', generating both acclaim and critical discourse. Reflecting an ecological model, a systems perspective and whole system thinking, the approach has been applied in a wide range of geographical and organisational contexts. This paper reports on a qualitative study undertaken through in-depth interviews with key individuals widely acknowledged to have been the architects and pilots of the settings movement. Exploring the development of the settings approach, policy and practice integration, and connectedness 'outwards', 'upwards' and 'beyond health', it concludes that the settings approach has much to offer but will only realise its potential impact on the wellbeing of people, places and the planet if it builds bridges between silos and reconfigures itself for the globalised 21st century. (C) 2013 Elsevier Ltd. All rights reserved.