The Ottawa Charter for Health Promotion (1986) framed health as a resource produced in the settings of everyday life. Forty years later, people inhabit hybrid environments in which digital platforms, algorithmic systems and data architectures shape the conditions for health decisively as housing, workplaces or neighborhoods. This commentary argues that reimagining the Charter requires applying its five structural action areas—building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services—to the hybrid settings of a rapidly transforming everyday life. The digital determinants of health have become vectors of inequity: shaping information access, social connection, economic participation and self-determination. A Charter reimagined in 2026 must treat the digital environment as a determinant of health that demands the same structural and political response as the physical and social environments addressed by the original Charter.
Since the 1990s, fragility has emerged as a concept that describes the nation states of low- and middle-income countries. The assumptions about people living in so-called fragile countries have influenced health promotion research and practice in terms of the topic areas studied and the way interventions are designed and implemented. In critiquing the assumptions underlying fragility, we apply and extend the harms of damage-centered research to the concept of state fragility. We argue that fragility labeling and classification systems are not neutral representations of the world. Rather, these approaches are underscored by the power hierarchies that further engender fragility. In this spirit, we critique ‘state fragility’ as a concept applied to people living in so-called ‘fragile countries’. Further, by amplifying expressions of self-governance as forms of everyday resistance and survival among people living in fragile countries, we highlight what global health promotion researchers and practitioners might overlook when adopting the fragility labeling and classification system. In drawing on Haiti as a case study of collective citizen resistance to state fragility, we illustrate the less measured expressions of everyday strength that can inform a new global health promotion agenda that is imagined and scaled from the bottom up.
