Public health Upstream journeys


December 19, 2021

Irving Zola’s “upstream-downstream” story has travelled a very long way. This post curates its journey through the published articles that explored its impact on public health narratives.


Published December 2, 2021

The image depicts a river naming upstream, midstream, and downstream.

Irving Zola’s upstream-downstream parable (or the metaphor) is a public health classic. He narrated a story of saving drowning individuals one by one; he spends all his time on that endeavour and laments the lack of time to search why so many people come downstream. This journey searches how public health organizations use this metaphor;


The image depicts a road with white and yellow lines in the middle as nudges

The “opt-out” default option becomes one of the most effective nudge strategies. It has brought many significant behaviour changes in all areas of our lives.

Do you want to know more about nudging?


Ottawa charter logo

The legendary Ottawa Charter for health promotion has travelled around the world for 30 years from 1986 – 2016.


Paulo Freire

Paulo Freire, a Brazilian educationalist revolutionized adult education principles; these are still popular.