Discussion on how to address the underlying causes of  ill health for
individuals within communities is of great interest to me.  Knowlege and
understanding of the root causes of health are important factors no doubt.
However without organisational structures and politcal will, knowlege alone
does not seem to necessarily enable health promotion workers to address the
baseline issues.
My experience has been one of specific job descriptions. Funding for these
positions is very prescriptive and tied to measured outputs that focus on
the symptoms rather than working on the interactions between individuals and
their environment that either support or deny health[access to
resources,community infrastructure,opportunity for participation in
meaningful work, sense of belonging, opportunity for feelings of control,
feelings of a hopeful future etc - environment in the wholistic sense ].  I
am interested in ways that health promotion can move beyond describing
conditions to taking action on the barriers or enablers to health.
cheers
Bronwyn Holmberg
Health Promotion

-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]]On
Behalf Of William B Ward
Sent: Saturday, 6 October 2001 1:25
To: [log in to unmask]
Subject: Re: Tyranny of Health


Dennis, this has always been a worry.

A lot of health promoters do not have the larger perspective of why some
smoke and others gain excess weight.  Increased work hours, the fact that
those who prepare the meals in a low income household may have to juggle
household duties with two part time low income jobs plus getting back and
forth by bus, and a lot of other challenges are not taken into
consideration.

Add to this the fact that many health promoters are narcissistic and work
with and for higher income clients tilts their perspective.  This is a
bit like the reduction in community organizing training and focus that
social workers have experienced in the past couple of decades.

Increased specialization has led to a reduced broad world perspective
which informs "professionals" as to the larger forces at work on
determining life styles.  I am probably one of the few fat people who has
no excuse [:>)}.

Bill Ward
Tampa, FL

On Thu, 4 Oct 2001 19:51:03 -0400 Dennis Raphael
<[log in to unmask]> writes:

> poor people's cardiovascular disease is due to their smoking, lack
> of activity and unhealthy diet.  A task that many public health units
have
> enthusiastically taken up.
>

> -Michael Fitzpatrick, The Tyranny of Health, 2001.