There are profound ethical issues involved in health promotion.  This is
especially the case in lifestyle approaches where individuals can be seen as
being coerced into believing that they are responsible for their own misfortunes
and poor health.

Seedhouse does an excellent job of raising many of these issues.  It has been
suggested by Michael Fitzpatrick and Sarah Nettleton that health promotion
initatives by governments -- especially those who do not intend to do anything
about the true causes of poor population health  -- are essentially exercises in
individual and community control.  I have suggested that such approaches have
the potential to be complicit in poor bashing by which untruths about the poor
are spread with concommitant negative consequences for the poor. Ontario is a
great example where the provincial government allocates 17,000,000 to promote
heart health, at the same time that it weakens the social safety net,
stigmatizes the poor, and oversees a massive transfer of wealth from the poor
and middle class to the wealth.

dr

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