Dennis, you've become far too cynical and evangelical about your views. I don't know
where you get your information on "lifestyle", but you don't work  with the same
dedicated lifestyle people that I do. To say that they engage in "victim blaming" is
extremely unfair, incorrect and insulting to thousands of honourable and descent
public health people in the USA and Canada. I think that you should stick to what
your research says and don't speculate beyond your data. Your expertise is not
"lifestyle" and the experts on lifestyle find your speculations very unfair and
border on slander.
Joe

Dennis Raphael wrote:

> sorry, but I don't see the evidence of lifestyle approaches -- either upstream
> or downstream -- being effective.  If you expand lifestyle to empowerment and
> community participation models, then I am with you. In contrast I see how public
> health's preooccupation with "lifestyle" has taken social determinants issues
> right off the table, and created an atmosphere of victim blaming. We have no
> idea of what  low income people make of all this.  I argue that they end up
> blaming themselves for their life situations and poor health. The BC model still
> has as its goals the changing of health-related behaviours.  This has a strong
> component of  expert-driven paternalism and  has a strong potential to be even
> more disempowering to marginalized communities.
>
> My experience in Ontario with the heart health community has been one where the
> poor are seen as "diseased" with their disease being their not wanting to listen
> to upper-middle class professionals who believe -- dogmatically -- in the
> healing power of exercise, fruits and vegetables, and non-smoking.  This in
> spite of the limited evidence as to the efficacy of these kinds of programs..
>
> Please read Michael's Fitzpatricks "Tyranny of Health" by Routledge.  You will
> never think the same again about these issues,  Sadly, it may come down to one
> of the other.  Right now we have one approach.  Its time for some of the other!
>
> dr.
>
> Send one line: unsubscribe click4hp to: [log in to unmask] to unsubscribe
> See: http://listserv.yorku.ca/archives/click4hp.html to alter your subscription

--
ÐÏ à¡± á

Send one line: unsubscribe click4hp to: [log in to unmask] to unsubscribe
See: http://listserv.yorku.ca/archives/click4hp.html to alter your subscription