I certainly did not intend to oversimplify the issue. I realize the
complexities inherent in population health promotion. In spite of the
sarcastic tone, I do not disagree with your point of view.

I blamed no one. Nor would I support the views of anyone who did. I do
realize that the "bag of choices" that some people have to select from are
smaller than that of many others. In fact, I have worked extensively with
families who must choose from options that are unacceptable. Many had no
refridgeration and cooked on hot plates. There was no cash at the end of the
month and little at all once the rent was paid. Fresh fruit and veggies are
financially out of the question. Many of these mothers went hungry in order
that their children could eat. Often the shelters and housing units in which
they live were closer to fast food joints than markets and there was no car
and absolutely no money in the budget for public transportation to get
there. Even if they could get to such facilities, there is no one to look
after the children. Their support networks are limited. Their children
cannot participate fully in school life or at all in extracurricular
activities. Life can be choatic and stressful for these families. No I agree
with you on many points.

I am simply saying that efforts to address the social determinants of health
and to facilitate people's adoption of health promoting behaviours
(including the removal of socioeconomic barriers to participation through
policy changes such as those to ensure free opportunities and subsidies) are
important.

Some practitioners are engaged in both others are involved in one or the
other. All are essential to the promotion of the health of populations.

Paula Robeson

-----Original Message-----
From: Vini K.Dhillon
To: Health Promotion on the Internet; Robeson, Paula
Cc: [log in to unmask]
Sent: 2/6/03 6:40 PM
Subject: Re: FW: Rand Research

Ok, so if the underlying cause of obesity/weight gain is  "an imbalance
between intake and energy expenditure," and the solution is simply to
engage
in "sufficient
 amounts of physical activity" why then, is the rate of obesity on the
rise?
The solution is so easy!! there shouldn't be any "obese" people around,
should
there? what are the conditions that lead to eating "improperly"? What
might
cause a person to binge on nutritionally deficient foods versus making a
nice
healthy organic salad?  what conditions are necessary for one to take an

aerobics class, hire a trainer, or join a gym? The last time I checked,
these
activities were not free, nor are they subsidized.

 Ok, so maybe you don't need to join a gym to stay healthy. Running and
walking are free, right?  I have a friend who is a single parent of two
and is
on social assistance. She receives approximately $1100/mo. Her apartment
costs
approximately $1000/mo. So I guess ALL of the money she has left over
could be
invested in a pair of running shoes right?? Yes that's it!! shame on her
for
not eating fruits and veggies! So if she wants to go out for a run or a
brisk
walk, I guess she could leave her small children with the babysitter,
right?
Unfortunately, there aren't any free childcare facilities in her
building. Why
is she eating a chocolate bar when she could be working out, or taking
her
kids out to play hockey or go skiing! Do you think that stress plays a
role in
her life?  Is it possible that she had a poor start in her early life?
perhaps
she has been under stress virtually all her life? what are her coping
strategies? Can she just roll up her yoga mat, and head on down to a
Hatha
yoga class ??  Are her basic needs being met on social assistance?
Should she
be counting calories or counting pennies??
She is "overweight," but I suppose this is her fault, because she
CHOOSES to
be this way!!


Vini K. Dhillon



Quoting "Robeson, Paula" <[log in to unmask]>:

> I appreciate both these links to relevant health promotion literature.
>
> The causes of obesity/overweight are an imbalance between intake and
energy
> expenditure. True socioeconomic status is a factor in the equation
(through
> its impact on access to appropriate foods, stress etc). But whatever
the SES
> if one eats too much of certain foods and does not engage in
sufficient
> amounts of physical activity the result is overweight or obesity. Yes
it is
> important to work to eliminate poverty and enhance food security. But
it is
> also important to promote healthy eating and physical activity. I
realize
> that access to physical activity, for example, is also impacted by
SES,
> neighbourhood safety, and other associated factors, but nutrition or
> physical activity promotion is not limited to educational or awareness
> campaigns. It also involves healthy public policy development to
eliminate
> barriers to access associated with SES (and disability, culture,
gender
> etc). And there are those of us health promoters who are involved in
social
> action aimed at eliminating poverty as well as working to reduce
barriers to
> access for those currently living in poverty (and advocacy related to
> improving infrastructure to make communities people focused not car
focused
> for example). But there are others doing equally important work who
are not
> focused on eliminating poverty and other associated risks to health.
> Further, some involved in physical activity promotion see the value of
> involvement in recreation and other structured or unstructured
programs
> (running groups, neighbourhood walking school buses, etc) as a means
of
> promoting social connectedness. It is important that work be done via
> multiple strategies, at multiple levels, with multiple sectors to
improve
> the health of Canadians. It is not an issue of either/or.
>
> Paula
>
>

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