Dennis,

This is the first opportunity that I have had to respond to your email. The
heart health list serve has always valued NEW information that will enhance
comprehensive community-based heart health programming. Given that the
message addressing your work was cross- posted on the heart health list
serve you are welcome to respond directly.

Please note, the heart health list serve is meant as a medium to address
issues and present facts to stimulate critical thinking. The outline of
appropriate postings for CLICK4HP, as posted by Alison Sterling yesterday,
apply to the heart health list serve. Personal attacks and unprofessional
conduct are not in the spirit of health promotion and are welcome on the
heart health list serve.  Please refrain from doing so in the future.

I look forward to a informative discussion.

Anne Lessio
Moderator for heart health listserve

Anne Lessio
Manager
Heart Health Resource Centre
Ontario Public Health Association
468 Queen Street East, Ste 202
Toronto, Ontario M5A 1T7
P:(416) 367-3313 ext. 229 or 1-800-267-6817
F:(416) 367-2844
E:[log in to unmask]
Website: www.hhrc.net <http://www.hhrc.net>


-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]]On
Behalf Of Dennis Raphael
Sent: December 11, 2002 6:45 AM
To: [log in to unmask]
Subject: Metaphors


The religious metaphor is not mine.  The holy trinity term was used by Sarah
Nettleton -- who is no slouch in the health promotion, sociology of health,
and
services areas -- and who points out that not only is the evidence of
lifesryle
factoes as a cause of disease, and the effectiveness for "heart health"
behavioural initatives lacking but that such an approach has harmful side
effects that blame victims for their poor health and absolve policymakers of
any
blame for their heart health threatening failures.

It should not be surprising that one of the most repressive and socially
unresponsive governments ever seen in Canada -- the Harris/Eves Ontario
conservative government is pouring money into "heart health" initatives that
actually do not allow any discussion of brader determinants of health. Stray
from the risk factors of diet and activity and tobacco and have your funding
cut
off!

Click for Hpers may wish to note that I am responding to a posting on the
Ontario heart health list-serve through this listserve as such views are not
countenced on that particular listserve!  see below!

Hey heart health  listserve moderator!  Do I not have the right to respond
directly to these statements?  Or is democratic discourse also verboten in
the
New Ontario together with any discussion of the social determinants of heart
disease?

dennis r.

From: "John Davies" <[log in to unmask]>
To: <[log in to unmask]>; <[log in to unmask]>
Sent: Monday, December 09, 2002 3:14 PM
Subject: RE: Behaviour change - a questionable approach


> Dennis Raphael's discourse, below, is unsatisfying because it uses
several
> hundred words to tell us that social determinants of health are
important,
> and that life style interventions recommended by government agencies
are
> less than perfect.  Unfortunately, his recitation of this well known
> information fails to add anything to the discussion - in Canada or
> elsewhere.
>
> He uses an inappropriate religious metaphor to sarcastically
denigrate a
> good outcome - healthy life style - in an apparent attempt to make
it the
> enemy of another good outcome - improved socio-economic status.  He
tells us
> that behavioral change may be of questionable effectiveness, but he
does not
> tell us what may be effective.  Instead. his conclusion seems to be
that a
> bad life style is not good, while such things as poverty and social
> exclusion are even worse.  This is not very edifying stuff.
>
> >From the same evidence we might arrive at a different and more
useful
> conclusion, namely that adequate diet, less smoke and adequate
exercise are
> really quite useful, but that public healthers should work harder to
find
> and use more cost-effective methods of helping individuals and
groups to
> adopt such behaviors.  In other words, it is better for individuals
to do
> something of proven value, such as improving their own life style,
rather
> than waiting, perhaps forever, for some other agent - such as the
> government? - to improve the socio-economic status of their group.
>
> John Davies,
> email: [log in to unmask]
> Website: www.johndavies.com
>
> -----Original Message-----
> From: [log in to unmask]
[mailto:[log in to unmask]]On
> Behalf Of Diana Daghofer
> Sent: Sunday, December 08, 2002 6:55 PM
> To: [log in to unmask]
> Subject: Behaviour change - a questionable approach
>
> Hello all,
>
> I recently attended a conference on the social determinants of
health and am
> getting some interesting feedback as a result of joining a listserv
on
> health promotion (Click4HP).  I would be interested in hearing
people's
> views on the following note.
>
> Diana
> ----- Original Message -----

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