At a very practical level, I would also add that most
marginalized, poor neighborhoods also tend to be
unsafe, running around the block for physical activity
in all likelihood would also lead to their injury or
death! Further, most inner city grocery stores tend to
have poor, high priced produce not to miss lots of
fast food restaurants easy to get to when you don't
have reliable transportation.

Perhaps we can address lifestyle changes along with
attending to economic infrastructural changes such as
reliable employment, job training programs, better
educational opportunities. In the meantime, focusing
solely on individual level changes and neglecting the
context in which they are occurring will only
perpetuate the problem.

Snigdha Mukherjee
Health Behavior
School of Public Health
University of Alabama at Birmingham
Birmingham, Alabama


--- Dennis Raphael
<[log in to unmask]> wrote:
> Lets look at the evidence.  Lifestyle programs are
> ineffective, and when
> delivered by middle class professionals to people
> who are marginalized are
> patronizing and demeaning.  This is nothing new.
> Penfold stated this in 1979
> and it has repeatedly been noted in the health
> promotion, sociology, and
> critical public health literature.
>
> Low income people -- when asked what they need to
> improve their health -- do not
> say help with changing their diet, exercise
> regimens, and cutting out tobacco.
> The want decent income and neighbourhood resources
> to support their and their
> families health.  These reuqests go unheeded.  What
> is given instead is the
> message that you are responsible for your own poor
> health -- Tough luck!  Is it
> any wonder that neo-loberal and neo-conservative
> governments are so keen to push
> out lifestyle messages.  Do we as health promoters
> need to be complicit to these
> activities?
>
> The bottom line is that if low income and other
> people exercised and ate fruits
> and vegetables until they became marathon athletes
> they would still die younger
> from a range of diseases since numerous studies
> indicated that these behaviours
> do not negate the effects of stress, deprived, and
> isloated environments.
>
> Health promotion is about listening to communities
> and enabling people to gain
> control over the determinants of health.  Putting
> fruits and veggies into
> people's faces or getting them to run around the
> block is NOT health promotion!
> It is a means of gaining government support for
> 'health promotion' programs.
>
> dr
>
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=====
Snigdha Mukherjee, Ph.D.
Assistant Professor
Department of Health Behavior
School of Public Health
University of Alabama at Birmingham
Phone: (205) 975-8074
FAX: (205) 934-9325

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