Bravo Glen. I will enjoy passing this along to some nursing students!
----- Original Message -----
From: Glen Brown <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, January 08, 2003 5:59 PM
Subject: Re: community capcity for healthy eating


> I just can't resist wading in to this one...
>
> I think Jacquie's note that people are their own agents is a crucial one.
> BUT that should prompt us to acknowledge their role (and our own) as
agents
> for political change. Shouldn't our programming (including our health
> promotion programming) make that front and centre? Why do so many 'health
> promotion' materials, intended to educate the communities we work with,
not
> even mention that poverty (and pollution, and unhealthy working
> conditions..) are the primary determinants of health? If it's supposed to
be
> a secret, it's not a very well kept one.
>
> Here's an illustration from my own recent experience. I worked on a
project
> a while back looking at heart health issues for multicultural communities.
> We did a literature review, some key informant interviews, and some focus
> groups with people from different ethnocultural communities in Toronto.
>
> Everything we read from the literature, and everybody we interviewed
pointed
> to poverty, stress, isolation, etc as the central culprit in poor heart
> health.
>
> The focus groups were fascinating: their level of knowledge about 'good'
vs
> 'bad' food was quite high. In fact, I was surprised at how frequently
people
> expressed anxiety about contaminants and additives in food. (Not a concept
> the heart health literature had acknowledged).
>
> They knew about smoking. They knew about exercise. (One woman left me
> speechless when she asked why the pamphlets suggested a daily walk when
the
> radio was warning people to stay inside because of smog. I wished I had
the
> power to hire her as a health promotion educator.)
>
> But what they really wanted to talk about was the stress in their lives.
Did
> I understand, they wanted to know, how little time they had for shopping
and
> cooking? Did I understand that after a 12 hour taxi shift they didn't
really
> feel like a jog? Did I understand that their kids were in danger of
dropping
> out of school because the new curriculum was so daunting? That gulping a
Big
> Mac down at lunch was really, really, really the least of their worries?
>
> They told us all of this with humour, patience and remarkable generousity
of
> spirit. I wanted to let them know that, yes, I understood. And that the
> great group of health promoters and public health folks I was working with
> understood. (They really did - the group I was working with worked with
> disadvantaged people every day, and they understood the determinants of
> health with a passion).
>
> And then I looked at the heart health brochures. Eat your vegetables, quit
> smoking and go for a walk. Or it's your fault. Not a word about the
primary
> causes of heart disease that everybody - the researchers, the health
> promoters, the service providers, the people in our focus groups;
> everybody! - knew about. I wondered if this didn't border on contempt.
>
> The person who first started this exchange, so many emails ago, asked
about
> community capacity. I wonder if part of building capacity is building
> awareness (or, more accurately, validating the awareness they already
have)
> that social conditions are the biggest keys to health and that communities
> can mobilize to affect those social conditions. That doesn't preclude
> messages about individual behaviour change, but I think it should preceed
> them.
>
> Glen Brown
>
> Glen Brown & Associates Consulting
> 488 Parliament Street, #1
> Toronto Ontario M4X 1P2
> T: 416-892-2286
> F: 416-966-1362
> E: [log in to unmask]
>
>
> -----Original Message-----
> From: Health Promotion on the Internet [mailto:[log in to unmask]]On
> Behalf Of Jacquie Poitras
> Sent: January 8, 2003 4:36 PM
> To: [log in to unmask]
> Subject: Re: community capcity for healthy eating
>
>
> I recognize that health and healthy eating have many social determinants.
> Every choice we make is based, in part, on societal factors,
dis/advanatage,
> peer group, consumerism--you name it.  But in the end, it is us as
> individuals
> who make decisions about our lives.  We are agents who act in a manner to
> improve our health or who choose "unhealthy" options.
>
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