At the risk of repeating myself over and over, I will nevertheless say again
what I have been saying all along (for 35 years!), since the situation
obviously requires it! I'm preparing lecture notes for my Health Promotion
course, and at the risk of sounding like a Professor, let me reiterate that
all health strategies, be they primary, secondary or tertiary, require a micro-
meso-macro integrated approach. Now at times, we have to take a micro approach
in order to treat acute illness and prevent death. However, unless we move
downstream to the social, political, economic, psychological, ecological, etc.
determinants, then all our direct service programs, be they lifestyle or
otherwise oriented, will not be sustained. Heart disease, obesity, diabetes,
homelessnes, etc., are only symptoms of deeper underlying issues in the lives
of people and the structures of society. We need to cooperate and bring
together all professionals and service-providers, rather than being divisive
and blaming. Our clients' health problems are not the "fault" of any
professional group. Unless we work together both downstream and upstream, we
will never have enough resources to address the health care crisis which we
all face in post-industrial society. All health care professionals need to
support each other since the pressure to make major health care funding cuts
is immense and will continue.
Wishing all my colleagues a very happy and healthy holiday season.
Cheers,
Joe
--
Dr. Joseph Levy
Professor, School of Health Policy and Management
Atkinson Faculty of Liberal and Professional Studies;
Director, Wellness Centre at York University;
Academic Advisor, Vanier College
274 Vanier College, 4700 Keele Street
Toronto, Ontario M3J 1P3
Phone: 416-736-2100 ext, 33898
email: [log in to unmask] <mailto:[log in to unmask]>
Fax: 416-736-5899
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Quoting King David <[log in to unmask]>:
> Rachel, As a public health nutritionist who studied for six years I would
> expect you to say exactly what you have said. As a result of your personal
> investment in studying and practising nutrition you are bound to say that
> diet is important and should be valued - which it is because so many
> professionals and institutions have invested resources. I would expect
> similar responses from smoking cessation specialists and those specialising
> in promoting physical activity. Sometimes we need to stand back from our own
> professional perspectives in this debate. Whenever the lifestyle vs social
> and economic determinants debate develops on this list (usually twice a
> year) someone will point out that the two positions are not opposed, that
> they should be complimentary, that lifestyle interventions need to take into
> account social and economic factors and adapt their programmes accordingly.
> I agree that the recent debates are not productive, I would love to move the
> debate on to the relative effectiveness of social and economic interventions
> to promote health, however whereas nutrition is an accepted as a legitimate
> area of activity for health services to be engaged in action on the
> determinants of health is not. The relatively low numbers of practitioners
> engaged in this sort of activity and the paucity of relevant research and
> evaluation reports prevents us from having similar debates. Surely the
> debate should be about how we can promote the development of health
> promotion/public health infrastructure based on the broader determinants of
> health so at least the debate about the debates would be more balanced.
>
> > David King
> > Health Development & Regeneration Team
> > Barnet Primary Care Trust
> > Hyde House
> > The Hyde
> > London NW9 6QQ
> >
> > email: [log in to unmask]
> > tel: (020) 8201 4860 (w)
> > tel: 07973 739 158 (m)
>
>
> -----Original Message-----
> From: Rachel Moon Kelly [mailto:[log in to unmask]]
> Sent: 16 December 2003 14:40
> To: [log in to unmask]
> Subject: Re: Trans-fat...
>
>
> Thank you Jane - finally a balanced opinion. As a public health
> nutritionist who studied nutrition for 6 years I can confirm that your
> common sense approach of whole grains, vegetables & fruit, &
> lower-fat protein i.e. meat & alternatives (I would include lower-fat
> milk products as well) is supported by research. While the details
> of nutrition will probably continue to be debated for years to come
> since it is a young & complex science, these basics will not.
> I am also a strong believer in the determinants of health as well as
> in the fact that the two (i.e. determinants of health & healthy
> lifestyle) are not mutually exclusive. In fact, I believe that
> constantly debating whether nutrition has any value (which of
> course it does) actually diverts the focus from the social
> determinants of health even further. This completely defeats the
> purpose of those who are constantly devaluing the importance of
> healthy lifestyle. Does the media focus too much on healthy
> lifestyle? Yes. Does that mean we need to devalue it's
> importance. No. It means we need to take every opportunity to
> increase the profile of the social determinants of health as well.
> Why can we not agree that all facets of health are important &
> support each other's work rather than sabotage it? In-fighting only
> reduces the credibility of health professionals & does nothing to
> further the social determinants of health agenda.
> Thank you,
> Rachel Moon Kelly, MHSc, RD
> Public Health Nutritionist
> HKPR Health Unit
> 200 Rose Glen Road
> Port Hope, ON
> L1A 3V6
> Phone: (905) 885-9100
> Fax: (905) 885-9551
> email: [log in to unmask]
>
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