Dennis's comment is spot on.
For a start, it is not just a question of addressing people's smoking or
levels of physical activity, but asking why these behavioural risk factors
are so closely linked to a range of social factors, such as powerlessness
and social isolation.
But then, and even more critically, we need to judge the direct causal
links between such structural forces and ill health.
Australia's National Heart Foundation recently established an expert
working party to review the available evidence on the risk factors for
heart disease. The expert group concluded that (i) there is strong and
consistent evidence of an independent causal association between
depression, social isolation and lack of quality social support and the
causes and prognosis of CHD; and (ii) there is no strong or consistent
evidence for a causal association between chronic life events, work-related
stressors (job control, demands and strain), Type A behaviour patterns,
hostility, anxiety disorders or panic disorders and CHD.
The increased risk contributed by these psychosocial factors is of similar
order to the more conventional CHD risk factors such as smoking,
dyslipidaemia and hypertension.
The report can be found at
http://www.mja.com.au/public/issues/178_06_170303/bun10421_fm.html
At 09:36 PM 4/04/2003, you wrote:
>the evidence is clear -- statistically -- that it is not lifestyle, but rather
>structural forces typically involving oppression of the poor. See articles at
>my website,
>
>dr
>
>
>Dennis Raphael, PhD
>Associate Professor and Undergraduate Program Director
>School of Health Policy and Management
>Atkinson Faculty of Liberal and Professional Studies
>York University
>4700 Keele Street
>Toronto, Ontario M3J 1P3
>tel: 416-736-2100, ext. 22134
>fax: 416-736-5227
>email: [log in to unmask]
>website: http://quartz.atkinson.yorku.ca/QuickPlace/draphael/Main.nsf/
>
>To unsubscribe send one line: unsubscribe click4hp to: [log in to unmask] .
>To view archives or modify subscription see:
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Bernie Marshall
Senior Lecturer, Health Promotion
School of Health Sciences
Deakin University
Burwood, Vic 3125
Australia
Tel: (61+3) 9244 6822
Fax: (61+3) 9244 6017
http://www.hbs.deakin.edu.au/healthsci/
To unsubscribe send one line: unsubscribe click4hp to: [log in to unmask] . To view archives or modify subscription see: http://listserv.yorku.ca/archives/click4hp.html
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