At least I struck an nerve.

It seems  that the primary health care system [what there is of a system]
might be the place to integrate health promotion into services which
reach more than the elite.

When the City of Baltimore built a running track in inner-city East
Baltimore, my racist attitude was that the last thing that 'these folk'
needed was a running track.

I was a bit surprised when I saw it becoming highly used by local
residents.

Bill Ward

On Wed, 9 Jul 2003 10:23:38 -0400 Jacquie Poitras
<[log in to unmask]> writes:
> A very noble idea.  Luckily for us, there are many middle- and
> upper-class
> individuals who see struggle to get into academia and spend their
> days musing
> about how wonderful it would be if those poor folk stopped dealing
> with
> troubles paying the rent, buying food, and trying to escape the
> cycle of
> poverty and instead went into the field of health promotion.  It
> seems a touch
> paternalistic to me.
>
> Jacquie Poitras
>
>  --- Bill Ward <[log in to unmask]> wrote: > Dennis,
> >
> > Health Promoters tend to be middle class or above. They understand
> the
> > middle and upper income groups and the methods work well there.
> >
> > What is needed is to recruit people from lower income groups into
> health
> > promotion. That has not happened yet. It may be that potential
> health
> > promoters from the low classes are two busy fighting 'downstream'
> > problems [
> >
>
http://www.easp.es/ProyectosTem%E1ticos/wwwiuhpe/esp/ponencias/Inequaliti
> > es/Heeman.doc ] to have time for 'upstream' strategies.
> >
> > Bill Ward
> >
> > On Wed, 9 Jul 2003 09:36:19 -0400 Dennis Raphael
> > <[log in to unmask]> writes:
> > > please respond to [log in to unmask]
> > >
> > >  Sent by:  "The Health Equity Network (HEN)"
> > >            <[log in to unmask]>
> > >
> > >  To:       [log in to unmask]
> > >
> > >  cc:       (bcc: Dennis Raphael/Atkinson)
> > >
> > >
> > >
> > >  Subject:  Re: remind me again...
> > >
> > >
> > >
> > >
> > >
> > >
> > >
> > > I think the last point is a useful one, and relates to an issue
> that
> > > has been
> > > bugging me for some time.
> > >
> > > In measuring health inequalities and impact on health
> inequlaities
> > > we all seem
> > > to be comparing and contrasting disparities in health status of
> two
> > > populations with disparities in economic and social advanatage.
> > >
> > > Thus comparing the health staus within two populations with
> > > comparable  social
> > > and economic status, but different smoking status would be
> > > extremely
> > > informative. But surely this has been done?
> > >
> > > I also think it would be useful to look at the health status of
> > > populations
> > > with similar social and economic status, but some with
> inequality
> > > interventions (say through urban regeneration funding of some
> sort)
> > > and some
> > > without.
> > >
> > > This controlled approach would probably tell us more about the
> > > effectiveness
> > > of inequality  interventions than the before and after
> assessments
> > > that tend
> > > to be done now.
> > >
> > > [log in to unmask] wrote:
> > >
> > > > Well, that is a good question. There is pretty good
> > > > evidence that not smoking and possibly eating more
> > > > fruit and veg decrease the risk of diseases that are
> > > > major causes of premature mortality. There is also
> > > > a debate on whether this is the case only for people
> > > > who don't have other major health risks such as
> > > > poverty. I would think non-smoking must actually
> > > > be a better choice in strict health terms no matter
> > > > what your economic situation. However, the next
> > > > question is why should anyone living under such
> > > > conditions NOW worry about a disease they might
> > > > get in 20-30 years' time? And the next question is
> > > > about the ethics of threatening people who already
> > > > have so many serious problems with health doom
> > > > unless they begin behaving in a more middle
> > > > class way. I have never actually seen a study
> > > > of disease incidence or mortality in a very
> > > > disadvantaged population comparing those who
> > > > did and did not smoke, come to think of it.
> > > > Someone else might know one?
> > > >
> > > >
> > > > healthDate sent:        Tue, 8 Jul 2003 21:46:04 -0400
> > > > Send reply to:          Dennis Raphael
> > > <[log in to unmask]>
> > > > From:                   Dennis Raphael
> > > <[log in to unmask]>
> > > > Subject:                remind me again...
> > > > To:                     [log in to unmask]
> > > >
> > > > > Remind me again how exercising, eating fruits and
> vegetables,
> > > and
> > > > > quitting smoking is going to improve the health of
> Ontarians...
> > > > > --------------------------- News Release
> > > > >  Released:July 08, 2003
> > > > >
> > > > >  Bitter strikes, rationed services, increasing poverty
> > > > >  and homelessness, and a crumbling social safety net
> > > > >  legacy of Tory policies
> > > > >
> > > > >  Toronto - The Ontario Conservative government's social
> service
> > > > >  spending cuts are a false economy leading to growing
> poverty
> > > and
> > > > >  homelessness, less home care support services, fewer
> affordable
> > > child
> > > > >  care spaces, and increasing labour disputes in the
> community
> > > agency
> > > > >  sector, say members of a social justice labour alliance.
> > > > >
> > > > >  Many community-based social service agencies are in a
> deficit
> > > > >  situation, and in an effort to stay afloat financially,
> are
> > > > >  extracting wage and benefit concessions from already
> low-paid
> > > > >  workers. Bitter strikes, like the one now underway at
> > > Toronto's
> > > > >  Central Neighbourhood House, a community agency that
> provides
> > > home
> > > > >  support, shelter and youth services, and child care, are
> > > becoming
> > > > >  increasingly commonplace in the sector.
> > > > >
> > > >
> > > > Mel Bartley
> > > > Dept of Epidemiology and Public Health
> > > > University College London Medical School
> > > > 1-19 Torrington Place
> > > > London WC1E 6BT
> > > > tel: 0207 679 1707
> > > > mobile: 07740 438775
> > > > fax: 0207 813 0280
> > >
> > >
> > > --
> > > Message sent with Supanet E-mail
> > >
> > > To unsubscribe send one line: unsubscribe click4hp to:
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> see:
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> > >
> > >
> >
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