As a health promotion student, and a student of the social determinants
of health, I have the utmost respect for Dr. Raphael, his work and his
tireless advocacy efforts. However, I can't help feeling a slight tinge
of irony when the statement "HP is dead" comes from a person who is
responsible for reducing the dialogue on this HP listserv by a fair
amount! I'm confused as to why a person so seemingly passionate about
health promotion dropped his contribution to this critical aspect of the
field (communication and education), even though healthy and meaningful
dialogues on all aspects of HP were happening on a regular basis. Or
perhaps Dr. Raphael can enlighten us as to how the social determinants
of health and HP are different?
Health promotion is a large variety of fields, including lifestyle,
social determinants, policy, and front-line work, and is very much
alive. I agree that changing the title of community health nurses to
"healthy lifestyle nurses" is silly, but does that really change the
valuable services these people provide to those they serve and help?
There are a huge number of people doing health promotion work, neither
policy or lifestyle, that aren't even aware that they are doing so - by
no means does this make their contribution to the field less valuable
than others who may be more vocal.
In my opinion, the only sure way to kill HP is to place social and
lifestyle determinants in silos, and to claim that one is "better" than
the other. Sure, people have leanings, opinions, areas of expertise and
interest, etc., but those should be respectfully and tactfully received
even if they happen to not coincide with your own. Even as an HP
student with a distinct social orientation, I feel it is far more useful
to quietly learn about those who conduct breast cancer screening or
smoking cessation, rather than expend valuable time and energy
describing how these people should be doing something else. Further, I
would think that information around the social determinants of health
should be made easily available to those who lean towards the lifestyle
side of HP, rather than simply "preaching to the converted" in a
separate forum.
Of course, these are my opinions. I respectfully welcome others :-)
Eric Hemphill
[log in to unmask]
-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]] On
Behalf Of Alison Stirling
Sent: Tuesday, September 21, 2004 9:13 AM
To: [log in to unmask]
Subject: Is health promotion 'dead'? Or quietly building capacity of
others?
Hello,
Last week I posted a message titled "Does endorsement of lifestyle
programs = health promotion?" with a link to a Toronto Star article
about
the Canadian provincial premiers endorsing lifestyle programs of the
federal government. I noted that Dennis Raphael had responded to this
article on the SDOH list commenting on the neglect of determinants of
health. I suggested that the same could be said about the broad concepts
of health promotion, and invited CLICK4HP subscribers to add comments.
Robyn Kalda replied, asking about language use of 'health' instead of
'medical' care, and when that change occured.
I also received a message directly back from Dennis Raphael, which he
agreed could be posted to the CLICK4HP (he is not a subscriber).
Dennis Raphael had some provocative comments about the question of
lifestyle = health promotion. To reply directly to him, please contact
[log in to unmask] Or post your reply back to this list and keep the
discussion going...
The following comments are not my own opinion (which is that health
promotion may be a 'quieter' field than others, and is quite broad in
perspective and participants):
Dennis Raphael [mailto:[log in to unmask]]
09/16/2004 05:25 PM
Subject: HP is dead
It is dead because its advocates have let it die. When Toronto public
healthy renamed all of its community health nurses to healthy lifestyle"
nurses. No body said a word! This has happened all across Canada.
Indeed,
click4hp is dominated by lifestyle discourse and adherents. H.P. R. I.
P.
[he added that an unpublished letter signed 'anonymous' and attached,
said
it all. that unpublished letter is not included here]
Dennis added in a later email:
"I tell people that the middle has fallen out of HP.
People have either moved into policy -- like me -- or retreated to
lifestyle approaches like... "
Anyone wish to respond? Does it feel like health promotion is either
policy or lifestyle?
I believe that the 'middle' is still vigorously alive. The strategies
and
places that we use may be more focused on enabling communities to take
control of the conditions affecting the health of their communities,
rather than being outspoken advocates for our field.
Alison
~~~~~~~~~~~~~~~~
Alison Stirling
health promotion consultant (on leave until Aug 2005)
co-facilitator, CLICK4HP listserv
email: [log in to unmask]
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