Absolutely, and well said Anne! These two are absolutely interrelated
and interwined. It's not just about academicians and politicians coming
up with unrealistic policies, and it's not just about individual
responsiblities of one's lifestyle choices. We need policies that
affect the "social determinants", and why? Because these policies could
change the environment that affect our individual lives, and also in a
larger social and political context that help to facilitate and
encourage changes in our lifestyle. For example, you can't promote
outdoor activities, if the neighborhood that you live is unsafe and
can't afford developing recreational spaces and activities for its
residents. We do also need "ordinary people" who are constantly making
the lifestyle decisions and choices to stand up and voice their issues
so that we can change the "social determinants" from the larger
environmental and social context. In other word, to come up with useful
policies and get it passed in our political system, we need people to
advocate for themselves and for the communities, and we need people to
understand the issues and to vote! When these two forces join, we can
do great things!
>>> Annette Penney <[log in to unmask]> 01/08/07 6:43 AM >>>
One listserv member stated that "Life-style choices are simply not
separable from the social context in which they occur. " and that "It
might be more appropriate to ask what is the most effective way to
impact upon the health of a population: to try to change the life-style
choices of individuals or to change the social determinants."
Since they are not separable and there is an effect on health from the
interaction of the social determinants and lifestyle choices, both need
to be addressed. First of all address the SDOH and then lifestyle
choices. My view is that after I make certain lifestyle choices because
I have limited options (I am a low-income single parent for instance), I
may continue to make them after I have more options simply because it's
what I'm accustomed to doing. If the SDOH are addressed and I have more
options I may need information to allow me to make better "lifestyle
choices." I wouldn't want anybody to get the idea that we can toss the
health promotion model aside just because we have addressed SDOH. It is
a combination of the two that will make the greatest difference in
health outcomes and quality of life (addressing SDOH first). .
Annette A. Penney, B.A. (Hons), M.A.
Community Researcher
LFVA Community Health Centre
www.langs.org
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