I think that I need to address the situation of Health Promotion and
it's efforts in the public venue specific to the cancer populations.
Healthy lifestyle/choices are simply of minor importance to many cancer
patients. The issue is not what they will eat that day, but whether they
will live that day or the next. Cancer in the near future will become
the leading cause of death in the North America's and it is simply a
fact that a large percentage of cancers are not directly or indirectly
related to this specific area of health promotion. Healthy lifestyle
issues will not make an impact on many in this patient population and is
seen as a barrier and another 'blame the Patient' advertising campaign.
Alison wrote that certain segments of the population do not seem to
understand that this approach is a general approach. However, as can be
seen from the responses which were generated through  different
dialogues, each group has a specific need. Until it is recognized that
these groups are a rather large part of the sum of the total, then it is
my view that health promotions which are general in nature and do not
address these needs, will quite simply fail.
In those populations where healthy choices are not available or not the
priority that some would wish, please understand one item of
significance. This also places an additional burden on certain segments
of the population over which adoptions of these policies are not going
to have any significant impact.
It is interesting because I had a conversation recently with a senior
person in a cancer centre around this very same issue. This individual
was speaking about efforts to reduce osteoporosis and heart disease,
through choice, to reduce the burden of health issues in persons of
advancing age. This individual should have known better and it was a
rather poor statement of understand given that the palliative care unit
was only steps away from our discussion.
Sandi Pniauskas

Stirling, Alison wrote:

>Greetings,
>
>The following item was sent by a colleague who noted that the different
>advice received about the new Canada Public Health Agency, included a
>warning about over-emphasizing health promotion. They seem to miss the point
>about health promotion as an approach that addresses multiple
>factors/determinants that contribute to overall health, not only personal
>choice. Note near the bottom of the article, that participants in one
>Canadian city warned that:
>"Promotion strategies tend to assume that all Canadians have the ability to
>make health choices, they said. But many people do not have adequate
>resources, or live too far away, to have access to a true range of healthy
>choices.''
>
>Let's have some discussion on the nature of health promotion to address
>access to adequate resources, and the connection of public health and health
>promotion!
>
>Alison Stirling,
>health promotion consultant,
>Ontario Prevention Clearinghouse
>http://www.opc.on.ca
>
>~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *
>
>-----Original Message-----
>From: [log in to unmask] [mailto:[log in to unmask]]
>Sent: May 6, 2004 7:47 PM
>May 7, 2004 Volume 8 Issue 18
>*****BENNETT GETS EARFUL ON PUBLIC HEALTH AGENCY*****
>
>Secretary of State for Public Health Carolyn Bennett has received a lot of
>different advice about the new Canada Public Health Agency the government is
>creating. She toured the country in March, meeting with over 300
>stakeholders in "roundtable" sessions. Summaries of these meetings have been
>posted on the Health Canada website.
>While Dr. Bennett heard things that mirrored the contents of the Naylor
>report on SARS last year, and which prompted the creation of the new agency,
>she also received feedback that may cause her to take the agency in a
>different direction.
>All sessions talked about a need for adequate, long-term funding for public
>health, and a number of sessions highlighted the disparities in public
>health services between regions.
>Participants in Iqaluit, Nunvaut remarked that the public health system is
>only as good as its weakest link, and said Nunavut is one of the weakest
>links. They said front-line workers are too busy addressing illness issues
>and have little or no time for public health.
>The same point was raised elsewhere. In Calgary, the minister was told to
>ensure the new public health agency avoids the "tyranny of the acute."
>Participants said acute health care issues tend to grab the most attention
>and funds, and deprive public health of scarce resources.
>The need to bolster health human resources in public health was a clear
>message delivered by most groups. There was also a call for the agency to
>encourage more people to specialize in public health, and ensure other
>specialists are educated in the principles of population health. And it was
>suggested some health professionals, like pharmacists, play a larger role.
>The Toronto session came up with the idea of creating a Canadian reserve - a
>cadre of health professionals licensed in all jurisdictions who can respond
>to emergencies in all parts of the country. However, participants in
>Edmonton said it is more important to ensure people at the local level are
>adequately trained to respond to crisis situations. They said SWAT teams
>sent out from a national location will not work.
>Local human resource capacity in public health is more important than a
>national vaccine stockpile, Regina participants warned.
>A common theme in all sessions was the need for the new agency to address
>the needs of different populations such as First Nations people and
>francophones in English communities. "One size does not fit all," Dr.
>Bennett was told.
>Similarly, participants in all sessions stressed that public health
>activities have to do more than deal with infectious diseases. They said the
>agency needs to focus on chronic diseases too, and the root causes of
>illness like poor housing. Mental health issues were repeatedly mentioned as
>something the agency has to address.
>It was also felt that the agency should have a public education mandate. Not
>only should the Chief Public Health Officer be a "champion" for public
>health, and a calming voice in times of emergency, but the agency this
>person runs should engage educators and schools in communicating basic
>public health messages to children.
>However, participants in Winnipeg warned about over-emphasizing health
>promotion. Promotion strategies tend to assume that all Canadians have the
>ability to make health choices, they said. But many people do not have
>adequate resources, or live too far away, to have access to a true range of
>healthy choices. "Health promotion strategies risk widening the health gap
>between the rich and poor," they said.
>In Regina, they said the agency needs to ensure Canadians have access to
>healthy choices. They said alcohol is the same price across Saskatchewan,
>but milk is 5 times more expensive in northern regions.
>In the coming months, the government will start broad consultations with
>Canadians on how it can better protect Canadians and the type of information
>and services Canadians are looking for. In the House of Commons Wednesday,
>Dr. Bennett said the search to fill the position of Chief Public Health
>Officer will begin next week.
>
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>
>

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