Sandi:

While I do agree that health promotion isn't necessarily the answer to
all of the health problems in the health care system, I think we need
to clarify what health promotion is.

Health promotion is about empowerment; mobilizing community action
on the determinants of health.  It is not simply "advertising campaign";
this is *one* strategy of health promotion that is often mis-understood
to be representative of all that health promotion undertakes.

In fact, health promotion practitioners recognize the most effective
way to changing behaviors is changing environments and policies, directed
by community action.  The results are enormous - most importantly,
generating capacity in communities to take action on other important
issues in their lives.

And, if health promotion activities are undertaken in an effective manner,
statistics show that 50-70% of cancers are in fact preventable.

This doesn't mean that there aren't a large number of cancer patients who
*have* led healthy lives, that still, unfortunately get struck by this
disease.
But there are a number of cancers that can be prevented.  Even more
important,
health promotion strategies can be used to increase the frequency with
which community members get screened for cancer, and hopefully, intervene
before the cancer is fatal.

So, I think Alison's point is quite valid.  If the future Canadian Public
Health
Agency loses its focus on health promotion, many populations will indeed
suffer.

If you'd like to know more about where I got my statistics and the health
promotion
work that my unit is doing in cancer prevention, feel free to send me an
email.

Sincerely,
Roxanne Felix
Diversity Outreach Coordinator
Alberta Cancer Board
([log in to unmask])
780-432-8884

-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]]On
Behalf Of Sandi Pniauskas
Sent: Saturday, May 08, 2004 2:03 AM
To: [log in to unmask]
Subject: Re: FW: Weekly Health Edition focus on National Public Health
Agency, cautions about HP


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

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