Dennis and others -

Congratulations for helping create a national vehicle, and thanks for so
much interesting contextual material, Dennis. I assume it's a long-wave
strategy, since "getting it" for most people/politicians/jurisdictions/power
blocs means a paradigm shift from seeing society as a disarticulated set of
parts to seeing it as an articulated whole, without obliterating the parts..

The sociobiologist Edward O. Wilson, in his book "Consilience: the Unity of
Knowledge" (1999?) talked about the need to foster a "jumping together" of
disparate knowledge cultures. Perhaps consilience will occur around the
social determinants of health as a precursor and spur to action. Perhaps we
steely-headed idealists can make it so. As Berry Fleming said in his 1943
novel Colonel Effingham's Raid, "Idealists. are the really practical people.
They are the realists; not the materialists necessarily, but the realists".

John Butler
Markham Ontario


----- Original Message -----
From: "Dennis Raphael" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, December 08, 2002 6:45 AM
Subject: Re: ideas re a national stratrgy


> The Institute of Population and Public Health and the Canadian Population
Health
> Initative (CPHI)at CIHI are pushing from the top.  At last weekend's
conference
> on Social Determinants of Health Across the Life-Span attendees decided to
set
> up a "social determinants of health movement" in Canada.  This had various
> parts.
>
> The first was to have parties join click4hp.  I note that enrolment on it
has
> jumped 120 in the past few days since the conference.
>
> Second, a statement of charter is being prepared that sets the stage for
such a
> movement.  Michael Polanyi and/or Peggy Edwards would be able to update
you on
> that.
>
> Third, I will be approaching -- once I catch my breath -- the CPHI to
support
> information dissemination related to social determinants.
>
> In the meantime, the website at www.socialjustice.org is beginning to post
all
> of the presentations from the conference, proceedings will be posted
shortly,
> and a book based on the conference will be forthcoming in 12-14 months.
>
> dr
>
>
>
>
>
>
>
>
>
> Agora Group <[log in to unmask]>@YorkU.CA> on 12/08/2002 12:17:11
AM
>
> Please respond to Health Promotion on the Internet <[log in to unmask]>
>
>   Sent         Health Promotion on the Internet
>   by:          <[log in to unmask]>
>
>   To:          [log in to unmask]
>
>   cc:          (bcc: Dennis Raphael/Atkinson)
>
>
>
>   Subject      ideas re a national stratrgy
>   :
>
>
>
>
>
>
>
> 4HP colleages -
>
> May I take a minute of your time, and a few of your brain cells?
>
> Below you will find an editorial I wrote for the Nov. 25 edition of
Import,
> a free e-newsletter I publish weekly for folks in the health and human
> services sector. The gist of the editorial is that the Romanow Report
helps
> give us a national strategy for health care, but there has been no similar
> process to develop a national strategy for determinants of health.
>
> If you are of a mind to share your thoughts, may I ask two questions:
>
> 1.  Is there any national process underway, with both credibility and
> influence, that is addressing the determinants of health as a national
> priority (or could easily address them) that I just don't know about?
>
> 2.  Does the idea of a national strategy make sense in the first place, or
> is it best to just keep plugging away from the bottom, or is there another
> option?
>
> 3.  If there is no process addressing determinants of health as a national
> priority, are you aware of (or can you suggest) tactics to move us, as a
> nation, toward such a strategy?
>
>  I ask these questions because I plan to keep returning to the
determinants
> theme in the newsletter, but I could use the wisdom of those with more
> experienced minds - as well as fresher, newer minds - before I get wildly
> out of my depth.
>
> I apologize in advance if these seem like "duh" questions with obvious
> answers.
>
> Thanks for considering this request...
> John Butler
> Markham Ontario
>
> .......................................
>
> IN MY HUMBLE OPINION: GETTING PAST ROMANOW
>
> I will be glad when Commissioner Roy Romanow issues his final report.
Then,
> the debate that has been simmering for years among our political
> jurisdictions will be overt and fractious. At least the battle lines will
be
> drawn for all to see, and our political jurisdictions have a chance to
prove
> their mettle by finding agreement after the inevitable first round of
> posturing. It is likely that Romanow will argue for maintenance of a
> publicly funded system. He will also likely argue for more federal
funding -
> but for a system as it ought to be rather than as it is (uncoordinated,
> bureaucratized, dominated by professional pressure groups, and slanted
> against populations most at risk of ill health). Romanow may well propose
an
> expansion of medicare into pharmacare and home care.
>
> Provinces (once bitten, twice shy) will resist unless expansions are
> accompanied by ironclad federal guarantees to fund the expansions. Some
> provinces will still yammer on about the private sector as a potential
major
> new player, but most will not. The idea of user fees will largely and
> rightly be discarded as irrelevant silliness.
>
> But important though medicare reform is, it is not the crux of our
society's
> health problems. Romanow, if he follows past patterns in major reform
> reports, will acknowledge, as we all do, that the determinants of health
go
> well beyond the health care system, and that addressing health means
> addressing all the other social elements - the economy, education,
housing,
> the environment, and on and on - that make the biggest difference to our
> health. But again, if he follows past patterns he will say "We really must
> do something about these determinants of health", without proposing a
> detailed national blueprint addressing the determinants of health.
>
> Ever since Canada's Lalonde Report was released to international acclaim
in
> 1974, Canada and other nations have paid a good deal of lip service to
> coordination of societal engines so they produce health and well-being
> rather than misery. And there has been good work done - witness, for
> instance, the rise of the population health paradigm, and the growth of
the
> healthy communities movement, an international groundswell in which
> Canadians - particularly Trevor Hancock - took a lead.
> But by and large governments have done little to act in accord with the
> belief that economic and social justice yield health. They seldom
integrate
> their own internal operations across social and economic fields. Their
> departments remain separate grumpy hippopotami, unlikely or unable to
> cooperate on the creation of health.
>
> Maybe after Romanow's work is done - and after the post-Romanow squabbling
> has abated - we can get back to pushing our governments (through the
ballot
> box, through lobbying, through creative community action that governments
> are expected to match) in the direction of integrated approaches to health
> and well-being.
>
> John Butler, The Agora Group
>
> FROM THE QUOTES VAULT
>
> "But if men cannot live on bread alone, still less can they do so on
> disinfectants."
>           Alfred North Whitehead
>
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