I agree with you.

In their recent book "The Obesity Epidemic, Science, Morality and
Ideology", authors Michael Gard and Jan Wright cover the issues you have
just raised.  It was a fascinating book that discussed a variety of
issues that must receive higher profile in professional discourse.
These include the accuracy of using the term obesity "epidemic", the
risks and ethics of the obesity epidemic and the repercussions of
medicalizing obesity.

I think it should be required reading for health educators and health
promoters, perhaps at the undergraduate level.  

Cheers,
Helen

-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Dennis Raphael
Sent: Thursday, August 03, 2006 3:43 AM
To: [log in to unmask]
Subject: [SDOH] The Ethics of Problem Identification in Public Health

A paper needs to be written about the ethics of the public health
community
taking it upon themselves to define what the primary health problem is
among a population independent of the wishes, desires, and needs of the
population in question.  Consider the ethics of the Canadian public
health
establishment, CPHA, CIHR, Ministries of Health, Ontario Medical Officer
of
Health Basrur deciding that obesity (or smoking for that matter) should
be
the primary target of public health workers activities, exhortations,
campaigns, leaflets, etc.  Asking Canadians at risk of poor health --
and
we know who they are -- what would improve their health would reveal a
different story:  These families would like to see decent and secure
incomes, adequate housing and food resources, respect from the society
in
general, and a belief that there is some semblence of a social safety
net
to support them and their families (see refs below).

Instead,  these desires and needs are brushed aside by the public health
establishment in the service of healthy behaviours and obesity
eradication.
Not a compelling picture of public health and professional ethics, is
it?

dr


Raphael, D., Renwick, R., Brown, I., Phillips, S., Sehdev, H, &
Steinmetz,
B. (2001). Community quality of life in low income urban neighbourhoods:
Findings from two contrasting communities in Toronto, Canada. Journal of
the Community Development Society, 32, 310-333.
Raphael, D., Renwick, R., Brown, I., Steinmetz, B., Sehdev, H., &
Phillips,
S. (2001). Making the links between community structure and individual
well-being. Community quality of life in Riverdale, Toronto, Canada.
Health and Place, 7 (3), 17-34.

Raphael, D., Phillips, S., Renwick, R., & Sehdev, H. (2000). Government
policies as a threat to public health: Findings from two community
quality
of life studies in Toronto. Canadian Journal of Public Health, 91,
181-187.

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