Please take me off your email list.
I appreciate your excellent work but can't keep up with all the
communications unfortunately.
Best of luck,
Liyu
Liyu Guo
Campaign 2000/Social Reform
Family Service Assoc. of Toronto
355 Church St. Toronto M5B 1Z8
Tel: 416-595-9230 x244; Fax: 416-595-0242
E-mail: [log in to unmask]
Websites: www.campaign2000.ca & www.fsatoronto.com
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-----Original Message-----
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
Dennis Raphael
Sent: Thursday, August 03, 2006 6:33 AM
To: [log in to unmask]
Subject: [SDOH] Obesity as a "cause" of diabetes?
Actually, the evidence concerning obesity as a causal factor in type II
diabetes is rather equivocal. This is another example of the dominant
behavioural paradigm distorting analyis and understanding of a health issue
-- see below...
-------------------------------------------------------------------------
"Ninety percent of the variance in occurrence of metabolic syndrome
observed in the Whitehall studies cannot be accounted for by conventional
behavioural risk factors.33"
"Virtually nothing is known about the causes of recent increases in
morbidity and mortality among the Canadian population in general, and the
low-income population in particular.28 The presence of the metabolic
syndrome has been identified as a significant indicator of a predisposition
to diabetes (as well as CVD).29 30 Conventional thinking among health care,
public health workers, and disease-oriented associations attributes
increases in the presence of the metabolic syndrome and increases in
morbidity and mortality to changes in dietary and activity patterns among
Canadians 31, similar to traditional thinking concerning CVD-related
issues.12,32 Yet, this dominant "health behaviours" paradigm takes little
account of the increasing literature concerning the importance of the
social determinants of health in population health in general and the
incidence and management of diseases such as diabetes in particular. Ninety
percent of the variance in occurrence of metabolic syndrome observed in the
Whitehall studies cannot be accounted for by conventional behavioural risk
factors.33 "
"An extensive analysis of the determinants of adults' health-related
behaviours such as tobacco use, physical activity, and healthy diets, found
these behaviours were predicted by poor childhood conditions, low levels of
education, and low status employment.(37) The study also found that poor
socioeconomic conditions during early life make it less likely that people
feel they have control over their lives - a factor that can contribute to
illness Identifying some of the possible pathways to diabetes mellitus such
as material deprivation, excessive psychosocial stress, and adoption of
health threatening behaviours suggests value in applying a societal
determinants of diabetes approach. Certainly, such an analysis would
contribute to our understanding of why and how diabetes mellitus is an
especially important issue for low income and other vulnerable populations.
And considering the increasing numbers of low income families living in
urban Canada, such a focus seems especially important.(12)"
Yu, V. & Raphael, D. (2004). Identifying and addressing the social
determinants of the incidence and successful management of type 2 diabetes
mellitus in Canada. Canadian Journal of Public Health, 95, 366-368.
http://quartz.atkinson.yorku.ca/QuickPlace/draphael/Main.nsf/h_Library/083BA
721B77F5BA485256F2E004EB029/?OpenDocument
Raphael, D., Anstice, S., Raine, K., et al. (2003). The social
determinants of the incidence and management of Type 2 Diabetes Mellitus:
Are we prepared to rethink our questions and redirect our research
activities? Leadership in Health Services, 16, 10-20.
http://quartz.atkinson.yorku.ca/QuickPlace/draphael/Main.nsf/h_Library/2F5A8
832066E485F85256D86003EE54C/?OpenDocument
Steve Cummins <[log in to unmask]>@YORKU.CA> on 08/03/2006 05:49:06
AM
Please respond to Social Determinants of Health <[log in to unmask]>
Sent by: Social Determinants of Health <[log in to unmask]>
To: [log in to unmask]
cc:
Subject: Re: [SDOH] anti-obesity technology
I find the view that obesity is an unreliable indicator of physical
health rather a strange and potentially dangerous one.
It is true that how obesity is measured is contested and that
discrimination and weightism is rife. For example BMI is not as reliable
as Waist-Hip Ratio or Abdominal Fatness and that certain groups (such as
athletes for example) can be heavier and still be healthy. It is also
true that some people who are overweight are not unhealthy (in fact
being overweight in old age is protective). You can be 'fat' and 'fit'.
However the evidence that being obese causes physical health problems at
the population level CANNOT be seriously contested at present. For
example there is strong evidence that being overweight is implicated in
half of all diabetes cases and reduces life expectancy by up to 7 years.
To suggest otherwise is factually incorrect based upon current evidence
and detracts focus from what is a very real and pressing public health
problem
A thorough evidence-based resource can be found here:
http://www.cdc.gov/nccdphp/dnpa/obesity/index.htm
Cochrane Reviews for obesity-related illnesses and interventions can
also be found here:
http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME
Best
Steve Cummins
Carrie Brown wrote:
> Thank you Graeme, I believe weight is an unreliable indicator of
> physical health. I know many people within the "acceptable weight
> range" with high cholesterol, high blood pressure and who are not
> physically active or who don't eat well enough to achieve health
> benefits. I also know many people who are above the "acceptable weight
> range" who are physically fit and extremely healthy.
>
> I think in the next couple of years we're going to find that obesity
> rates have decreased, but overall, people's physical health has not
> improved. Because all those people who do not fall into the overweight
> or obese category do not get the message because they are not being
> targeted and don't feel that they are at risk.
>
> I'm afraid as a society we've created the situation where we look at
> each other and judge health and character based on appearance. This is
> extremely disconcerting, especially in a world so desperately in need of
> acceptance, empathy and compassion.
>
> Carrie Brown
> Health Promotion Liaison
> Northern Lights Health Region
> 11202 - 100 Ave.
> High Level, A.B. T0H 1Z0
> Phone: (780) 841-3204
> Fax: (780) 926-7375
> [log in to unmask]
>
> "Take care of ourselves and each other, spend time with loved ones, take
> breaks when necessary and enjoy each moment on this lovely green and
> blue planet." ~Tooker Gomberg~
>
>
> -----Original Message-----
> From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of
> Graeme Bacque
> Sent: Wednesday, August 02, 2006 11:08 AM
> To: [log in to unmask]
> Subject: Re: [SDOH] anti-obesity technology
>
> One more serious issue to point out about this whole obesity obsession -
>
> this kind of excessive state and medical-sanctioned focus on impossible
> standards of physical appearance and performance is in fact a known
> aspect of fascism. It indicates a degree of social intolerance which is
> becoming extreme.
>
> These kind of 'standards' have been used deliberately and systematically
>
> to denigrate and oppress women, non-Europeans, religious minorities and
> persons with disabilities (among others) for centuries.
>
> The original history underlying this probably dates back to Biblical
> times, where a person's physical characteristics were routinely
> associated with either 'good' or 'evil'. This became highly evident in
> Europe during the Burning Times. The Nazis escalated this form of
> persecution to an extreme degree during their reign.
>
> This is a no-win situation and the worst form of victim-blaming -
> although the person affected may actually be primarily a 'victim' of
> society's scorn over physical attributes which are entirely beyond their
>
> control and which may not even specifically be a health issue. In the
> end it boils down to other peoples' sense of aesthetics being offended
> as opposed to being a valid indicator of someone's true state of
> physical well-being.
>
> I for one find this obsessive, narrow, judgmental, out of context
> official focus on certain physical characteristics (to the exclusion of
> most other personal attributes) to be highly alarming. People need to be
>
> valued in all their diversity, no matter what color, shape or size they
> may come in.
>
> Graeme
>
> Adam P. Coutts wrote:
>> an innovative individual protective mechanism for the impending
>> obesity epidemic! I think it's US based.
>>
>> http://www.harrietcarter.com/Detail.cfm?pth=13&Cat=111&prod=4594&sr=1
>>
>> -------------------
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>>
>
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--
Steven Cummins MSc PhD
MRC Fellow
Department of Geography
Queen Mary, University of London
Mile End Road
London E1 4NS
T: 44 020 7882 7653
F: 44 020 8981 6276
E: [log in to unmask]
W: http://www.geog.qmul.ac.uk/staff/cummins.html
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