Sandi,
this is a parallel situation to acute care. I doubt if anyone is suggesting
that we do away with essential acute care services. If I'm having a heart
attack or am in a car accident, I sure as hell want the best acute care
available. Health promotion in no way refuses to acknowledge this, and by
the same token, palliative/ hospice care should be equally part of the
equation.
At 10:47 PM 5/10/2004, Sandi Pniauskas wrote:
>I support, every single day, women in palliative/hospice care
>situations. The families are unable to cope and are stressed to the
>breaking point. The community support is in many cases inadequate. Who
>is it in this environment that will advocate for change?
>Please do not take this as an indication that I do not value health
>promotion. That is not the intent. My intent is to try to make it clear,
>in my view, that in certain segments of our populations, a part of the
>sum of the total, that health promotion is simply not either on the
>agenda at all or at the lowest rung on the proverbial ladder. What I
>don't understand is the inability to understand that unless you can
>solve the immediate needs, then in select populations, health promotion
>will continue to be a challenge. I applaud all those who are involved in
>efforts of health promotion but if it is to be an inclusive venture then
>we need to understand where those efforts require special
>considerations. Unfortunately, there are many special considerations.
>Sandi
>
>
>Joyce Fox wrote:
>
>>Health promotion can be applicable at the individual level through to the
>>broad community level and encompasses helping indivudals ( and speciifc
>>groups within the pospulation)find strengths and capacity within
>>thmselves even when they are in dire cirsumstances. While the indivudal
>>may not be in a position to take large scale action, others who can serve
>>as advocates for change while the individual is coping with their issue
>>ahev an opoprtunity to influence the environment in which people who are
>>sstruggling live.
>>
>>Health promotion work can indeed be long term, and as we know from Maslow
>>it is next to impossible to worry about that future while trying to feed
>>or shelter your family. It is about taking baby steps and gaining
>>greater strength and belief that you can be susccessful, one small thing
>>at a time. Health promotion is not either or - education is one piece
>>but we know that promoting healthy eating by itself will not assit people
>>to get food on the table.
>>Joyce Fox
>>
>>
>>>From: Sandi Pniauskas <[log in to unmask]>
>>>Date: 2004/05/10 Mon PM 12:20:26 EST
>>>To: [log in to unmask]
>>>Subject: Re: FW: Weekly Health Edition focus on National Public Health
>>> Agency, cautions about HP
>>>
>>>Hi Roxanne;
>>>I am not at all disputing the need for healthy lifestyles and education.
>>>However, my response was directed with specific reference to the
>>>communities' replies, as per the prior message. It is a matter of
>>>priorities within those communities. The problem remains that each
>>>community whether it be cancer, Aboriginals, abused women and the like,
>>>have differing values and health promotion may not be and is quite
>>>possibly not at the top of the list.
>>>The larger question remains in how it is anticipated that communities
>>>can be empowered or motivated to address health promotion when they are
>>>simply trying to survive on a day to day basis? In many cases they do
>>>not have the ability to see the future as longterm and health promotion
>>>is seen' as a longterm goal. How can health promotion be integrated
>>>under these circumstances when these communities are making very little
>>>headway in already existing endeavours?
>>>I am glad that you brought up the subject though of screening. Other
>>>than breast cancer and prostate there is, to my knowledge, few other
>>>screening recommendations. There is no effective, or otherwise,
>>>screening for colorectal cancer nor for ovarian cancer. In the case of
>>>colorectal cancer there is a screening mechanism, the colonoscopy, but
>>>it has not been adopted due to cost. In ovarian cancer there simply is
>>>not one.
>>>Again, I am not disputing the value of healthy lifestyles but I guess I
>>>am repeating myself when I say that the environment for success is a
>>>difficult one.
>>>Sandi
>>>
>>>
>>>Roxanne Felix wrote:
>>>
>>>
>>>
>>>>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
>>>>
>>>>To unsubscribe send one line: unsubscribe click4hp to:
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>>>>
>>>>
>>>>
>>>>
>>>To unsubscribe send one line: unsubscribe click4hp to: [log in to unmask]
>>>. To view archives or modify subscription see:
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>>>
>>>
>>
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>>
>
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David Burman DDS PhD
University of Toronto
19 Russell Street
416-978-0536
www.rael.org
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