The role of political ideology in health promotion is especially important.  In
Ontario, Canada the (very right wing) province has allocated $17,000,000 to
health units and related coalitions to "promote cardiovascular health."  The
program is rigidly limited to diet, tobacco use, and physical activity.  There
is NO space provided for community inout into other issues that we know impact
cardiovascular health.  And by the way, these other factors (poverty, lack of
services, lack of housing, etc. ) are the very ones that the province is hell
bent on increasing).

This is a tremendous example of what Michael Fitzpatrick calls the control of
individuals and communities especially low income ones by governments -- and
their agents -- unwilling to address these more important pressing issues.  The
message sent out to the public -- and these affected (low income) communities --
is that your health is in your hands (which we know isn't the case) and that you
are the cause of your own misfortune (such as the tremendous gap between rich
and poor in heart disease.) That public health units are complicit in this
effort.

Our experience in produncing our income and heart health report is another
example of the kind of resistance we must deal with.  The only member of the
coalition who expressed opposition to the substance of the report was a member
of the local health unit whose objections were overuled by the community
partners.  Nonetheless, the network has been told that no further reports of
this kind will be tolerated! and life would be calmer for all if they went back
to walking trails, fruits and vegetables, and anti-smoking campaigns and left
the issues of poverty, hunger, homelessness and exzclusion to "activists."

Any thoughts on this are welcome!

dr

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