A couple of days ago I received the link to this superb critical
analysis of Health Promotion in Canada, by Blake Poland of University of
Toronto's graduate Health Promotion program.  Many thanks to Dennis
Raphael for sharing it with me. The paper "Health Promotion in Canada:
Perspectives and Future Prospects" is a reworked version of a
presentation in Portuguese given to the Universidade de Fortaleza in
Brazil April 19, 2006.  It available as an 11 page PDF at
http://redalyc.uaemex.mx/redalyc/pdf/408/40820102.pdf  

Blake Poland offers a brief overview of the development of health
promotion in Canada, reflections on the social, political and economic
context of the field, three (3) key tensions he sees in the field, some
successes and a refreshingly candid look at failures and shortcomings of
Canadian health promotion. He closes with thoughts on future prospects
and some of the challenges ahead.
My margin notes and underscores riddled throughout the paper, with
exclamations of agreement, alarm and hope show how his perspectives
resonate with me. I hope that CLICK4HP readers will join in a discussion
of some of the points that Blake Poland makes in this paper.  We need to
explore the issues and ideas that he raises - especially our
shortcomings and challenges, and how to realize the future prospects
that are ahead.

Here are some highlights:

Some qualified successes of Canadian health promotion practice:
- qualified success in municipal leadership in healthy public policy and
with healthy communities movements
- acknowledgement of the need for environmental supports for behaviour
change
- recognition of the need for competence in culturally appropriate
programs
- training of health promotion practitioners in a full scope of practice
as described in the Ottawa Charter

Failures and shortcomings
- an inability to make meaningful, sustained progress on key health
disparities 
- the narrow scope and framing of mainstream health promotion;
including :
    * federal leadership in health promotion has diminished since the
1990s
    * an overwhelming emphasis on individual lifestyles modification
despite evidence of the importance of broader determinants
    * too much emphasis to single-issue approaches and funding silos
targeting tobacco, diet or exercise
    * health promotion programming designed by white middle-class
professionals for populations that are not; 
    * programs 'educating' people about healthy behaviours, even when
vital role of environmental supports is known
    * fewer forums for discussing health promotion practice and
research; 
   * education programs slow to incorporate qualitative participatory
methods and anti-oppression perspectives

Future Prospects
> Expect health promotion (HP) prominence to shift to countries of the
global South 
> New interest, funding and innovation in: environmental HP, mental HP,
global  HP and use of HP in conflicat resolution
> health promoters greater skilled in issues of diversity and addressing
systemic barriers
> spirituality, human connection, social relations, environmental
sustainability assume greater importance
> new forums for interdisciplinary debate and action
> new approaches to understanding the human condition and to working in
community.

Thank you Blake for opening the dialogue!

Alison

~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *
Alison Stirling,
Knowledge Management Developer,
The Ontario Prevention Clearinghouse,
180 Dundas Street W., Suite 1900 
Toronto, ON M5G 1Z8 
Direct: 416-408-6918 or 416-408-2249 x 2227
Toll-free (in Ontario)  1-800-397-9567 x2227
Email: [log in to unmask]  
www.opc.on.ca



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