It seems to me that we can affect the social determinants of health, that
we all agree are fundamental, at both the community and policy levels.
Policy can work top down to enable or hinder community, or community action
can develop to cause policy change. In fact, most progressive policy change
is in response to sustained, astute, community based pressure. On the other
hand, the European healthy cities movement was very much a top down
initiative. Can we call it complementary? But neither of these approaches
focus on trying to get individuals to change their lifestyle.
I've just returned from the Ontario Healthy Communities Coalition
conference where many examples of citizen initiatives in community economic
development, for example, were having an effect at the local level. In
addition, Duff Conacher gave us some very pointed advice about the
political do's and don'ts in influencing policy change. Excellent conference.
david
At 11:12 AM 9/21/2004, you wrote:
>Hello,
>
>Last week I posted a message titled "Does endorsement of lifestyle
>programs = health promotion?" with a link to a Toronto Star article about
>the Canadian provincial premiers endorsing lifestyle programs of the
>federal government. I noted that Dennis Raphael had responded to this
>article on the SDOH list commenting on the neglect of determinants of
>health. I suggested that the same could be said about the broad concepts
>of health promotion, and invited CLICK4HP subscribers to add comments.
>
>Robyn Kalda replied, asking about language use of 'health' instead of
>'medical' care, and when that change occured.
>
>I also received a message directly back from Dennis Raphael, which he
>agreed could be posted to the CLICK4HP (he is not a subscriber).
>
>Dennis Raphael had some provocative comments about the question of
>lifestyle = health promotion. To reply directly to him, please contact
>[log in to unmask] Or post your reply back to this list and keep the
>discussion going...
>
>The following comments are not my own opinion (which is that health
>promotion may be a 'quieter' field than others, and is quite broad in
>perspective and participants):
>
>
>Dennis Raphael [mailto:[log in to unmask]]
>09/16/2004 05:25 PM
>Subject: HP is dead
>
>It is dead because its advocates have let it die. When Toronto public
>healthy renamed all of its community health nurses to healthy lifestyle"
>nurses. No body said a word! This has happened all across Canada. Indeed,
>click4hp is dominated by lifestyle discourse and adherents. H.P. R. I. P.
>
>[he added that an unpublished letter signed 'anonymous' and attached, said
>it all. that unpublished letter is not included here]
>
>Dennis added in a later email:
> "I tell people that the middle has fallen out of HP.
>People have either moved into policy -- like me -- or retreated to
>lifestyle approaches like... "
>
>Anyone wish to respond? Does it feel like health promotion is either
>policy or lifestyle?
>
>I believe that the 'middle' is still vigorously alive. The strategies and
>places that we use may be more focused on enabling communities to take
>control of the conditions affecting the health of their communities,
>rather than being outspoken advocates for our field.
>
>
>Alison
>
>~~~~~~~~~~~~~~~~
>Alison Stirling
>health promotion consultant (on leave until Aug 2005)
>co-facilitator, CLICK4HP listserv
>email: [log in to unmask]
>
>To unsubscribe send one line: unsubscribe click4hp to: [log in to unmask] .
>To view archives or modify subscription see:
>http://listserv.yorku.ca/archives/click4hp.html
David Burman DDS PhD
University of Toronto Dental Care Centre
19 Russell Street 81 St. Clair Ave E
416-978-0536 416-961-8778
www.rael.org
To unsubscribe send one line: unsubscribe click4hp to: [log in to unmask] . To view archives or modify subscription see: http://listserv.yorku.ca/archives/click4hp.html
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