I agree that health promotion has to consider the role that societal
structures and social policy play. You are right, typically speaking,
biomedical and epidemiologic traditions have focused on individual risk
factors. However, by my understanding of epidemiology ( "the study of the
distribution and determinants of disease frequency"), epidemiology is not
by definition constrained from cosidering of societal determinants, but it
just rarely includes them. I think what is needed is not to fault the
epidemiologist in taking a limited view, but help find ways for
epidemologists and health educators to work in interdisciplinary ways with
others to get to the bigger picture. The way public health is funded at
least in the U.S. is an impediment to this.
Pat
Patricia P. Lillquist, MSW, PhD
Dennis Raphael
<Dennis.Raphael@M
AIL.ATKINSON.YORK To
U.CA> [log in to unmask]
Sent by: Social cc
Determinants of
Health Subject
<[log in to unmask]> [SDOH] Tell me I am wrong, PLEASE!
05/22/2007 02:31
PM
Please respond to
Social
Determinants of
Health
<[log in to unmask]>
I have been asked to write a "critique of the history and development of
health promotion in Canada."
Here is my abstract!
dr
-----------------------------------------------------------
Grasping at Straws:
The History and Development of Health Promotion in Canada
Arguably, the most important contribution of health promotion has been the
identification of the role that societal structures and public policy play
in shaping the health of populations in general and the most vulnerable in
particular. Despite Canada's reputation as a leader in the development of
such health promotion concepts, the implementation of these concepts in the
service of health has always been far from stellar and has lagged behind
developments in most other developed nations. Much of this has to do with
Canada's liberal political economy and the recent ascendance of neo-liberal
approaches to public policymaking. These developments have combined with
longstanding biomedical and epidemiological traditions to inhibit the
development of a structural approach to health promotion. While the
emergence of population health as a competing discourse to health promotion
has facilitated the development of numerous research initiatives related to
t! he determinants of health, any potential benefits of such activities
have been more than offset by the negatives associated with population
health's epidemiological orientation. There are continuing efforts by a
handful of visionary Canadian health promotion advocates to implement the
vision of health promotion outlined in the Ottawa Charter and subsequent
WHO health promotion declarations and charters. There is also increasing
attention being paid in reports and documents to the social determinants of
health. These efforts however count for little in the face of massive
amounts of government spending, media attention, and health sector
activities being lavished on "lifestyle" approaches to health promotion.
The emergence of the "obesity epidemic" as a focus of public, media, and
health sectors attention has only served to reinforce this orientation.
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