Forgive me for raining on Margie Rutledge's parade (What illness can teach
you, Sept. 17, 2005) but the research evidence strongly contradicts her
platitude concerning the causes of disease: "We all know we should
exercise, eat properly and get enough sleep." It is now well established --
though generally unknown to the public -- that the primary determinants of
health and illness are the degree of income one has, the quality and
security of one's employment,  and the degree of uncertainty associated
with obtaining adequate housing, food, and societal respect. Health Canada
and the World Health Organization recognize the importance of these social
determinants of health. And research study after research study continue to
show that "lifestyle" choices account for a rather small proportion of
incidence of  afflictions ranging from cardiovascular disease to type II
diabetes to arthritis.  Why do we continue to be bombarded with the common
sense -- but wrong -- notion that our health is a result of our own
actions?

Dennis Raphael, Ph.D.
Associate Professor & Undergraduate Programme Director
School of Health Policy & Management
Atkinson Faculty of Liberal & Professional Studies
York University
4700 Keele St.
Toronto ON M3J 1P3
Ph: 416-736-2100 ext. 22134
Fax: 416-736-5227
E-mail: [log in to unmask]
Website: http://www.atkinson.yorku.ca/draphael

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