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Social Determinants of Health

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From:
christine mckay <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Tue, 21 Nov 2006 21:29:47 -0800
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Thanks for your comments!  Christine

--- Brian Fleming <[log in to unmask]> wrote:

> Certainly the Ottawa Charter included strong equity
> principles. However,
> while the 1978 Declaration of Alma Ata resulted from
> the participation of
> developing nations, only industrialised countries
> attended the First
> International Conference on Health Promotion in
> 1986, which resulted in the
> Ottawa Charter.
> 
> In the interim, the idea of ‘lifestyle’ and its
> impact on health became
> prominent and ‘lifestyle’ took distinctly
> different forms in Anglophone and
> non-Anglophone countries. A WHO European publication
> in 1985 devoted a
> chapter to lifestyle but emphasised ‘structural
> influences on behaviour’, …
> where Anglophone countries tended to emphasise
> individuals. (Canada?) . So,
> where in Alma Ata there is a framework called
> Primary Health Care, this is
> replaced by Health Promotion in 1986. By 1997 the
> Jakarta Declaration
> refers to lifestyle as a characteristic of the
> person and the conference
> was attended by a health promotion workforce which
> is overwhelmingly
> individualist in practice, if not in ideals.
> 
> I think the drift to an individualist orientation of
> ‘health promotion’ in
> Anglophone countries was assisted by the separation
> of developed countries
> from developing countries, in international health
> conferences. In
> retrospect, Ottawa marks the point. Separating from
> developing countries
> assumes a threshold model of material circumstances'
> impact on health that
> developed countries have passed, which is
> contradicted by familiar evidence
> from states/ countries like Kerala, Cuba etc. This
> underlying assumption is
> at odds with the evidence of a social gradient in
> health in all countries.
> 
> Brian Fleming
> Adelaide
> 
>
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