The religious metaphor is not mine.  The holy trinity term was used by Sarah
Nettleton -- who is no slouch in the health promotion, sociology of health, and
services areas -- and who points out that not only is the evidence of lifesryle
factoes as a cause of disease, and the effectiveness for "heart health"
behavioural initatives lacking but that such an approach has harmful side
effects that blame victims for their poor health and absolve policymakers of any
blame for their heart health threatening failures.

It should not be surprising that one of the most repressive and socially
unresponsive governments ever seen in Canada -- the Harris/Eves Ontario
conservative government is pouring money into "heart health" initatives that
actually do not allow any discussion of brader determinants of health. Stray
from the risk factors of diet and activity and tobacco and have your funding cut
off!

Click for Hpers may wish to note that I am responding to a posting on the
Ontario heart health list-serve through this listserve as such views are not
countenced on that particular listserve!  see below!

Hey heart health  listserve moderator!  Do I not have the right to respond
directly to these statements?  Or is democratic discourse also verboten in the
New Ontario together with any discussion of the social determinants of heart
disease?

dennis r.

From: "John Davies" <[log in to unmask]>
To: <[log in to unmask]>; <[log in to unmask]>
Sent: Monday, December 09, 2002 3:14 PM
Subject: RE: Behaviour change - a questionable approach


> Dennis Raphael's discourse, below, is unsatisfying because it uses
several
> hundred words to tell us that social determinants of health are
important,
> and that life style interventions recommended by government agencies
are
> less than perfect.  Unfortunately, his recitation of this well known
> information fails to add anything to the discussion - in Canada or
> elsewhere.
>
> He uses an inappropriate religious metaphor to sarcastically
denigrate a
> good outcome - healthy life style - in an apparent attempt to make
it the
> enemy of another good outcome - improved socio-economic status.  He
tells us
> that behavioral change may be of questionable effectiveness, but he
does not
> tell us what may be effective.  Instead. his conclusion seems to be
that a
> bad life style is not good, while such things as poverty and social
> exclusion are even worse.  This is not very edifying stuff.
>
> >From the same evidence we might arrive at a different and more
useful
> conclusion, namely that adequate diet, less smoke and adequate
exercise are
> really quite useful, but that public healthers should work harder to
find
> and use more cost-effective methods of helping individuals and
groups to
> adopt such behaviors.  In other words, it is better for individuals
to do
> something of proven value, such as improving their own life style,
rather
> than waiting, perhaps forever, for some other agent - such as the
> government? - to improve the socio-economic status of their group.
>
> John Davies,
> email: [log in to unmask]
> Website: www.johndavies.com
>
> -----Original Message-----
> From: [log in to unmask]
[mailto:[log in to unmask]]On
> Behalf Of Diana Daghofer
> Sent: Sunday, December 08, 2002 6:55 PM
> To: [log in to unmask]
> Subject: Behaviour change - a questionable approach
>
> Hello all,
>
> I recently attended a conference on the social determinants of
health and am
> getting some interesting feedback as a result of joining a listserv
on
> health promotion (Click4HP).  I would be interested in hearing
people's
> views on the following note.
>
> Diana
> ----- Original Message -----

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