While I read the letters between Eberhard Wenzel and
and Kate Lawrence, it occurred to me that the issue of
health promotion vs disease prevention is as important
as whether a pharmaceutical or soft drink company was
part of the Jakarta conference or not.  They are
separate issues, however.

I remember the outrage at a recent provincial public
health conference when a deputy minister of education
(previously a Xerox employee) said in a plenary speech
that Xerox was helping revolutionize education because
they were advocating and providing co-op "jobs" to
students.  We in health promotion have to listen to
these comments, if only better to understand what our
"public" thinks.

Is "what is health promotion" getting across to the
broad community and business people, who really need to
understand it?

Health promotion is not that pure of disease
prevention.  We seem to be a crisis oriented society,
and respond best to alarm bells.  Our policy makers
(not just business people) are more likely to respond
when there is a problem, reinforcing the disease
prevention or problem-oriented focus.

IF there ever was a breakthough in community and public
health in distinguishing health promotion from disease
prevention, it seems to have collapsed.  To discover it
may be so even at the WHO is a surprise.  I am not
shocked when students such as RN's obtaining a
baccalaureate, or first year med students, or public
health practioners, or even many Medical Officers of
Health here in Ontario, confuse or fail to distinguish
between the two. But this news convinces me more than
ever still have a lot of work to do, better
communication, education and research dissemination.
For example, we often speak of Heart Health initiatives
in the same breadth as health promotion, but
technically these are disease prevention initiatives
(even the policy work).

Maybe health promotion is more easily distinguished
when working on the determinants of overall health,
such as access to safe, nutritious and personally
acceptable food.  Even so, these things are an issue
because they are known to be DETERMINANTS and have a
causal association with health breakdown.

I will be spending a lot more time working on this for
the community health course this fall.  Any wisdom or
assistance would be welcome!
Lorraine