Sherrie Tingley wrote about the "3 P's"and the "3 E's"
> > I would like more detail on the three E's and wonder why you have
> chosen Economics over Equality???
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I did not choose equality because the topic to begin with was
"inequality", so it is a given that we are discussing categories for
greater equality.
Fundamental but complex ideas behind a range of innovative strategies
for empowering individuals, communities, and society at large to create
processes for health improvement begin with investigation of the nature
of 'Health', and the determinants of the 'Health Status' of populations.
** Defining Health in Positive Terms **
The basic processes of healthiness such as resistance, resilience,
adaptation, and hardiness are interdependent on contextual factors
including social support, respectful engagement, and a perception of
personal control within one's social environment. Health is purposeful.
The enabling functions of health include people's natural motivation to
contribute effectively in social groups: family, friends, neighborhood,
workplace and broader communities. Policy emphasis needs to be centered
on a positive definition of health. Preventing disease by modifying a
specific behavior without building up the mechanism's of sustaining
healthiness leaves a vacuum.
** Economics and Health Inequity **
Inclusionary socio-economic processes are determinants of improved
population health status that have not been adequately addressed.
Poverty needs to move from being a welfare / economic development issue
to also being a public health issue. The strategic issue is how to
create the economies of the future in a manner that successfully
matriculates historically under represented groups.
This direction involves work in health promotion creating contextual
solutions. These solutions are applications of an emerging
psycho-social-behavioral-environmental model of health. The cultural
perpetuation of poverty and exclusion are basic impediments to health.
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Sherrie Tingley also wrote
> And I wonder about a definition of Empowerment, as a consumer and
> advocate for poor people I may have a very
> different view and understanding of empowerment than the Health
> Promotion community.
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Empower People to Control Their Own Lives
A central organizing principle is to empower all people to do what the
affluent already have more capacity to do: control their own lives. A
sense of personal control in one's social environment is a fundamental
influence on health. There is an overarching link between class /
economic status and health. The mechanism may involve an internal sense
of being able to navigate within our social world in order to get our
needs met.
The personal psychology of Empowerment includes processes of developing
insight into one's own values, vision of one's own possibilities,
understanding of internal inhibitors to change, directional planning,
and perseverance. Group or Community Empowerment psychology has
corresponding developmental processes that are important to the process
of implementing transformations in health.
Encourage Mobility Toward Groupings that Fit
People have divergent urges for the freedom of individuality and the
order of conformity. An intrinsic urge in human beings is to have a
sense of who we are in relation to the greater world in a way that is
satisfying. The concept of 'particularity' is a tool to think about
this (Berger and Neuhaus). We identify with particulars to gain
reference points in establishing our sense of identity. Some are
elective, such as lifestyle, ideology, friends, or home. Other parts in
our social map of self may be more or less 'inherited', including race,
economic class, region, and religion.
An individual's experience of 'liberation' is not freedom from
particularity but discovery of groupings that fit. Pluralism allows a
lively interaction among people's fixed characteristics. Empowerment
enables individuals to elect and thus evolve new particular groupings to
find a context they identify with. The operative mechanism of
pluralistic policy is expanding the base and flexibilty of these
settings. Mobility allows people to discover and embrace life
environments that fit.
Solving the basic socio-economic problems at the root of so many
unacceptable health conditions will require greatly intensified
participation from a widened base of individuals and institutions. The
failures of poverty and exclusion 'disempower' everyone. To overcome
them we all need to be 'empowered'. Celebrating diversity offers far
greater joys and rewards than any monoculture, no matter how privileged.
Even as we respect and savor our differences the power of transformation
lies in the deep bond of knowing, beyond all else, we are each other's
people.
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I hope this discussion continues
Paul Lee
Oakland, California USA
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please explore my emerging web-site
http://www.netcom.com/~pbl/circle_of_health.html
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