Thank-you David and Rhonda for a stimulating exchange. If I might enter the
fray, I'd like to offer a few comments/observations:

* I think that David makes very valuable points about the need for
reflexivity in theory and practice of health promotion, and about the
potential for 'false consensus' when people choose not to be explicit about
their values, ethical stance, and world view (or these remain hidden behind
'motherhood' statements that are perhaps too open to being coopted by those
with radically opposed ideological stances because they are not
sufficiently explicit about their ethical base).

* however, implicit in your line of argumentation, David, is an essentially
modernist call for consensus on what health promotion is in the context of
a postmodern panopoly of perspectives and voices. I think many people in
this field feel torn between desiring a more coherent consensus on the
goals, world view, and methods of health promotion (and the legitimacy it
is hoped this might portend in the eyes of those who may currently dismiss
health promotion as 'wooley', inconsistent, overambitious, etc), and on the
other hand, a profound unease about the prospect of an
artificial/imposed/engineered consensus or 'grand narrative' that
constructs health promotion in much narrower terms and in the processes
silences many voices and perspectives that reflect the full diversity of
the world we live in. I seriously doubt that consensus on the nature of
health promotion will make it an more palatable to those who oppose it; the
nature of their objections will simply change to allow for their continued
opposition, because in many cases their objections re scope, vagueness etc
mask a deeper-seated but rarely articulated discomfort with the ideological
stance embodied in the type of health promotion Rhonda is talking about
(more explicitly oriented towards social justice).

* while I agree with you David that "clear thinking" (critical thinking) is
vital (not just in health promotion, but in all aspects of life), I am less
convinced that it need be in service of definitively arbitrating the nature
of health promotion. Precisely because values and politics infuse virtually
all aspects of human endeavor (not just health promotion), critical
thinking about implicit values, assumptions, perspectives, agendas and
so-forth is vital on an ongoing basis as part of being clear for oneself
and to others about our own ethical stance in our practice, even as we
disagree about what we construe health and health promotion to be

* I think that some of what people are reacting to in what David writes is
not so much the contention that theory and practice are value-bound and
political, but rather his sweeping portrayal of health promotion
practitioners as naive, uncritical and misguided... which may be perceived
as dismissive, pejorative, and patronizing.  I for one would be much
relieved if David you could share your excellent ideas and profound
challenges to the profession in a gentler, more supportive and encouraging
manner...


Thanks for the opportunity to share. I look forward to people's feedback
and ongoing debate.






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Blake D. Poland, Ph.D.
Department of Public Health Sciences
Faculty of Medicine, McMurrich Building
University of Toronto
Toronto, Ontario
Canada   M5S 1A8

tel: 416-978-7542; fax: 416-978-2087
email: [log in to unmask]
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