Rhonda

Thanks for a nicely stated and argued repsonse.

Michael

On Tue, 30 Jun 1998 05:44:53 -0400 [log in to unmask]
wrote:

> From: [log in to unmask]> Date: Tue, 30 Jun 1998
05:44:53 -0400
> Subject: Re: FW: Politics
> To: [log in to unmask]
>
> Dear All:
>
> Sherry Tingley sent us a post asking how we could get
health issues driven
> by evidence and not politics. She sent us a post from
David Seedhouse, who
> has written numerous books on values, ethics and health
promotion. I want
> to make a few comments about these issues.
>
> First, I accept the belief that health and medicine ARE
political, through
> and through. From the moment you "choose" to be interested
in health
> questions, you make political choices. These choices,
ranging from what
> you're interested in to what you do and don't do with your
choices are
> political.
>
>
> So, David wrote:
>
> > It is impossible to have health, economic and social
policy driven by
> > evidence.  It is always - all of it - driven by values.
> ............
> > Show your evidence to someone who disagrees with your
beliefs and all
> > they need do is show you some other evidence that
coheres with
> > theirs - how, then , do you arbitrate between the two?
>
> The arbitration over different points of view is what the
lay person sees
> played out in the media everyday and the scientist
professes to engage in.
> How does one theory PROVE itself to be more explanatory
than another; how
> is one set of evidence more powerful than another is the
stuff of what is
> called "science." (Forgive me for being simplistic or
obvious.)
>
> > This need not be a negative conclusion.  It seems to me
that health
> > promoters should ditch the myth that 'we are obviously
right because
> > this is a _health_ matter' (as if health were an
objective notion)
> > and recognise that the health promotion task is to work
out a
> > comprehensive justification (based on values) for the
health
> > promotion endeavour, and then try to implement this,
bearing in mind
> > that to do so is inevitably a political action.
>
> I think it is unfair to cast people interested in health
promotion as
> believing they are "obviously right because this is a
_health_ matter" but
> David and I probably have different experiences with
health promotion. My
> experience has almost always been that, by and large,
people working in
> health promotion have had to fight an uphill battle to get
_health_ on the
> agenda. By this of course I mean that prevention is almost
never
> poitically palatable because it requires a redistribution
of resources
> from the haves to the have-nots. I can't think of anything
much more
> political than that.
>
> >
> > Health promotion plays into the hands of the new right
because they
> > have a political outlook (albeit a brutal and simplistic
one)...
>
> The health promotion that I know doesn't play into the
hands of
> the new right..it gets grabbed by the neck and beaten into
submission by
> the blunt hammer called deficit-reduction and all the
ideological baggage
> that goes with that concept and political actions. What we
do about this
> is the test of our savvy and mettle, to say the least,
isn't it?
>
>
>         ... and
> > health promotion has nothing more than a collection of
woolly
> > declarations about what is wrong with the world.
>
>
> DAVID, with friends like this......! Declarations of what
is wrong with
> the world are not woolly in my view. They are acts of
faith and bravery in
> the face of real threats to jobs and even life, in some
instances. So, I
> choose to woollyily declare that abuse, unemployment,
poverty, etc. are
> among the things that are "wrong with the world" and ought
to be changed,
> period. Acting on these beliefs in the _health_ arena is a
choice
> also..and maybe not a good choice...we all know that there
are arguments
> that we should just get out of the health area and get to
the
> "basics" of housing, income, etc..
>
>   Health promotion
> > needs to get theoretically tough - until it does it will
remain a
> > pawn of both the political and medical establishments
(just as it
> > always has been).
>
>
> There is health promotion and there is health promotion.
The health
> promotion I choose to support is actually well-grounded
theoretically in
> the disciplines of psychology, sociology, political
science, economics,
> liberation theology, etc. Unforutnately (in my view) too
many front line
> practitioners are not aware of the strong base from which
the ideas
> and practices of what- I- choose- as- health- promotion
grew. Also
> unfortunately, all the knowledge of both the theory and
the data, don't
> always give the help you need in the political times in
which we live. The
> worm WILL turn.
>
> Thnnks for reading!
>
> Regards,
> Rhonda
Michael Goodstadt Ph.D.
Deputy Director
Centre for Health Promotion
University of Toronto
Banting Institute
100 College Street, Suite #207
TORONTO, Ontario, Canada
M5G 1L5

Phone:  (416) 978-6861
Fax:    (416) 971-1365

e-mail: <[log in to unmask]>