Hello All!
Just want to comment that I fully support the perspective that Barbara has
put forward here.  I strongly believe that it by using a combination of
strategies that we will be able to bring about the changes we are working
toward.  We can not effect major change from a prevention or health
promotion perspective if we don't provide the individuals with the tools
they personally need to improve their health or reduce their risk.
But at the same time, we also need to influence the environment and supports
available to people to enable them to make choices and changes in support of
health - for themselves and their community.
Perhaps part of the struggle with harm reduction being viewed as the only or
best approach is that people are looking for more concrete outcomes and
tangible program strategies that they can relate to more easily than work in
health promotion at the community level.  In these times where it seems we
are being called upon to be able to show "results" in response to shifting
funding mechanisms it can be challenging to maintain a focus on a long term
initiative.
Perhaps part of the solution is the partnership work that occurs across the
various health agencies and the volunteer sectors so that some strategies
can be done in collaboration while others are lead by specific partners.
When they are all put together though you have the comprehensive approach
that I referred to earlier.
That's my soapbox for tonight!
Joyce Fox

-----Original Message-----
From: BARBARA NEUWELT <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Monday, January 18, 1999 11:13 AM
Subject: harm reduction, prevention & promotion


>This is a very timely question for me as I am doing some research on
>harm reduction at the moment and thinking about how harm reduction fits
>with what we do here.
>
>It's great to see health promotion defined with the depth and breadth that
>you give it. I do think that despite the chronic problem of people equating
>prevention with health promotion, it is still a part of health promotion -
a
>small part but still a part.
>
>I think harm reduction is in some respects treatment and in some respects
>prevention. It overlaps both, depending on what form of harm reduction
>we are talking about and the goal of the program/policy/intervention.
>
>I don't think harm reduction contradicts health promotion at all.  To my
>mind, there is a continuum of work needed in health - from health
>promotion through to treatment and beyond (palliative care). Harm
>reduction is a part of the continuum . I don't see it as an either/or
thing -
>either we do harm reduction or we do the kind of broad health promotion
>work that you see that we need. For agencies that are involved in a
>broad range of health-related activities I think it's possible to do both.
>
>The issue for me in what you wrote is that staff at the agency think all
>we need to do is harm reduction.  It may be people expressing their
>frustration that most of the rest of the health world working on drugs/sex
>issues is still focused on everything else BUT harm reduction. Clearly, as
>you say, harm reduction doesn't deal with the cause of the initial
>problems, but it can deal with the cause of some of the attendant
>problems (i.e. the socially constructed part of those problems - no safe
>place to do drugs, etc.)
>
>The other way I think of harm reduction is in terms of good practice. Part
>of health promotion is starting with where people are at, whether it's
>behaviour change or community development or policy work. Harm
>reduction involves meeting people where they are, rather than expecting
>them to want what we want.
>
>What do others think?
>