I think it is interesting that we are taking the same approach to addressing
poverty and health as we took to health promotion in the early 1970s.
Namely, a lifestyle approach that assumes that "if people only knew the
dangers of smoking, drinking and driving, poor diet, lack of physical
activity...the widening income gap between rich and poor...they will change
their behavior." We now know that knowledge alone does not change behavior
and, as a result, have developed much more sophisticated ecological models
to understand the issues and develop effective interventions.

I believe we, similarly, need different and more comprehensive models to
bring about change with respect to poverty. Knowledge/information alone is
not going to significantly change the minds or direction of policymakers or
the priorities of the population. It is an important component, but it is
only one piece of the puzzle. Do I know what the other pieces of the puzzle
are? I have some ideas but not the whole picture. I believe that is the next
great challenge for health promoters.

Alana

Alana LaPerle Consulting
[log in to unmask] <mailto:[log in to unmask]>
Phone: 780.435.9908
Fax: 780.438.6837




-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]]On
Behalf Of Stirling, Alison
Sent: December 6, 1999 9:45 AM
To: [log in to unmask]
Subject: "Poor too busy surviving to worry about disease prevention"
artic le in AJPH


The following is a short article/newspiece in Charity Village Vibes (an
email bulletin sent out on Mondays) that comes from the American Journal of
Public Health.  I thought that it would be of interest to this list. While
these findings are not very surprising to most of us - it is an important
study to be able to have published and be able to use in our work.

It is an 'interesting', and painfully revealing, accompaniment to several
messages posted recently on CLICK4HP which have discussed poverty and
health. In particular, these messages have included information supplied by
several health units' monitoring of 'food baskets' (where low-income
families would have a choice of shelter OR healthy food, not both); and also
Michael Valpy's recent column in the Globe & Mail, about Mel Hurtig's book
"Pay the Rent or Feed the Kids - the Disgrace of Poverty in Canada".  That
title says a great deal.

I would like to revive our discussion about what health promotion
practitioners can do, strategies and approaches that we can take, to address
poverty and economic determinants of health. We know that there is a direct
correlation of income to health, and these studies and messages have shown
us that our 'mandated' work in programming is not enough to make any impact
in changing the basic situation of people experiencing poverty. So what
should we be doing that IS effective?

Comments anyone?

Alison

* * * * * * * * * * * * * * * * * * * * * * *
Alison Stirling, health promotion consultant
OPC - Prevention Clearinghouse
E-Mail: [log in to unmask]  Internet: http://www.web.net/~stirling/
1(800) 263-2846 OR (416) 408-2121 ext 2226
Suite 1900, 180 Dundas St. W. Toronto ON M5G 1Z8.
* * * * * * * * * * * * * * * * * * * * * * * * * *


Poor too busy surviving to worry about disease prevention

Writing in the latest issue of the American Journal of Public Health,
Canadian researcher Jennifer O'Loughlin concludes that poor people are "more
concerned with...day-to-day social and economic living challenges  than they
[are] about the possibility of developing a chronic disease in the distant
future." As a result of these immediate challenges, prevention-oriented
public health campaigns are often ineffective in poorer regions. In studying
a low-income neighbourhood in Montreal over a five-year period, O'Loughlin
and fellow researchers found that participation rates for a Healthy Heart
program came in at only two percent and concluded that "benefits [of the
program] at the community level were minimal." Researchers also noted that
the prevention program may have suffered because of high rates of illiteracy
in the area and overtaxed community groups that could not deliver program
elements over time.