On Mon, 13 Jul 1998, David Seedhouse wrote:

In reply to Sherry, who replied to Elizabeth, and with reference to
Blake.....


>...... health promotion doesn't have
> an implicit 'social justice agenda', it (ie the group of people
> claiming to promote health) has vaguely expressed, conflicting
> political ideals.  Some health promoters favour some forms of social
> justice (and there are many types of social justice of course),
> some have quite different goals.

Sometime let's get to what we think "health promotion" is...I have seen it
referred to as a discipline and as a profession (or quasi-profession,
etc).  In my humble opinion, it is neither. But, it is, at least, a
*process* of attempting to improve the conditions which impede individuals
and societies from attaining improved health.

Of course, we have to define health. We have all read the various attempts
to define health which range from "the absence of disease" to the
attainment of "complete spiritual, physical, etc... a la the WHO..."
We've all read the documents from the Lalonde Report to the Jakarta
Declaration, or at least heard of their contents.

Defining health seems to be an elusive task. Current research treatises on
health are often really discussions of the factors that contribute to
mortality...even morbidity isn't very well measured or discussed. So, in
earlier emails, I have referred to research that indicates a strong
relationship between health and income disparity. To be more precise,
many, but not all, of these studies are about DEATH, not HEALTH.
That is becase the measures of health status are often measures of
death and disease rates. However, there are respectable studies which
attempt to talk about health and not just death rates...and, there are
similar economic issues affecting the attainment of "health."

So, there is powerful information about the role of *class* and health.
The social justice issues are simple are they not? If improving health is
a value to you, work anywhere and anyway you can to redistribute income
(or some issue about access to resources). Good luck, but that is what you
"should" be doing.

This continuing ambiguity causes
> health promotion to be eclectic and focused on the short-term - a
> survival strategy not a positive development plan.
>
> I think Blake, for example, is quite wrong to wish to get whatever
> funding is available on any terms - even someone else's.

I am fairly certain that Blake did not say "get whatever funding is
available on any terms-even if someone's else's."  Without referring to
past communications, I believe he said we are in dangerous political times
and should be cautious about disclosing our theories, etc.

There is absolutely NO doubt that HP is rife with "ambiguity," is
"eclectic" and "focused on the short-term..." But, when I read the Ottawa
Charter and Jakarta Declaration and the CPHA statement on world trade and
its health implications, I am NOT that confused by ambiguities,
eclecticism and short- term thinking. I KNOW what is being said, and in my
mind it IS a form of social justice, and it IS about redistribution of the
world's resources, and THAT is no short-term goal.

It is time
> for health promotion to state a) where it stands and b) what this
> implies practically (in particular, health promoters must begin to be
> able to say which practical ventures we will NOT engage in -
> otherwise, where is health promotion ethics?).

Well, OK, somebody do it...I have refused to engage in research on topics
I thought to be insulting to "victims" (eg, just how hugry are the
hungry?..) I would NOT take tobacco money, I would NOT
take the money from any corporation which is "blacklisted" by the Jesuits
Social Justice Committee; I would NOT work with men's groups attempting to
discredit feminists working in the violence against women movement, ETC...

David keeps asking people to disclose in a public forum. David, let's hear
from you...what are your limits..what guides your values...what are the
"practical ventures" that you won't engage in.

Rhonda