Interesting discussion.
I think both Rick and Dennis’ sound bites are effective
and necessary. It’s good balance. The average person needs to
hear what Rick is saying, and it also offers an awful lot of potential
interventions that are politically viable today. But Dennis brings up
points that governments (bureaucrats, particularly) ought to be discussing as
well.
Ketan Shankardass
-
Research Associate
Centre for Research
on Inner City Health
St. Michael's Hospital
-
Assistant Professor
Division of
Epidemiology
Dalla Lana School
of Public Health
University of
Toronto
-
Phone: 416-864-6060
ext. 3360
Cell: 416-917-1086
Fax: 416-864-5485
From: Social Determinants
of Health [mailto:[log in to unmask]] On Behalf Of Malcolm Lewis
Sent: November 7, 2010 7:16 PM
To: [log in to unmask]
Subject: Re: [SDOH] shifting the discourse...
I think it is not
helpful to think about how average people read this.
There are people who
support effective- action. We only need to maintain their support. They read
messages differently and read different media.
There are people who
we could convert to support the action we hope to see back effective action.
There are people who
be predisposed to politically organise around this issue
as it violates their ideas of how people should live and die), how
society should run.
(eg Health reform in
USA - motives strong grassroots and corporate political activism because
it many people believe that the rich should not be taxed to bail out the poor
who have become sick. To do so will ruin America. To understand why
health policy changes can be associated with such vigorous and
irrational opposition, read and think about the Terror Management Theory
particularly as it applies to health behaviors.)
Thus I would argue
we need public health policy advocacy that:
1 maintains
supporters,
2
Coverts potentially movable converts
3 and does not
overly alarm others in such as was that corporate PR can easily organise
grassroots anti-campaigns.
We need to think
segmented populations not the average person.
In the article under
discussion, I suspect for some people that to mention "injustice"
turns on the unhelpful frame that governments can't do much about
injustice.
Some people see
injustice as one of those unfortunate things in life that happens that
can't really be prevented. Efforts to reduce it are often counterproductive or
otherwise harmful.
I suspect people on
this e-list, have different values and frames on this issue.
Also to talk about
jobs maybe to turn on another unhelpful frame about the need to
governments to be pro-business which really means small government,
and market solutions.
If you have these
frames as the author might then might be an internally consistent article.
eg
> The myth, he
said, is that governments can intervene on obesity and ?that
> would make everything fine.?
1 The
government's lifestyle focused effort of obesity reduction are waste of tax
payers money.
2. to
reduce diabetes we need more social justice- This is a moral
issue and the government can't do too much about that. What governments do
needs to be done with cautious, as strategics may have harmful
unintended consequences.
3. It is about jobs
and thus about pro-growth, pro-business policies.
4 There is a double
bind, business doesn't want to pay for the costs of high diabetes so maybe
there is a reluctant case for health food taxes and subsidies.
5 The best
evidence public health evidence seems to be for food supply, and
planning healthier neighbourhoods as this supports individual choice. The
frames about planning, public transport and food supply seems to have worked on
this author.
I suspect a frame
about creating more good high control jobs creating productive health &
wealth producing workplaces, might be helpful with all these segments.
I wish I had more
research on hand how work environments are related to chronic disease
behaviors and to workplace productivity and profits.
I have a fair of
evidence about work environments and mental illness outcomes, less on mental
wellbeing outcomes, and less still on productivity and profitability
outcomes
By the way this
is just come to my attention and should be of interest to this e-community.
Job stress as a
preventable upstream determinant of common mental disorders: A review for
practitioners and policy-makers
--------------------------------------------------------------------------------
Author(s): Anthony D
LaMontagne 1 | Tessa Keegel 2 | Amber M Louie 3 | Aleck Ostry 4
doi:
10.5172/jamh.9.1.17
Advances
in Mental Health
Volume: 9 | Issue: 1
Cover date: August 2010
Page(s): 17-35 http://bit.ly/9d3zMf
I wish we had more research
on framing the SDoH particularly in Australia.
Cheers
Malcolm
Malcolm Lewis.
Mental Health Promotion Officer
Darling Downs Public Health Unit
Southern Regional Services,
Division of the Chief Health Officer
Queensland Health
Phone 07 46319801
Fax: 07 4639 4772
Email: [log in to unmask]
Address: 3 Bell St, Toowoomba QLD 4350
Postal Address: PO Box 1775, Toowoomba QLD 4350 Australia
>>> "E. Maya de Szegheo" <[log in to unmask]> 8/11/2010
5:15 am >>>
To the average person it reinforces the diet/excercise argument- poverty limits
access to healthy food, monitoring etc. Social justice could alleviate the
conditions of poverty and therefore allow better access to necessities. To the
average person, I think, the initiating factor- the stress of constant
insecurity leading physiologically to diabetes, heart disease etc. needs to be
spelled out first, then followed by the difficulty of managing the disease.
M.deSzegheo
> I am curious as to how this reads... to the average person.
>
>
http://www.healthzone.ca/health/yourhealth/diabetes/article/885277--poverty-drives-the-epidemic
> ----------------------------------------------
> And on the macro level, Glazier believes there are options for government
> policy that would fight obesity. For example, governments could tax
> unhealthy food and use that money to subsidize nutritious food, he said.
> ?We are looking at the first generation in history (today?s teens) that
> will not live longer than their parents because this generation is much
> more obese, they have very unhealthy lifestyles and don?t have any
> physical activity in the course of a day,? Glazier said.
> Dennis Raphael, a professor of health policy and management at York
> University, has published numerous studies concluding that poverty is the
> main cause of diabetes.
> Raphael argues that the only way to put a dent in the explosive growth of
> the disease is to focus on social justice ? and the jobs that allow people
> to emerge from poverty.
> ?The better argument is to say that today?s generation will not be as
> healthy as we are because of growing income inequality, insecure
> employment and a lack of affordable housing,? he said.
> The myth, he said, is that governments can intervene on obesity and ?that
> would make everything fine.?
>
> ------------------------------------------------------------------
>
> dr
>
>
> To leave, manage or join list:
> https://listserv.yorku.ca/cgi-bin/wa?SUBED1=sdoh&A=1
>
>
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