Abstract
Population health promotion illustrates most robustly that health is a shared responsibility. Improving our understanding of the social production of health and the purchase population health promotion has on shaping social welfare policy presents a number of challenges to the future development of this discourse. Three are briefly discussed in this paper. First is the matter of language we use to describe our understanding of processes and influences. Second is the conceptualization of the pathways that shape population health status. Finally, cultural practices both extant and required to improve health status and reduce inequalities are addressed.
Abrégé
La promotion de la santé de la population illustre de façon convaincante que la santé est une responsabilité partagée. Améliorer notre compréhension de la production sociale de la santé et de l’impact de la promotion de la santé de la population sur la structuration des politiques de bien-être social présente un certain nombre de défis pour le développement futur de ce discours. Trois d’entre eux sont brièvement discutés dans cet article. Premièrement, nous notons le langage que nous utilisons pour décrire notre compréhension des processus et influences. Deuxièmement, la conceptualisation des mécanismes qui structurent les états de santé des populations est discutée. Enfin, les pratiques culturelles actuelles et requises pour améliorer l’état de santé et réduire les inéquités sont traitées.
References
- 1.Hayes MV, Dunn RJ. Population Health in Canada: A Systematic Review. Ottawa: Renouf Publications; 1998. [Google Scholar]
- 2.Poland B, Coburn D, Eakin J, et al. Wealth, equity and health care: A critique of a ‘population health’ perspective on the determinants of health. Soc Sci Med. 1998;46(7):785–98. doi: 10.1016/S0277-9536(97)00197-4. [DOI] [PubMed] [Google Scholar]
- 3.Coburn D. Income inequality, lowered social cohesion and the poorer health status of populations: The role of neo-liberalism. Toronto: Department of Public Health Sciences, University of; 1999. [Google Scholar]
- 4.Health Canada, Sustainable Development Secretariat. Sustaining Our Health. 1997. [Google Scholar]
- 5.Health Canada, Population Health Development Division. Taking Action on Population Health. 1998. [Google Scholar]
- 6.Robertson A. Shifting discourses on health in Canada: From health promotion to population health. Health Prom Int. 1998;13(2):155–66. doi: 10.1093/heapro/13.2.155. [DOI] [Google Scholar]
- 7.Hayes MV. Evidence, determinants of health and population epidemiology. In: Hayes MV, Foster LT, Foster HD, editors. The Determinants of Population Health: A Critical Assessment. Victoria: Western Geographic Series Vol. 29; 1994. [Google Scholar]
- 8.Hertzman C, Frank J, Evans RG. Heterogeneities in health status and the determinants of population health. In: Evans RG, Barer ML, Marmor TR, editors. Why Are Some People Healthy and Others Not? New York: Aldine De Gruyter; 1994. [Google Scholar]
- 9.Wilkinson RG. Unhealthy Societies. London: Routledge; 1996. [Google Scholar]
- 10.Sayer A. Method in Social Science. 2nd. London: Routledge; 1992. [Google Scholar]
- 11.Muntaner C, Lynch J. Income inequality, social cohesion, and class relations: A critique of Wilkinson’s neo-Durkheimian research program. Int J Health Services. 1999;29:59–81. doi: 10.2190/G8QW-TT09-67PL-QTNC. [DOI] [PubMed] [Google Scholar]
- 12.Giddens A. The Constitution of Society. California: University of California Press; 1984. [Google Scholar]
- 13.Tarlov AR. Health and Social Organization. London: Routledge; 1996. Social determinants of health. [Google Scholar]
- 14.Kawachi I, Kennedy B, Lochner K, Prothrow-Stith D. Social capital, income inequality, and mortality. Am J Public Health. 1997;87:1491–98. doi: 10.2105/AJPH.87.9.1491. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15.Kawachi I, Kennedy B. Health and social cohesion: Why care about income inequality? Br Med J. 1997;314:1037–40. doi: 10.1136/bmj.314.7086.1037. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16.Lomas J. Social capital and health: Implications for public health and epidemiology. Soc Sci Med. 1998;47(9):1181–88. doi: 10.1016/S0277-9536(98)00190-7. [DOI] [PubMed] [Google Scholar]
- 17.Veenstra G, Lomas J. Home is where the governing is: Social capital and regional health governance. Health and Place. 1999;5(1):1–12. doi: 10.1016/S1353-8292(98)00037-9. [DOI] [PubMed] [Google Scholar]
- 18.Hayes MV, Dunn JR. On the currency of social capital in health inequalities; 1999. [Google Scholar]
- 19.Ignatieff M. The Needs of Strangers. Harmondsworth: Penguin; 1984. [Google Scholar]
- 20.Angus Reid. Angus Reid World Monitor. 1998. The tragedy of exclusion; pp. 27–34. [Google Scholar]
- 21.Editorial. National Post. 1999. The new politics of health. [Google Scholar]