Spiritual_Wellness_Holistic_Health_and_the_Practic

180 Philosophical Foundations of Health Education
HEALTH PROMOTION, EMPOWERMENT,
AND SOCIAL MOVEMENTS
Implicit in this question is a belief that professionals and their employing institutions
might play an important role in challenging oppressive and health - threatening political
and economic structures. At times, this potential role is accorded an almost revolutionary
status. Health promoters in Europe and in the three countries in which the workshops
were conducted often describe health promotion as a social movement,
concerned with health “ prerequisites ” such as “ peace, shelter, food, income, a stable
ecosystem, social justice and equity ” (WHO, 1986, p. 1). This mimics the manner in
which community development was described in the 1960s and 1970s, and how
empowerment was described by the mental health literature in the 1980s. Stevenson
and Burke (1991) argue that, in doing so, health promotion conceptualizers have
usurped the discourse of social movements, emphasizing the empowering capacity of
“ the community ” but failing to address the role of the state (governments and their
bureaucratic institutions) or macrosocial power structures in creating unhealthy conditions.
Health promotion, particularly in countries like Canada where it has been
embraced by government policy, is “ a bureaucratic tendency; not a movement against
the state, but one within it ” (Stevenson & Burke, p. 282). This is a valuable insight.
Although government initiatives may at times be empowering (itself a complex concept
that will be examined shortly), the relationship between government institutions
and community groups has disempowering qualities that many theorists relate to capitalist
economies (Miliband, 1983; Offe, 1984).
Many health promoters acknowledge the disempowering qualities of government
bureaucracies (often their employers) by contending that health promotion belongs to
the whole community. Community groups do organize and act in the name of health
promotion, however, they are more likely to do so around specific issues involving
welfare rights, pollution, housing, safety, or employment concerns. The abstract
concept of health promotion, like that of empowerment, is of more concern to professionals
working for government agencies. To claim health promotion is a community
phenomenon, especially when many health promotion initiatives remain focused on
personal life - styles, could fulfill Stevenson and Burke ’ s bleak prophecy of a bureaucratically
conceived concept colonizing how people view their day - to - day lives: What
is important is not your relationships, your work, your identity, your capacity; it is
your cholesterol level.
Does health promotion ’ s bureaucratic parentage mean that it surrenders any
empowering potential to the co - opting “ power - over ” tendencies of government institutions?
To the extent that health promotion becomes a marketing tool for government
agencies and their agendas, the answer would be yes. But health promotion can also
be regarded as a response to social movement groups and the challenges they make to
government. Eyerman and Jamison (1991) discuss social movements as a form of
cognitive praxis, in which social movement groups challenge dominant social beliefs
and norms, generate new knowledge, and create new ways to look at old problems or