Spiritual_Wellness_Holistic_Health_and_the_Practic

Health Promotion and Empowerment 189
most economic and social policy is national and transnational in nature (a disempowering
impact). Local decision - making can only be within narrow parameters at best,
and is unlikely to include substantial control over economic resources. As Durning
(1989) recently commented “ Small may be beautiful, but it can also be insignificant ”
(p. 168). A similar point is made by Daly and Cobb (1989) in reference to environmental
economics: Political decision - making must remain at the level at which economic
decision making occurs, otherwise public policy, those decisions embodying
community ethics, will devolve to private economic interests. Health workers must
exercise particular caution that their support for community groups does not become
an unintended buttress to political and public policy actions based upon economic theories
that would see power continue to accumulate in fewer and fewer hands.
Coalition Building and Advocacy
Coalition building and advocacy can overcome the political limitations of community
organizing. Coalitions are groups of groups with a shared goal and some awareness
that “ united we stand, divided we fall ” ; advocacy means taking a position on an issue,
and initiating actions in a deliberate attempt to influence private and public policy
choices. The two are linked in the Holosphere model because advocacy usually
involves coalitions.
There are three facets to advocacy in professional practice. First, professionals can
aid community groups in their own advocacy by offering knowledge, analytical skills,
information on how the political and bureaucratic structures function, and so on. Their
support for advocacy is an extension of their support for community organizing.
Second, health organizations can also support advocacy by creating policy documents
and analyses that form the policy nutcracker ’ s inner arm, thereby legitimizing the
advocacy concerns of community groups with which they work. Institutions play a
powerful role in shaping and defining what is important in social life (and consequently
political discourse) through the implicit and explicit statements made by the types of
services they offer, and the policies they create and make public. Third, professionals,
individually or through their professional organizations, can increase the strength of
their own political voices, taking positions on such policy issues as social welfare
reform, housing needs or affordability, employment policies, environmental standards,
or any other concerns that may be expressed by individual clients or community
groups. An organized political voice of caring professionals may be crucial in moving
us towards more just and sustainable forms of social organization: It is professionals
who see the human costs of current economic and political practice, who have access
to the knowledge and information on how the governing system works, and who have
a degree of professional credibility in their statements. Empowerment for professionals,
then, is both recognizing and claiming the power they already hold, not “ over ”
others, but in relation to how governments and economic elites currently enact programs
and policies.