Spiritual_Wellness_Holistic_Health_and_the_Practic

190 Philosophical Foundations of Health Education
In Ontario, public health has established itself as an important, legitimating voice
in policy debates. When the Ontario Public Health Association (OPHA) argued a few
years ago that welfare reforms were an essential investment in health that should be
funded through freezes in hospital and physician expenditure increases, the Association
helped to influence all party support for the reforms. As professional advocates, the OPHA
met the institutions on their own terms. It gave them studies and debated in the language
of policy, but the OPHA was not alone. The OPHA worked with coalitions of
church groups, anti - poverty groups, unions, newly forged organizations of the poor
themselves. There were peoples ’ stories behind the studies ’ statistics, and an incredible
power that came in recognizing and honoring the differing but mutually supporting
roles of community activists and professional advocates.
Political Action
Political action represents an intensification of actions initiated under the rubric of
coalition advocacy. Such action may be partisan or nonpartisan, local or national, participatory
or representative in democratic form, legally enacted or civilly disobedient.
The line between what comprises coalition advocacy and what constitutes political
action is fuzzy; one important difference may lie in the role played by social movement
organizations and groups and the degree to which health workers allow themselves
to be scrutinized by these movements. This scrutiny often involves moments of
conflict, as social movement organizations create their own political legitimacy and
voice. But the healthy and often essential role that intergroup conflict plays in social
change should not lead health workers to shun the necessity of uniting diverse, conflicting
groups at some higher level of community. Pragmatically, the community born
in conflict or struggle rarely survives the eventual peace “ unless those involved create
the institutional arrangements and noncrisis bonding experiences that carry them
through the year - in - year - out tests of community functioning ” (Gardner, 1991, p. 14).
Gray (1989) provides a comprehensive collaboration model for promoting those
functions. There are several steps in effective collaborating, first and most important
being problem - setting. Effective collaborating requires the efforts of persons Gray
labels “ midwives, ” the community developers of organizations - as - communities. These
midwives (functionally distant from all of the stakeholders) work with the stakeholders
before they come to the table, seeking to find the “ superordinate goal ” that Sherif
(1966) years ago argued was the basis for initiating any reduction in intergroup
conflict.
Using principles from collaboration theory, experiences based on case stories
(Labonte, 1993b), and insights gleaned from attempts to forge relations between community
health and social service centers and neighborhood volunteer centers in Quebec
(Panet - Raymond, 1992), it is possible to propose some preliminary terms for effective
(authentic) partnership. Although tenuously offered, these terms provide a starting
point from which health agencies might ground an empowering health promotion in
day - to - day practice: