Spiritual_Wellness_Holistic_Health_and_the_Practic

262 Philosophical Foundations of Health Education
different from public ones. We need to know what interim, individual actions we can
rely on until public policies are in place. (p. 81; emphasis in original)
Thus, we must incorporate, not only into the discourse of the new health promotion
movement but also into its practice, this notion of both micro and macro conceptualizations
of health. As an example of how we might do that, we now turn to an
examination of another fundamental concept of the new health promotion movement
over which there is considerable ideological conflict: the concept of empowerment.
EMPOWERMENT REVISITED
It is now well documented that health is significantly affected by the extent to which
one feels control or mastery over one ’ s life, in other words, by the amount of power or
powerlessness one feels (see Wallerstein [1992] for an excellent review of this literature).
For this reason, the new health promotion movement places an emphasis on
empowerment as a primary health promotion strategy. With its roots in community
psychology (Rapport, 1985), feminist theory (Gutierrez, 1990), liberation theology
(Freire, 1973, 1988), and social activism (Alinsky, 1972), empowerment can be defined
very broadly as “ a process of increasing personal, interpersonal, or political
power ”(Gutierrez, 1990).
At the core of the notion of empowerment is the concept of power, defined as the
ability to control the factors that determine one ’ s life. Conceived of in this way, power
is an attribute of individuals and communities. In Pinderhughes ’ (1983) words:
power and powerlessness operate systemically, transecting both macrosystem and
microsystem processes. The existence or nonexistence of power on one level of
human functioning (e.g., interactional) affects is affected by its existence or nonexistence
on other levels of functioning — for example, intrapsychic, familial, community -
ethnic - cultural, and societal. (p. 332)
The larger political aspect of power is emphasized by Gutierrez (1990), who
writes: “ Empowerment theory is based on a conflict model that assumes that a society
consists of separate groups possessing different levels of power and control over
resources ” (p. 150). In other words, power is a nonmaterial resource differentially distributed
in society.
If power is the ability to predict, control, and participate in one ’ s environment,
then empowerment is the process by which individuals and communities are enabled
to take such power and act effectively in transforming their lives and their environment
(Miller, 1985). With the concept of empowerment, the new health promotion movement,
borrowing from earlier feminist conceptualizations of power (French, 1986),
attempts to reframe power not as “ power over ” but rather as “ power to ” (O ’ Neill,
1990) or as “ power with ” (Labonte, 1992). This, in turn, suggests the notion of partnerships
between professionals and individuals or communities rather than the more
traditional hierarchical provider/client relationship. Yet as Siler - Wells (1989) has