Spiritual_Wellness_Holistic_Health_and_the_Practic

New Health Promotion Movement 271
for commodification and obfuscation. As we have argued, the adoption by the new
health promotion movement of a unidimensional notion of empowerment may obscure
the interdependence of individual empowerment and collective empowerment. Finally,
the rush to embrace community participation may lead to an over - idealized view of
community solidarity and, in addition, may inadvertently subvert needed professionally
based, direct services.
In health education and health promotion, empowerment provides the link between
health and community participation both conceptually and in practice. Health, broadly
defined as a resource for everyday life, is a desired outcome of empowerment strategies
at both the individual and community levels. Similarly, high - level community
participation, which increases capacity on the individual and community levels, is
both an effective empowerment strategy and an outcome of empowerment.
We do not argue for a single framework to embrace notions of health, empowerment,
and community participation. Rather, our intent was to make explicit the multiplicity
of meanings surrounding these concepts, thereby revealing their inherent
contestedness. Indeed, we suggest that to ignore the extent to which these concepts
continue to be contested is to underestimate their power for analysis and practice. We
suggest that the field of health education and health promotion is advanced by bringing
these issues into open discussion.
One of the issues not addressed in this paper, and which needs to be addressed in
future analyses, is the whole area of research. How are we to evaluate the effectiveness
of the new health promotion movement? As McLeroy, Steckler, Goodman, and
Bordine (1992) note with respect to health education, “ whether labeled as capacity
building, empowerment, or other terms, what is missing from our literature are methods
for measuring changes in problem solving ability at various levels of analysis ”
(p. 2). In a similar vein, health practitioners who advocate the new health promotion
cannot continue to implement these strategies simply because they sound good. Rather,
practitioners must be able to demonstrate that the approaches advocated indeed do
achieve more health and social benefits for more people than previous approaches.
Otherwise, how will we know if anything has changed with respect to health promotion
other than the language we use to talk and write about it?
Finally, proponents of the new health promotion must continue to scrutinize themselves,
their theory, and their practice. Medicalized versions of health and individual
lifestyle health promotion efforts represent stable knowledge domains with their own
language, theories, and experts who possess specific skills. The new health promotion
movement emerged as a new knowledge domain by challenging these existing domains
and has created its own language and theories and experts. For the new health promotion
not to become itself another imperialistic ideology, we must heed the warning of
John McKnight (1992b) when he writes, “ the possibility of health in a modern society
depends upon our ability to free the idea of health from its subordination to managed,
commodified and curricularized activities ” (p. 3). As health professionals committed
to the promotion of health, we must be vigilant that the new health promotion is not
just a revolution in professional discourse, not just another tyranny.