Shifting discourse on health in Canada: from health promotion to population health |
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Authors: | Robertson A |
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Institution: | Department of Public Health Sciences, McMurrich Building, University of Toronto, Toronto, Ontario M5S 1A8, Canada |
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Abstract: | This paper argues that discourse on health are products of the particular
social, economic and political context within which they are produced. In
the early 1980s, the discourse on health in Canada shifted from a
post-Lalonde Report lifestyle behaviour discourse to one shaped by the
discourse on the 'social determinants of health'. In Canada, we are
currently witnessing the emergence of another discourse on
health-'population health'-as a guiding framework for health policy and
practice. Grounded in a critical social science perspective on health and
health promotion, this paper critiques the population health discourse in
terms of its underlying epistemiological assumptions and the theoretical
and political implications which follow. Does it matter whether we talk
about 'heterogeneities in health' or 'inequities in health'? This paper
argues that it does, and concludes that population health is becoming a
prevailing discourse on health at this particular historical time in Canada
because it provides powerful rhetoric for the retreat of the welfare state.
This paper argues further that it is health promotion's alignment with the
moral economy of the welfare state that makes it a countervailing discourse
on health and its determinants. |
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Keywords: | |
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