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Looking Back and Looking Ahead in Health Promotion

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I Introduction

Last week, we summarized some of the behind-the-scenes work at OHPE, some comings and goings in the field, and provided a handy list of all the feature articles from 2006. This week, we asked you to reflect on 2006 and look to the year ahead. Here are your responses.

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II Connie Clement, Executive Director, Ontario Prevention Clearinghouse
 
2006 heralded renewed interest in the promise of population health promotion. Appetite to address health disparities and social determinants of health is palpable. Partnerships to prevent chronic diseases are encouraging. Evidence and demand for healthy child development is steady — despite bad Federal policy. Inclusion and community engagement are recognized as vital to healthy communities.
 
In response to these trends, new policy levers and partnerships are forming. Ontario's health promotion resource centres increased collaboration to respond to health needs, and the gap between clinical treatment and health promotion is narrowing. The potential of the Public Health National Collaborating Centre on Social Determinants of Health, the Ontario Health Protection and Promotion Agency, and the Minister of Health Promotion's inter-ministerial committee to effect change are great.
 
On health promotion's horizon, I see the needs of an aging population, the importance of promoting mental health, and more strategic partnerships between health promoters and environmentalists. Health promoters need to keep building and applying best practices and to better define evidence to include local successes. To bridge the gap between intention and actually improving health outcomes will require an influx of resources that are better timed and sustained.

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III Jane Bellman, Manager, Nutrition Resource Centre. Ontario Public Health Association

Nutrition news, as always, made headlines in 2006. Last year was all about trans fats, food recalls — spinach, carrot juice and chocolate — Omega-3 and, of course, obesity. Food is an integral part of our lives. We need to make efforts to ensure that healthy choices make up most of our daily routine. Here are some tips with links to helpful guidance to keep you on track:

Learn about what you are eating. Read food labels, and be selective in your choices at http://healthyeatingisinstore.ca/.

Eat vegetables and fruits (fresh, frozen or canned), whole grains and omega 3s every day. Learn more at http://dietitians.ca/public/content/eat_well_live_well/english/faqs_tips_facts/dc_tips/index.asp.

Watch how much you eat—we don't need to super size! See
http://www.dietitians.ca/english/pdf/fact%20sheet_2_english.pdf (link opens PDF file).

Follow safe food handling tips. See http://canfightbac.org/en/.

Most of all, have a happy new year of delicious, nutritious and healthy eating.

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IV  Marilyn Pope, Research Officer, Ontario Tobacco Research Unit

2006 has been an exceptional year for tobacco control in Ontario. The past year saw the implementation of the Smoke-Free Ontario Act, which came into force on May 31, 2006 and promised further provisions to follow as of May 31, 2008. This forward-thinking legislation, part of the province's comprehensive tobacco control strategy, promotes the goals of prevention, cessation and protection.

From the point of view of public health, particularly promising highlights of the Smoke-Free Ontario Act include prohibitions on smoking in enclosed workplaces and enclosed public places, restrictions on tobacco promotions in places of entertainment, enhanced restrictions on selling tobacco to young people, and restrictions on sale of tobacco through countertop displays. The restrictions on countertop displays are slated for upgrading at the end of May 2008, at which time a total ban on displaying tobacco products for sale where customers can see them will be enforced.

Although the Smoke-Free Ontario Act reduces retail access by minors, it does not directly reduce the overall availability of tobacco products. There are still outstanding issues to be dealt with regarding exposure to second-hand smoke in automobiles, multi-unit dwellings, and private residences, in particular when children are present.

While much work remains to be done, the Smoke-Free Ontario Act is a major historical step towards improved tobacco control in the province of Ontario. It has been a very good year.

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V Pamela Benson, Manager, FOCUS Resource Centre

From 2006, FOCUS communities can add these three accomplishments to their health promotion efforts:

FOCUS communities throughout Ontario launched a province-wide media campaign on alcohol risk and chronic disease, specifically looking at stroke and cancer. The campaign provided new collaborative opportunities at both the local and provincial level, and provided an opportunity for people to explore the connections between alcohol consumption and chronic disease. The campaign was funded through the Ontario Stroke Strategy to coincide with Stroke Month in June 2006. The materials and information were well received and are posted on the web site www.frcentre.net/asc.htm for access beyond the FOCUS communities.

The FOCUS Provincial Program developed a tagline that identifies individual FOCUS coalitions and the FOCUS Resource Centre as part of a larger provincial organization: "A member of Ontario's FOCUS Program: Community partners in alcohol and other drug abuse prevention"

The alcohol and drug Resource Centres of the Ontario Health Promotion Resource System (Focus Resource Centre, Ontario Drug Awareness Partnership, Parent Action on Drugs, Council on Drug Abuse, Alcohol Policy Network and Association to Reduce Alcohol Promotion in Ontario) continued to strengthen their collaborative efforts in response to the needs of Ontario health promoters by working collectively to address common alcohol and drug issues.

Our hopes for 2007 are that health promotion will continue to be recognized as an important and cost-effective element of the health care system as all of our efforts continue to have a positive impact on the health of Ontarians.

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VI Alison Stirling, Health Promotion Information Specialist, Health Promotion Affiliate of the Canadian Health Network, Ontario Prevention Clearinghouse

It has been a banner year for the Canadian Health Network (CHN) Health Promotion Affiliate, a joint project of the Ontario Prevention Clearinghouse and the Centre for Health Promotion at the University of Toronto. In our special role supporting the health promotion capacity of CHN, we have coordinated regional workshops, developed a health promotion tool, enlarged and enhanced CHN's web site with health promotion and determinants of health resources, took part in the creation and launch of the Best Practices Portal in Health Promotion, seen changes and growth in staff and much more. The Health Promotion Affiliate's article in OHPE in March 2006, "Creating a Consistent Health Promotion Approach in a National Network" (http://www.ohpe.ca/index.php?option=com_content&task=view&id=7231&Itemid=78), describes the challenges for 22 national health organizations (Affiliates) to practically apply health promotion in their contributions to the collaboratively produced CHN web site. Through intensive workshops, forums and focus groups coordinated by the Health Promotion Affiliate, all 22 Affiliates unanimously adopted a working definition of health promotion and a tool for assessing HP content to ensure that collections and network and audience-building activities reflect health promotion in its broadest sense. Of particular interest to OHPE readers is our Health Promotion Assessment Tool/Checklist, which is based on OHPE's subject search framework and provides access to definitions and examples of complex health promotion and determinants of health concepts through multiple hyperlinks. It has been thoroughly tested, evaluated and adapted for multiple applications across CHN. This tool is now available in English and French to be explored and commented on at http://www.opc.on.ca/draft/HPChecklist.htm and http://www.opc.on.ca/draft/HPChecklist_fr.htm.

Ahead of us in 2007 await exciting initiatives such as coordinating the CHN presence at the World Conference on Health Promotion & Education in Vancouver in June and developing regional CHN workshops on social marketing in online health promotion with renowned expert Craig Lefebvre. At the same time, there are uncertainties as we look at wavering support for health promotion across the country, and at the federal level of government. As we prepare to re-apply for Affiliate status for three more years with the Canadian Health Network, we can hear the "buzz" about health promotion and the social determinants of health. We want that "buzz" to become a roar throughout Canada and beyond. Keep an eye on the Canadian Health Network http://www.canadian-health-network.ca and the Health Promotion Affiliate for more action.

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VII Larry Hershfield, Manager, The Health Communication Unit, Centre for Health Promotion, University of Toronto

In reflecting on Health Promotion in 2006 and where it has brought us, I find myself considering Rudyard Kipling's "six honest serving men" (http://members.optusnet.com.au/~charles57/Creative/Techniques/elephants_child.htm). My own mental model of health promotion focuses on two of the six: "what" and "how."

I think of the "what" dimension of health promotion as the overarching paradigm of health--the choices being medical, lifestyle, and socio-environmental. The influence of, and support for, each paradigm waxes and wanes with current events. As of the close of 2006, what with pandemics and anti-biotic resistant bacteria and wait times, the medical model is holding steady in first place. The media saturated "obesity epidemic" reflects all that is right and all that is wrong about the lifestyle model. Hanging in second place, it shows staying power. The social-environmental model remains in third place. However, I remain optimistic that we are moving in the right direction. Each year, the data on the social-environmental model gets better and has more traction, at least in the media, if not in actual policy.

How we make progress on health promotion issues is a complex dimension that considers empowerment and enabling. For simplicity, let me focus just on health communications. We now have many positive examples of impressive networking and collaboration facilitated by new technologies, including the Human Genome Project, as pointed out by Tapscott (http://www.wikinomics.com/book/) and others. The blogosphere and infotainment worlds (such as the Daily News show with Jon Stewart, http://en.wikipedia.org/wiki/The_Daily_Show) are leading the way in media transparency and literacy. Social marketers have embraced policy and environmental determinants. Media advocates are demonstrating powerful uses of research, strategy development, and front-line activism. The Berkeley Media Studies Group Paid Family Leave (http://www.bmsg.org/proj.php) and Sustainability Agriculture projects are good examples of this. Risk communication is now organized around broader paradigms and consensus on best practices. The work of Seeger and Reynolds with the Centre for Risk Communication Research is a case in point (http://www.comm.riskcenter.umd.edu/Spotlight/spotlight.htm).

So what's next? A bellwether issue (no pun intended) that I'll be watching is climate change. The issue of climate change shows just how long the knowledge use cycle can be. We can safely predict that climate change will stay on the agenda for some time now. And thanks to the Union of Concerned Scientists, we know that ExxonMobil acted like Big Tobacco. The question is will they pay the price like Big Tobacco? 2007 may tell...

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VIII Conclusion

The OHPE editorial team thanks our contributors. Many others wanted to contribute, but were unable to during the busy post-holiday season. Not to worry, there will be plenty of opportunity to contribute feature articles as the year unfolds. If you're not sure what you can contribute, have a look at our Most Wanted List from last week (January 5, 2007) for some ideas. Send your ideas and contributions to [email protected].