The ecological approach in health promotion programmes: the views of health promotion workers in Canada

Abstract

The purpose of this study was to explore attitudes, beliefs, and values related to the ecological approach among health education and health promotion workers. Data were collected using self-administered questionnaires. The sample consisted of 157 health education/promotion workers involved in Canadian regional public health organisations. The response rate was 79 per cent. Respondents tended to know the ecological approach, perceived it as effective, and acknowledged a need for interventions aimed at modifying people's environment. However, many respondents perceived that they had insufficient competencies to operationalise the ecological approach. A sizeable proportion of respondents seemed to hold values inconsistent with the ecological approach. Compared to doctors/dentists, nurses expressed a higher satisfaction with interventions targeting individuals. In general, respondents' cognitive profile was favourable to the ecological approach. It is hypothesised that the particular patterns of response obtained for some scales might be related to the respondents' previous training.

Immigration as a Social Determinant of Health

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Structural Vulnerability and Health: Latino Migrant Laborers in the United States

“…This involves an awareness that a larger ‘risk environment’ precedes individual decision-making (Rhodes 2002), but, significantly, there is not yet a logically consistent conceptual vocabulary or analytical approach to the definition of the risk environment in public health and medicine. Critical public health approaches propose a broad range of overlapping terms for grappling with the effects of social inequality, including among others: “social epidemiology” (Poundstone, Strathdee, and Celentano 2004; Diez Roux 2007; Galea, Hall, and Kaplan 2009), the “eco-social” or “socio-environmental perspective” (Brown and Inhorn 1990; Krieger 1994, 2001; Richard, Potvin, and Mansi 1998; Burris et al 2004), “eco-epidemiology” (Susser 1996), and the “the risk environment framework” (Rhodes and Simic 2005; Rhodes 2009; also see review by Strathdee et al 2010). They call for a focus on “fundamental social causes” (Link and Phelan 1996, 2002), “social determinants of health inequality” (Strathdee et al 1997; Kawachi and Kennedy 1999; Marmot 2005; Marmot and Wilkinson 2006), “income inequality” (Kawachi and Kennedy 1999), “political and economic determinants” (Singer 2001, Navarro and Muntaner 2004), “conjugated oppression” and “hierarchies of embodied suffering” (Holmes 2007), “zones of abandonment” (Biehl 2005), “higher order causal level structural factors” (Miller and Neaigus 2001), and “discrimination” and “racial disparities in health outcomes” (Marmot 1984; Lillie-Blanton and Laveist 1996; Williams 1999; Ferrie et al 2003; Smedley, Stith, Nelson and Institute of Medicine 2003; see also review of race and inequality in the public health literature by Krieger 1999).…”

Making Youth Tobacco Control Programs More Ecological: Organizational and Professional Profiles

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