Update and what gets on the table

Classified as: reflective journal - updates, discourse, theory

(25 June -  just updated this update! - some more recent info, a few corrections and reference details.)

Where the project is up to: I've been conducting interviews and focus groups, discussing what people are doing to promote equity, environmental sustainability and health, and the barriers or enablers to this work.

So far I've done seven interviews and three focus groups in this round. I'm hoping to do one more focus group and possibly two more individual interviews in the next month or so. I've talked with people in all three PCPs.

I'm still transcribing tapes at present so won't discuss emerging themes yet. However I'd like to share some of the thoughts I had about stage one of the research.


The key results of stage one are described on 'The project' tab. This was the stage where ISEPICH participants developed a draft framework - principles for how we should promote equity and sustainability together. ISEPICH research participants then discussed these in more detail in groups.

Some thoughts on this: what discourses does health promotion sit in? What does it contribute to discourse?

There's a lot of complicated definitions of discourse (eg see Wikipedia http://en.wikipedia.org/wiki/Discourse), but I think of it as the world of ideas and meaning that we live in.

Within this world, there's many discourses. Discourse, as Wikipedia suggests, is like conversation, except it's more than just conversation. It also shapes what you can and can't say - what "gets on the table" as one of the research participants said recently. (What didn't seem to get on the table in this case was a serious discussion about community gardens - more on that in later posts.)

In health promotion, we aim to promote health and wellbeing - it's an idealist aim, devoted to "human flourishing" as Guba and Lincoln say. (Some say utopian, but I think calling it utopian actually reflects our problems with discourse). Often, however, we try to justify it in rationalist and utilitarian terms, including monetary terms. The question is, how relevant is this to health promotion?

Much of what we are advocating is never going to make money for anyone. More walkable cities and more people walking: where's the money in that? Ok, individuals might save money (which is good in a society where we are all dependant on money, especially for poorer people), and some local shops might benefit, but basically there's not much profit in it. This is different from the medical world of fee-for-service and medication, which fits well with a capitalist economy.

We also talk about how much money we save governments by preventing disease, but as this can only ever be theoretical, it's not clear how useful or convincing it is. It also may not work in practice - rather than money being saved, it might actually go towards new programs or better treatments. I'm not sure that we would ever see the health budget cut as a result of our efforts, because in political terms it's pretty hard to cut health budgets. We might say we're preventing the budget from growing by slowing the increase in chronic disease, but again that's theoretical.

The previous reference to capitalism might seem as if I'm doing a Marxist analysis, but actually that's only part of the analysis. Marxist analysis is useful, but ultimately both Marxist and neoliberal approaches are limited. In particular that they both share the assumption that competition and exchange have primacy over care and nurture.

I'm planning to write an article about this so won't go on here, but I'm wondering what people think. When we try to justify our work in terms of diseases prevented or money saved, are we just trying to operate in someone else's discourse? Are we doing ourselves and health promotion a disservice? Should we be challenging the primacy of this discourse rather than trying to fit ourselves in it?

Interested in your thoughts.


Reference cited: Guba, E. and Y. e. Lincoln (2005). Paradigmatic Controversies, Contradictions and Emerging Confluences. The Sage Handbook of Qualitative Research. University of Illinois,
Urbana-Champaign, Texas A&M University, Sage.

What is this blog for? Thoughts to the ether

Classified as: reflective journal - blog

When I first had the idea of this blog, I was having to make some changes to the project. Rather than writing or emailing everyone, I thought it would be better to set up a blog for information. Then I could just send a link by email or text when I needed to do an update.

After I decided to set it up, my supervisor suggested it could be interesting to use comments as part of my data, so I included an (open) comment function. It's a public blog so anyone can comment. As the blurb says, comments may form part of the research, but they won't be linked to any individuals. Rather I see comments as providing background information about the way people think and talk about health, equity and sustainability.

In order to make the changes to the project, I had to organise a lot of things and get approval from the Monash human research ethics committee. And in order to do that I had to inform participants about the changes before the blog went live anyway. (The Project tab outlines what the major changes were and I might comment a bit more about the impact of them in a later blog.)

So now I've been thinking more about what the purpose of the blog is and what it can do. The main things I'm thinking are:
- providing information about the project and its progress (that's still the basic purpose even though hopefully there won't be so much change in future)
- as this is a participatory action research project, the blog can also be a way to share ideas
- I can float some of the  themes and ideas that are coming out of the focus groups and interviews get  feedback on them
- sharing ideas about resources and good practice (I haven't had any response to my earlier request about this yet, but I already know several examples and hope to get them up soon)

Also I guess - random thoughts and observations. There are some really interesting blogs on the web and I find quirky personal ones quite fascinating (like blue milk, a blog about motherhood and feminism - you can google it if you're interested). I might include some more diverse links on the front page in future - at the moment the links are specifically related to the research. Although I think those websites are interesting, they're not really quirky or out there.

Part of the data for my research is a reflective journal I'm keeping (I've been a bit slack on this lately).  So I thought maybe some of that could go on here sometimes - random thoughts and reflections, spin-off ideas. I've always wanted to write in a way that's interesting as well as academically sound, so maybe that will help. On the other hand, it may just come across as wordy and self-absorbed! I honestly don't know.

Hopefully too some comments will eventually land here? I always find comments interesting on the web (though some of them make me despair).

When I first started to write this post I was going to call it thinking aloud, but of course that's not what you do on the web. It's more like putting a message in a bottle, or sending your carrier pigeon off - throwing your thoughts to the ether. So here they go ...

(Next time some information about where the project's up to)

Visit to the Wimmera

Classified as: reflective journal

I went to the Wimmera a few weeks ago to talk with some health promotion people there. The picture shows a view from the bus window.


Over the last ten years this region has had drought, heat waves, fires and floods. Like most of Victoria, the Wimmera  has now had another dry spell, since September last year. For example in Horsham, all months except February have had less rain than average, in most cases much less.

People there told me that farmers have been very innovative in coping with drought. But you have to ask, what are the long term implications of a changing climate for the people of the Wimmera, and  for everyone who depends on the food they produce? And what can we all do to ensure this region survives and thrives?

Call for action

Classified as: project update

Tuesday 14 May 2013
There's a big call for action on climate change and health in Crikey today - read about it here where is the leadership ...
Interesting to see the Public Health Institute in California is funding projects addressing climate change and health - if only we had that here! However, as I have been discussing with a few of the research participants lately, we can disseminate information about what people are doing through case studies.
If you know of any good work that is being done on addressing health, equity (social justice) and environmental issues, please let me know.
If you want to post it in comments, please do. Please remember this site is a public one and anyone can read or comment.

Getting going

Classified as: project update

2 May 2013 - it took a while to get ethics approval for the next stage of this project, but it's now done, and the blog is going live at last...