Journal Article

Shifting Discourses on Health in Canada: From Health Promotion to Population Health

Ann Robertson

in Health Promotion International

Volume 13, issue 2, pages 155-166
Published in print January 1998 | ISSN: 0957-4824
Published online January 1998 | e-ISSN: 1460-2245 | DOI: http://dx.doi.org/10.1093/heapro/13.2.155
Shifting Discourses on Health in Canada: From Health Promotion to Population Health

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This paper argues that discourses 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 epistemological 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.

Keywords: health discourses; health promotion; population health

Journal Article.  0 words. 

Subjects: Public Health and Epidemiology

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