Wednesday, March 6, 2013

Toronto Public Health DOES Get It

This is a poster I saw at a bus shelter a few days ago in downtown Toronto:

It's self-explanatory, but let's go over what it says--and perhaps even more importantly, given the hysterical, anti-obesity environment we're living in--what it doesn't say.

What we see is a public health poster on certain things we can do to prevent type 2 diabetes. It is made up of some text and three pictures. The picture on the left shows a family going for a walk. They're pretty ordinary people, not particularly slim nor fat. Just ordinary folk, not two ripped young people running through the woods, making sure their arm muscles appear to their best advantage.

The picture on the upper right shows a man of about 60. He's a little on the heavy side, again, not some super, lean and mean senior showing off his incredible physique despite his age. The gentleman is holding some fruit. He's standing in front of the fresh produce section of a grocery store.

The picture on the lower right shows a young man drinking from what is clearly a (non-plastic) water bottle. Just an ordinary guy.

The messages are simple, clear and POSITIVE: "be active - eat well - be tobacco-free". The question, "what's your small step?" simply encourages people to do their best.

This kind of inclusive public service message tells us that we can all do something to improve our health, rather than telling us that we are BAD and FAT and destined to be SICK.

Compare this poster with the fortunately short-lived Georgia campaign to stop childhood obesity:

That's a mighty positive message, isn't it (sarcasm alert)?

Contrary to the state of Georgia, I think Toronto Public Health has got it right.


  1. OMG, in some ways I love this post so much. :)

    I literally LOL at the line "...making sure their arm muscles appear to their best advantage." LOVE LOVE LOVE the cultural analysis you start to unpack with that statement.

    On the other hand...

    My greatest concern in relation to your post (and in relation to the message in the poster) can be summed up by the attitude or perspective which I perceive (accurately or not) may be interpreted from the following type of statement:

    "This kind of inclusive public service message tells us that we can all do something to improve our health, rather than telling us that we are BAD and FAT and destined to be SICK."

    Maybe you and I just disagree about the impact of social conditions (such as able-ism, etc) on health outcomes. Period. That's okay. My lived experiences are of course very different from yours and present me with uniquely different (and biased) views about the concepts of health and illness.

    I've seen for example the stark differences in elderly people who have diabetes (people who share the same medical diagnosis) yet have lived with completely different *levels* of social privilege for much of their lives (different access to material comforts and/or basic needs, different access to all manner of security and safety regarding everyday life, etc, and who have lived with different kinds of stigma, for example, such as that which accompanies able-ism).

    In other words, the medical diagnosis may be EXACTLY the same ("diabetes") but the disease processes (e.g. including outcomes) are shockingly (and, to me, horrifyingly) different.

    I guess a lot depends on whether human experiences such as "disability" and "health", for example, are conceptualized from an individualistic perspective or from a (much broader and "inclusive") social perspective.

    For example, I've been reading blogs written by autistic people (who, like everyone else, experience a wide variation in health issues and problems), and one of the realities that smacks me in my consciousness the hardest (most painfully) is the profound differences in everyday and ongoing reality (lived experiences) as perceived by autistic people who were lucky enough to win, say, the socioeconomic lottery vs. autistic people who have not been so fortunate.

    Of course I'm talking in generalities and undoubtedly insulting some people because, naturally, there is no singular identity constructed with/by the concept "autistic." However, autistic people are members of a singularly stigmatized (and thus highly stereotyped) group. Therefore, the differences in health inequities, etc---depending on social conditions beyond the power of individuals to choose---tend to stand out much more vividly.

    And when I read first-person narratives about the different degrees and kinds of access to care/assistance, which autistic people (like all of us) require to continue living (vs dying), depending on unique individual needs and on social conditions, I might as well be reading about autistic people who exist on two VERY different planets.

    Saying that we can all take very small steps to help reduce our own individual risks for illness and sickness (such as diabetes) is really not that much different from saying that we can all take small steps to prevent or reverse the socially-constructed body size category known as obesity. It perpetuates cultural myths that say individuals have the power to overcome (if they make even "small" efforts) the very REAL health impacts of social conditions, such as fat stigma. Indeed, some of us are "destined" much more than others to become unavoidably SICK as a result of social conditions, such as fat stigma and able-ism.

  2. It seems like blogspot's eating my readers' comments, so I'm trying it out myself. Let's see if this stays posted.

  3. Great comments! I totally agree with you;)

  4. Wonderful post! I especially enjoy the line "...Just ordinary folk, not two ripped young people running through the woods, making sure their arm muscles appear to their best advantage." :) Ain't that the truth! We see that b.s. so much in popular media, in fact, I now believe we are socially trained in subliminal ways to look at our own bodies through those kinds of weird distorting lenses of oppression---you know, desperately straining at times to find those idealized shadows and "cuts" hopefully presented by our own muscles, and (if you're like me) sometimes feeling inadequate because they aren't visible. Yeah. It's hurtful to portray "health" through an airbrushed, photo-shopped (distorted) points of view.

    I would love to see intentionally subversive ads that call into question the meaning of "health", "healthy" and "sick"---showing that surface appearances are biased indicators of underlying conditions---and that "health" and "sickness" carry diverse and complex meanings depending on many other (hidden) factors.

    For some people, for instance, having the medical diagnosis of "diabetes" does not present such a tragic or even severely limiting kind of health issue or problem because they have so many other kinds of advantages and privileges and options available to make their lives less burdensome and more rewarding (secure, comfortable, etc). But that same diagnosis, "diabetes", can be utterly devastating and even lethal for people who don't have those socioeconomic advantages, or for people who are also disabled by other conditions which make access to adequate health care services (and/or access to the means to meet basic needs) close to impossible.

    In the latter cases, the disease process itself (including symptom severity and outcomes) can be extremely (starkly) different---even though the medical diagnosis ("diabetes") is the same. As a result, they might as well be two completely different diseases that just happen to share the same name.

    I get really cranky about this topic, "health", as something we all can improve by taking small steps and making little or gradual changes because of my own limitations. Frequently, unfortunately, the results of such efforts more closely resemble two baby steps forward then three giant steps back.

    But you already know that because of your own struggles with finding the best ways to care for and live with health problems and disabilities. :)

    Most of my concern comes from the similarities between the beliefs that fat people can just do simple and small things differently, make small choices each day, which are then (according to cultural mythology) supposed to result in BIG reductions in weight...over time, with patience, etc. I don't know of a much more oppressive message than one which suggest people can change something (with the right attitude and effort, for instance) over which they personally have little control.

    I find that distorted thinking dominates many aspects of health and illness discourses, too, and have begun to notice able-ism and other kinds of bias at the root of our culture's false assumptions.

  5. Yikes, hopeful and free, you're always so brilliant! I need some time to answer. Stay tuned!

  6. Hey, NewMe---Ahh, shucks, ma'am, I just calls 'em as I sees 'em. LOL. Not brilliant, btw (well, maybe, on my very best day), but mostly fortunate to have experienced some incredible learning opportunities related to "health" and disability and ways in which social systems interact with, and construct, physiological-social processes (e.g. dis-ease and "health") that our dominant discourses teach us to conceptualize as personal things that individual people (bodies) "have"---as if market ideology legitimates personal ownership of health ("biological") processes---and to conceptualize diseases as processes existing INSIDE individual bodies as consequences of genetics, or pathogens (germs or viruses or parasites, etc), or environmental toxins, or accidents, or personal choices...but we have almost NO ways of thinking about and talking about "health" and illness as socially constructed conditions, which are inextricable from culture and from social conditions.

    Anyway, it's important to acknowledge, as you do in your post, whenever there is enlightened social movement away from oppressive and distorted discourses (e.g. "just stay thin and you'll avoid these---XYZ---risks for terrible disease!!!"). Indeed, to borrow your metaphor, by taking small steps away from oppressive social/cultural perspectives, we open the way forward toward better ways of conceptualizing health.

    In other words, I'm suggesting that we still have a long way to go in this movement AWAY from health discourses that are distorted, oppressive and harmful, and TOWARDS critical health discourse that can help free us from our limited/limiting ways of understanding "health." Nevertheless, those beginning, uncertain, and small movements are ESSENTIAL. :) Thanks for reminding me to recognize progress, and to avoid the folly of ALL OR NOTHING thinking. :)