The political economy of health promotion: Part 1, national commitments to provision of the prerequisites of health

摘要

Canada is a leader in developing health promotion concepts of providing the prerequisites of health through health-promoting public policy. But Canada is clearly a laggard in implementing these concepts. In contrast, France is seen as a nation in which health promotion concepts have failed to gain much traction yet evidence exists that France does far better than Canada in providing these health prerequisites. Such findings suggest that it is the political economy-or form of the welfare state-of a nation rather than its explicit commitments to health promotion concepts-that shape provision of the prerequisites of health. Part 1 of this article examines how health promotion rhetoric specifically concerned with provision of the prerequisites of health differs among nations identified as being either liberal, social democratic, conservative or Latin welfare states. Governing authorities of nations that are liberal or social democratic welfare states are more likely to make explicit rhetorical commitments to provision of the prerequisites of health, the conservative and Latin states less so. Part 2 of this article provides evidence however, that despite their rhetorical commitments to provision of the prerequisites of health, liberal welfare state nations fall well behind not only the social democratic nations, but also the conservative welfare states in implementing public policies that provide the prerequisites of health. The Latin welfare states express little commitment to provision of the prerequisites of health and rather limited public policy activity towards meeting this aim.