Glenn. Laverack NHPRC2013
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Glenn. Laverack NHPRC2013



Health Activism. Foundations and Strategies

Health Activism. Foundations and Strategies



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    Glenn. Laverack NHPRC2013 Glenn. Laverack NHPRC2013 Presentation Transcript

    • Early Reformers • Rev John Edgar (1798-1866). Founder of the temperance movement-reduced use or prohibition of alcohol. • John Snow (1813-1858). The Broad Street pump-control of cholera outbreak. • Rudolph Virchow (1821-1902). Two causes of poor health- ‘one pathological and the other political’. • August Palm (1849-1922). Swedish trade union agitator and workers rights activist.
    • Health Activism • Activism is action on behalf of a cause, action that goes beyond what is conventional or routine (Martin, 2007). • Health activism involves a challenge to the existing order whenever it is perceived to influence peoples’ health negatively or has led to an injustice or an inequality (Plows, 2007).
    • What constitutes as activism depends on what is ‘conventional’ in society as any action is relative to others.
    • Health Activist Organisations • Code Pink (Women’s rights) • MAD Pride/Mind Freedom • Fathers 4 Justice • People’s Health Movement
    • Activist tactics Conventional/indirect • Advocacy • Petitioning • Consumer boycotting • Protests and demonstrations Unconventional/direct • Legal action • Publicity stunts-Graffiti, ‘lock-ons’ • Hacktivism • Property damage
    • What works? The strength of health activism lies less in numbers and more in assets such as: • Strong leadership; • Evidence-backed positions.
    • Increased choice for birth control • A key advocate for birth control at a time when it was illegal for any woman, even those who were married, to use these methods in the United States. • She was born in New York to a Catholic mother who had 18 pregnancies, 11 of which resulted in live births. • In 1916, Sanger opened a family planning and birth control clinic in Brooklyn, the first of its kind in the United States - violating laws. • Sanger founded the American Birth Control League in 1921 and in 1923 established the first legal birth control clinic. • In 1960 the birth control pill became available to the general public and in 1966 birth control was legalized for married couples in the United States. Margaret Sanger (1879-1966)
    • Radical surgery and breast cancer • A 45 year old American journalist who in 1974 was diagnosed with breast cancer. • Standard procedure: A biopsy and mastectomy in a single surgical operation in which muscle tissue and lymph nodes were removed along with the breast. • Fought for the right of women to make decisions about their own bodies -openly critized the medical profession. • Established the Breast Cancer Advisory Center. • A relentless activist and lobbyist. • In 1979 the National Institutes of Health concluded that radical mastectomy should no longer be the standard procedure for suspected cases of breast cancer and recommended total simple mastectomy. (1929-1990)
    • What works? • Using the mass media can help to shift public opinion if it is also followed up with a professional and public debate about the key issues, over a prolonged period of time. • Innovative strategies involving civil protests, media stunts and demonstrations help to gain attention and re-frame the health debate.
    • The Billboard Utilizing Graffitists Against Unhealthy Promotions (BUGA UP) Graffiti is images or lettering scratched, scrawled, painted or marked in any manner on property to express underlying social and political messages. Graffiti is considered defacement and vandalism and is illegal.
    • BUGA UP • BUGA UP started as a response against tobacco advertising in Australia in the late 1970s. • The campaigners defaced thousands of tobacco advertising billboards using humour and setting up parody organisations such as the ‘advertising double standards council’.
    • BUGA UP • BUGA UP caught the public attention and this helped to change opinion in the lead up to the national ban on cigarette advertising in Australia in 1994. (Chapman, 1996).
    • ‘Lactivists’ in Action • ‘Lactivists’ are activists seeking to increase respect for breast-feeding in public places. • In a well known coffee shop a mother was asked to breastfeed her child in the bathroom and not in the public area. And so………….. • In 2004, over two dozen ‘lactivists’ held a ‘nurse- in’ at an outlet of the cafe in Maryland, USA.
    • • Starbucks café was forced to concede to legal action and public support. It changed its corporate policy and now allows women to breastfeed in their cafes in public areas In the USA. (Metoyer, 2007).
    • What works? • The ability of the organisation to create alliances or partnerships with influential others who can act as ‘champions’ for their cause can be an effective strategy. • Frame the strategy and tactics around a single issue which has a clear policy solution.
    • The New Zealand Prostitutes Collective The NZPC was started by a small group of prostitutes in 1987. It advocates for the human rights, health and wellbeing of all prostitutes. It formed partnerships with other sex worker and ‘at risk’ groups, the MoH and with politicians. A single policy issue to decriminalise prostitution. This was achieved in 2003. (Laverack and Whipple, 2008)
    • 1987 1988 1989 1990 1991 1999 2000 2003 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - NZPC formed MoH contract with NZPC NZPC negotiates committee to be formed to review law on sex work MPs more involved in NZPC cause Prostitutes Reform Act 2003 NZPC legally est 1st and 2nd submissions to Parliament 3rd submission to Parliament with MPs help MPs vote for Reform Act to be passed Laverack and Whipple (2010)
    • Following the Reform Act 2003…….. Four years after decriminalisation: o 87% of all survey participants have a regular doctor; o Most participants reported always using condoms for vaginal and anal sex; o Over half of participants reported refusing to do the job without a condom in the last 12 months; o Managed sex workers spoke of the support that they now had from brothel management when it came to refusing to do certain clients; o A marked reduction in client violence, police harassment and Sexually Transmitted Infections. (Abel, Fitzgerald and Brunton, 2007)
    • What works? • Social networking is an important means to bring people together such as internet sites. • Activism backed by legal action has been one of the most effective means of achieving policy change.
    • South African Treatment Action Campaign TAC galvanized opposition to multinational drug firms that were against the government’s attempts to import cheaper versions of antiretroviral treatments. TAC lobbied and advocated and through a successful court case forced the government to dispense mother-to-child HIV transmission treatment. TAC created a network of partnerships in support of its cause.
    • What can we do as individuals? In our capacity to make autonomous choices we can support the cause of a health social movement or local action group. 1. Membership. 2. Donations. 3. Petitions. 4. Protests. 5. lobbying.
    • Our professional notions are………… o We need to do more with less in health system design, delivery and governance. o We need to support primary, community and social services. o Power sharing, empowerment and democratisation.
    • What can we do as professionals? 1. We can use our ‘expert’ power to legitimize a cause by raising awareness and advocating. 2. Help to provide an evidence base. 3. Directly or indirectly fund their activities. 4. Build networks and partnerships. 5. In our capacity as professional associations we can collectively support a cause or an activist organisation.
    • Successes in achieving radical changes in public health have been through partnerships: Professionals / Activists / Scientists
    • o Health Care Consumer groups. o Patient advocacy groups. o Citizen advocacy groups - the SDH. o Action on Smoking & Health (ASH). o Anti-boxing campaign
    • Working together for change • After the first reported AIDS case in 1981 services were soon over-stretched in the USA. • The gay community became angered by the government’s perceived mismanagement. • AIDS coalition to unleash power (ACT-UP) was formed in New York in 1987. • Social networking, discrimination within the health services, personal skills and education.
    • Working together for change • ACT-UP pushed for policy changes in drug testing and approval processes and education about safer sexual behaviour. • Medical researchers, activists and policy makers worked in partnership motivated by the magnitude of the epidemic. • This level of solidarity was probably not seen before in regard to a health issue (Brashers et al, 2002).
    • Historically, what has defined a contemporary practice has been its willingness to work with others to address the causes of social injustice and health inequalities in society.