Tuesday, 8 January 2013

My Big Fat-and-Caffeinated New Year’s Resolution

Posted by Heather Yoeli

I need a coffee. I can’t write without coffee. Happy New Year. May 2013 be a year of love and blessings and decaffeination for you and all those whom you love. And please excuse the very inept deployment of the subjunctive in the previous sentence. I need a coffee, you see...

I’m sure I’m not the only one within Fuse to have made a New Year’s Resolution. I imagine that I’m not the only one within Fuse to have made a health-related behaviour-changing type New Year’s Resolution either. I am (deep breath) going to make fewer – alrightalright NO - trips to the friendly new espresso machine located at the local garage and I am (even deeper breath) going to put the money saved towards one of those cringworthily excruciating-sounding Mummy-and-Tot Dance Classes, through which I will instil in my progeny an enthusiasm (grit teeth) for exercise. And I’m wondering what New Year’s Resolutions others might have, and how forthcoming they might be in sharing them with a blog…

My vice. This is a caffeine molecule, apparently. Chemistry was never my strongest suit, so I’ll take its word for it.
Within most areas of health, healthcare and health sciences, there exists an ethos which says that professionals and researchers should distance themselves from their area of practice or study. If, for example, you’re a doctor or a PhD student with diabetes or bipolar disorder, it’s nobody else’s business at all and they can piss off if they ask you anything about it. You don’t go there because to do so would be unprofessional or self-indulgent or irrelevant or burdensome to others, in essence a transgression of Western society’s Cartesian boundary of subject/object, body/mind, Self/Other. In other words, our personal lives need neither to be affected by nor to affect anything we do to pay the bills. It’s all a stress-management technique or a coping mechanism or a survival strategy, and one with which few would disagree.

Within public health, however, ethical challenges emerge from attempts to uphold such distinctions. Even those of us who subscribe to the most deterministic and we’re-all-merely-victims-of-our-social-environment woolly leftie-isms would concede that we all exercise some level of choice regarding our health behaviour: we decide, for example, how much (if any) chardonnay we drink, how frequently (if ever) we disinfect our chopping boards and whether (if female) we turn up for smear test appointments. Merely by virtue of possessing some level of personal autonomy and merely by living in a country offering virtually universal health services, we are all patients (or service users, clients or consumers) of public health. And some of the choices we make with regard to our health will be visible or apparent to those with whom we’re working.

Within qualitative service evaluation literature produced on public health interventions in the Cowgate community, smoking is a case in point. Davies (1998) does not mince her words:

… some families spend a third of their income on cigarettes. The smoking message is one that the midwives repeat over and over again, and everyone, including social workers, seems to ignore it... 

Stacy (1988) puts it a little more discreetly:

Staff should decide whether to make reduction in smoking one of the objectives in their health promotion work.

In other words, if we can’t give up smoking why should they want to?

And if I’m wasting £2.30 a day on un-recycled paper cups of over-caffeinated beverages funding a monolithic rainforest-destroying global multinational, how can I think with any integrity about questions of ethics and sustainability with public health? I’m really [expletive redacted after long tea-fuelled discussion with editor] going to have to do this. Aren’t it?

So, before I put the kettle on for camomile tea in a vain attempt to assuage the shakings and cravings of my coffee withdrawal, would anyone else like to share what they’re resolving to do to address their own un-public health-worthy little vices? What’s your New Year’s Resolution, and why?

1 comment:

  1. OK, I own up. I have resolved to get fit again this year. Everyone thinks I'm pretty fit. But the truth is that the rot set in a year ago, when I injured my knee skiing. Since then I have conceded a substantial decrease in regular activity and I have watched my girth gradually increase. I find it is now a significantly greater struggle, not only to actually run a couple of miles, but even to motivate myself to do it. It is a slippery slope - you use the injury as an excuse, both to avoid activity and to let yourself off that extra mile - even when the injury is no longer incapacitating. And, the lack of exercise means that I can no longer eat cake with gay abandon, so now I am forced to 'diet' as well, which is *bloody* miserable. So, something has to change. I may even need help from a behavioural scientist...