Allen, Caroline Frances (1999) Power, identity and Eurocentrism in health promotion : the case of Trinidad and Tobago. PhD thesis, University of Warwick.

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Abstract

While health promotion is ostensibly concerned with the full range of
processes through which people might control and improve their health, this thesis
shows that existing approaches and the literature are limited by Eurocentrism,
focusing primarily on the health concerns of Western people and obscuring those of
others.
Following literature review, the thesis examines the historical process of the
formation of health promotion as a hegemonic discourse within the West. A worldsystem
approach is then used to situate health promotion in a transnational structure,
and to analyse health data from Trinidad and Tobago regarding the relevance of
health promotion in the Third World. Fieldwork among non-governmental
organisations (NG0s) in Trinidad examines interpretations of health promotion,
drawing attention to areas of difference from hegemonic discourse and the symbolic
identities invoked.
Health problems in Trinidad and Tobago were found to be related to patterns
and fluctuations in capital accumulation on a transnational scale, with problems
usually associated with "modernisation" coexisting with diseases associated with
"poverty". Health promotion strategies need to take account of how both production
and consumption are structured globally.
In their health promotion work, most NGOs blended elements of non-
Western understandings, particularly in the area of spirituality, with hegemonic
concepts grounded in biomedical science. The postcolonial concept of hybridity is
used to analyse responses and resistance to Western discourse. Respondents
maintained that spirituality enabled people to transcend racism and to enhance
subjective well-being and control over health.
The results highlight that to devise appropriate health promotion strategies
means to respect difference, not by adopting a position of cultural relativism but by
understanding how transnational relationships of power pervade relationships
between cultures and affect health. Strategies should nurture the creative expression
of local views, contesting the centralisation of knowledge and material resources for
health within the West.

Item Type:	Thesis (PhD)
Subjects:	R Medicine > RA Public aspects of medicine
Library of Congress Subject Headings (LCSH):	Public health -- Trinidad and Tobago, Health promotion, Eurocentrism
Official Date:	January 1999
Dates:	Date Event January 1999 Submitted
Institution:	University of Warwick
Theses Department:	Centre for Research in Ethnic Relations (Economic and Social Research Council)
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Johnson, Mark, 1948 Mar. 16-
Sponsors:	Economic and Social Research Council (Great Britain) (ESRC)
Extent:	ix, 412 leaves
Language:	eng

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