{"id":476,"date":"2025-01-30T05:14:47","date_gmt":"2025-01-30T10:14:47","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/?post_type=chapter&#038;p=476"},"modified":"2026-05-03T15:35:34","modified_gmt":"2026-05-03T19:35:34","slug":"defining-health-disability-and-the-aims-of-health-promotion","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/chapter\/defining-health-disability-and-the-aims-of-health-promotion\/","title":{"raw":"Defining Health: Disability and the Aims of Health Promotion","rendered":"Defining Health: Disability and the Aims of Health Promotion"},"content":{"raw":"How did this new understanding of health contribute to changing meanings of health? Unfortunately, despite advancing greater recognition of the public\u2019s role and social and environmental factors in health outcomes, the changes left key elements in the dominant understanding of health unchallenged. For instance the women\u2019s health movement contended that women should understand their bodies and that their perspectives should be respected within the healthcare encounter, but health was still understood as the absence of disease. In many cases these health movements served to reify and entrench biomedical approaches to understanding health into a broader ideology of [pb_glossary id=\"705\"]medicalization[\/pb_glossary] upheld by an ever-increasing range of social functions (Crawford, 1980). The prominent (biomedical) conception of health, seen as a sense of well-being achieved through the mitigation of disease, illness, injury, and social impairments, was coming to be understood as not only a medical diagnosis but also as a matter of individual responsibility (Berthelot-Raffard, 2018; Crawford, 1980). Robert Crawford (1980) describes the emergence of healthism as a new health consciousness that situated the \u201cproblem\u201d of health as primarily an individual issue and product of personal actions, attitudes, and behaviours, achieved through modifications in lifestyle and sometimes with the help of therapeutic services. Health promotion entailed providing individuals with the necessary knowledge to make healthy choices that encourage healthy behaviour, resisting harmful influences, and reforming their mental responses to social stressors. In effect, the new health consciousness movements laid the groundwork for an \u201cage of medicalization\u201d in which the pursuit of health became a fundamental characteristic of popular culture and everyday life. As Crawford states, \u201cwhile modifications of dominant medical practices [were] being adopted, some of the most fundamental and disabling medical and other dominant cultural conceptions have remained untouched\u201d (p. 369).\r\n<div class=\"textbox\" style=\"border-left: 6px solid #7474C1;background-color: #f6f6fb;padding: 1em;margin-bottom: 2em\"><header class=\"textbox__header\"><img src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/noun-video-7467494-300x300.png\" alt=\"Video icon.\" width=\"80\" height=\"80\" class=\"alignright\" \/>\r\n<h3 style=\"color: #424294;font-weight: bold\">Media Moment<\/h3>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nTake a moment to engage with the following public health promotion videos created by ParticipACTION, a Canadian nonprofit charitable organization promoting physical activity. You can watch the videos below or access the transcripts.\r\n\r\n<strong>Time: 30 seconds<\/strong>\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=1OTVHUgnqcU[\/embed]\r\n\r\n<a href=\"https:\/\/www.youtube.com\/watch?v=1OTVHUgnqcU\" target=\"_blank\" rel=\"noopener\">Fall in with an active crowd<\/a>\r\n\r\n<span>[h5p id=\"45\"]<\/span>\r\n\r\n<strong>Time: 4 minutes, 35 seconds<\/strong>\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=MPAn-bvjllA[\/embed]\r\n\r\n<a href=\"https:\/\/www.youtube.com\/watch?v=MPAn-bvjllA\" target=\"_blank\" rel=\"noopener\">ParticipACTION Workout Videos | Break from Busy<\/a>\r\n\r\n<span>[h5p id=\"46\"]<\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<div class=\"textbox\" style=\"border-left: 6px solid #BFBE00;background-color: #fffef2;padding: 1em;margin-bottom: 2em\"><header class=\"textbox__header\"><img src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/noun-question-3407906-300x300.png\" alt=\"Question icon.\" width=\"80\" height=\"80\" class=\"alignright\" \/>\r\n<h3 style=\"color: #737200;font-weight: bold\">Reflection Moment<\/h3>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nHow do these two health promotion interventions conceptualize health and disability?\r\nWhat assumptions do they make about what it means to be healthy, active, or responsible for one\u2019s health?\r\n\r\n<code>[h5p id=\"47\"]<\/code>\r\n\r\n<\/div>\r\n<\/div>\r\nIn the readings associated with this module, Agn\u00e8s Berthelot-Raffard (2022) discusses the gap between the public health profession on the one hand and disability rights activists and scholars on the other in terms of how they conceptualize health and disability, and how these concepts frame health promotion. While the disability community has advocated for the inclusion, de-stigmatization, and de-institutionalization of people with disabilities as central aims in health promotion, the definition of health that has persisted in the public health field is rooted in the absence and prevention of disease, illness, injury, or other impairments to \u201cnormal functioning\u201d (Berthelot-Raffard, 2022; Crawford, 1980). In this definition, disability is seen as a form of deviance understood in contrast to the state of health, which is defined in terms of biostatistical markers of \u201cnormal functioning\u201d based on the most common levels of functioning for people of a particular age and sex (Berthelot-Raffard, 2022; Foucault, 1961). Critical theorists such as Michel Foucault have illustrated how the administration of normalizing biomedical categories have served as a form of population control from which conceptions of \u201cdeviance,\u201d \u201cpathology,\u201d and \u201cmadness\u201d arose. These concepts have long characterized people with disabilities as social \u201cproblems\u201d to be solved, treated, or extradited (Tremain, 2015; Foucault, 1961). In this framework, health is seen as the absence of impairment, and the role of public health is to minimize, prevent, and treat conditions that limit normal functioning to the greatest degree possible (Berthelot-Raffard, 2022).\r\n<div class=\"textbox\" style=\"border-left: 6px solid #7474C1;background-color: #f6f6fb;padding: 1em;margin-bottom: 2em\"><header class=\"textbox__header\"><img src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/noun-picture-7390883-300x300.png\" alt=\"Photo icon.\" width=\"80\" height=\"80\" class=\"alignright\" \/>\r\n<h3 style=\"color: #424294;font-weight: bold\">Media Moment<\/h3>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nRead this infographic or access the PDF here:\r\n<a href=\"https:\/\/www.wsps.ca\/resource-hub\/chemicals-hazardous-materials-whmis\/what-can-happen-to-your-hands-and-how-to-protect-them?utm_source=Resource_Hub&amp;utm_medium=website&amp;utm_campaign=top%20funnel&amp;utm_content=social%20media\" target=\"_blank\" rel=\"noopener\">\r\nWhat Can Happen to Your Hands and How to Protect Them\r\n<\/a>\r\n\r\nConsider the ways that the disability rights community and the public health field each conceive of the aims of health promotion. What are their shared aims and how do they differ?\r\n\r\n[caption id=\"attachment_483\" align=\"alignnone\" width=\"660\"]<img src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-660x1024.png\" alt=\"Infographic titled 'What Can Happen to Your Hands and How to Protect Them' shows five types of hand risks: dermatitis, lacerations, burns, repetitive strain injuries, and impact\/penetration. It highlights hazards, risks, and preventive measures, along with a list of controls for hand protection and the impact on the workplace. Access the PDF for more details.\" width=\"660\" height=\"1024\" class=\"wp-image-483 size-large\" \/> What Can Happen to Your Hands and How to Protect Them. Workplace Safety &amp; Prevention Services (2021). Used for educational purposes under fair dealing.[\/caption]\r\n\r\n<code>[h5p id=\"47\"]<\/code>\r\n\r\n<\/div>\r\n<\/div>","rendered":"<p>How did this new understanding of health contribute to changing meanings of health? Unfortunately, despite advancing greater recognition of the public\u2019s role and social and environmental factors in health outcomes, the changes left key elements in the dominant understanding of health unchallenged. For instance the women\u2019s health movement contended that women should understand their bodies and that their perspectives should be respected within the healthcare encounter, but health was still understood as the absence of disease. In many cases these health movements served to reify and entrench biomedical approaches to understanding health into a broader ideology of <button class=\"glossary-term\" aria-describedby=\"476-705\">medicalization<\/button> upheld by an ever-increasing range of social functions (Crawford, 1980). The prominent (biomedical) conception of health, seen as a sense of well-being achieved through the mitigation of disease, illness, injury, and social impairments, was coming to be understood as not only a medical diagnosis but also as a matter of individual responsibility (Berthelot-Raffard, 2018; Crawford, 1980). Robert Crawford (1980) describes the emergence of healthism as a new health consciousness that situated the \u201cproblem\u201d of health as primarily an individual issue and product of personal actions, attitudes, and behaviours, achieved through modifications in lifestyle and sometimes with the help of therapeutic services. Health promotion entailed providing individuals with the necessary knowledge to make healthy choices that encourage healthy behaviour, resisting harmful influences, and reforming their mental responses to social stressors. In effect, the new health consciousness movements laid the groundwork for an \u201cage of medicalization\u201d in which the pursuit of health became a fundamental characteristic of popular culture and everyday life. As Crawford states, \u201cwhile modifications of dominant medical practices [were] being adopted, some of the most fundamental and disabling medical and other dominant cultural conceptions have remained untouched\u201d (p. 369).<\/p>\n<div class=\"textbox\" style=\"border-left: 6px solid #7474C1;background-color: #f6f6fb;padding: 1em;margin-bottom: 2em\">\n<header class=\"textbox__header\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/noun-video-7467494-300x300.png\" alt=\"Video icon.\" width=\"80\" height=\"80\" class=\"alignright\" \/><\/p>\n<h3 style=\"color: #424294;font-weight: bold\">Media Moment<\/h3>\n<\/header>\n<div class=\"textbox__content\">\n<p>Take a moment to engage with the following public health promotion videos created by ParticipACTION, a Canadian nonprofit charitable organization promoting physical activity. You can watch the videos below or access the transcripts.<\/p>\n<p><strong>Time: 30 seconds<\/strong><\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-1\" title=\"Fall in with an active crowd.\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/1OTVHUgnqcU?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=1OTVHUgnqcU\" target=\"_blank\" rel=\"noopener\">Fall in with an active crowd<\/a><\/p>\n<p><span><\/p>\n<div id=\"h5p-45\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-45\" class=\"h5p-iframe\" data-content-id=\"45\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Module 6: Transcript - Fall in with an active crowd\"><\/iframe><\/div>\n<\/div>\n<p><\/span><\/p>\n<p><strong>Time: 4 minutes, 35 seconds<\/strong><\/p>\n<p><iframe loading=\"lazy\" id=\"oembed-2\" title=\"ParticipACTION Workout Videos | Break from Busy\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/MPAn-bvjllA?feature=oembed&#38;rel=0\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><a href=\"https:\/\/www.youtube.com\/watch?v=MPAn-bvjllA\" target=\"_blank\" rel=\"noopener\">ParticipACTION Workout Videos | Break from Busy<\/a><\/p>\n<p><span><\/p>\n<div id=\"h5p-46\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-46\" class=\"h5p-iframe\" data-content-id=\"46\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Module 6: Transcript - ParticipACTION Workout Videos: Break from Busy\"><\/iframe><\/div>\n<\/div>\n<p><\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"textbox\" style=\"border-left: 6px solid #BFBE00;background-color: #fffef2;padding: 1em;margin-bottom: 2em\">\n<header class=\"textbox__header\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/noun-question-3407906-300x300.png\" alt=\"Question icon.\" width=\"80\" height=\"80\" class=\"alignright\" \/><\/p>\n<h3 style=\"color: #737200;font-weight: bold\">Reflection Moment<\/h3>\n<\/header>\n<div class=\"textbox__content\">\n<p>How do these two health promotion interventions conceptualize health and disability?<br \/>\nWhat assumptions do they make about what it means to be healthy, active, or responsible for one\u2019s health?<\/p>\n<p><code><\/p>\n<div id=\"h5p-47\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-47\" class=\"h5p-iframe\" data-content-id=\"47\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Reflection\"><\/iframe><\/div>\n<\/div>\n<p><\/code><\/p>\n<\/div>\n<\/div>\n<p>In the readings associated with this module, Agn\u00e8s Berthelot-Raffard (2022) discusses the gap between the public health profession on the one hand and disability rights activists and scholars on the other in terms of how they conceptualize health and disability, and how these concepts frame health promotion. While the disability community has advocated for the inclusion, de-stigmatization, and de-institutionalization of people with disabilities as central aims in health promotion, the definition of health that has persisted in the public health field is rooted in the absence and prevention of disease, illness, injury, or other impairments to \u201cnormal functioning\u201d (Berthelot-Raffard, 2022; Crawford, 1980). In this definition, disability is seen as a form of deviance understood in contrast to the state of health, which is defined in terms of biostatistical markers of \u201cnormal functioning\u201d based on the most common levels of functioning for people of a particular age and sex (Berthelot-Raffard, 2022; Foucault, 1961). Critical theorists such as Michel Foucault have illustrated how the administration of normalizing biomedical categories have served as a form of population control from which conceptions of \u201cdeviance,\u201d \u201cpathology,\u201d and \u201cmadness\u201d arose. These concepts have long characterized people with disabilities as social \u201cproblems\u201d to be solved, treated, or extradited (Tremain, 2015; Foucault, 1961). In this framework, health is seen as the absence of impairment, and the role of public health is to minimize, prevent, and treat conditions that limit normal functioning to the greatest degree possible (Berthelot-Raffard, 2022).<\/p>\n<div class=\"textbox\" style=\"border-left: 6px solid #7474C1;background-color: #f6f6fb;padding: 1em;margin-bottom: 2em\">\n<header class=\"textbox__header\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/noun-picture-7390883-300x300.png\" alt=\"Photo icon.\" width=\"80\" height=\"80\" class=\"alignright\" \/><\/p>\n<h3 style=\"color: #424294;font-weight: bold\">Media Moment<\/h3>\n<\/header>\n<div class=\"textbox__content\">\n<p>Read this infographic or access the PDF here:<br \/>\n<a href=\"https:\/\/www.wsps.ca\/resource-hub\/chemicals-hazardous-materials-whmis\/what-can-happen-to-your-hands-and-how-to-protect-them?utm_source=Resource_Hub&amp;utm_medium=website&amp;utm_campaign=top%20funnel&amp;utm_content=social%20media\" target=\"_blank\" rel=\"noopener\"><br \/>\nWhat Can Happen to Your Hands and How to Protect Them<br \/>\n<\/a><\/p>\n<p>Consider the ways that the disability rights community and the public health field each conceive of the aims of health promotion. What are their shared aims and how do they differ?<\/p>\n<figure id=\"attachment_483\" aria-describedby=\"caption-attachment-483\" style=\"width: 660px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-660x1024.png\" alt=\"Infographic titled 'What Can Happen to Your Hands and How to Protect Them' shows five types of hand risks: dermatitis, lacerations, burns, repetitive strain injuries, and impact\/penetration. It highlights hazards, risks, and preventive measures, along with a list of controls for hand protection and the impact on the workplace. Access the PDF for more details.\" width=\"660\" height=\"1024\" class=\"wp-image-483 size-large\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-660x1024.png 660w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-193x300.png 193w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-768x1192.png 768w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-990x1536.png 990w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-65x101.png 65w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-225x349.png 225w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM-350x543.png 350w, https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-content\/uploads\/sites\/422\/2025\/01\/Screenshot-2025-01-30-at-5.28.36\u202fAM.png 1228w\" sizes=\"auto, (max-width: 660px) 100vw, 660px\" \/><figcaption id=\"caption-attachment-483\" class=\"wp-caption-text\">What Can Happen to Your Hands and How to Protect Them. Workplace Safety &amp; Prevention Services (2021). Used for educational purposes under fair dealing.<\/figcaption><\/figure>\n<p><code><\/p>\n<div id=\"h5p-47\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-47\" class=\"h5p-iframe\" data-content-id=\"47\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Reflection\"><\/iframe><\/div>\n<\/div>\n<p><\/code><\/p>\n<\/div>\n<\/div>\n<div class=\"glossary\"><div class=\"glossary__tooltip\" id=\"476-705\" hidden><p>The process of assigning medical meaning to behaviors and conditions, and positioning medical practices as the primary method of treatment or resolution. It often results in the lives of disabled people being imbued in medical meaning.<\/p>\n<\/div><\/div>","protected":false},"author":543,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-476","chapter","type-chapter","status-publish","hentry"],"part":63,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/chapters\/476","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/wp\/v2\/users\/543"}],"version-history":[{"count":40,"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/chapters\/476\/revisions"}],"predecessor-version":[{"id":1962,"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/chapters\/476\/revisions\/1962"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/parts\/63"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/chapters\/476\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/wp\/v2\/media?parent=476"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/pressbooks\/v2\/chapter-type?post=476"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/wp\/v2\/contributor?post=476"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/accessiblehealthcare\/wp-json\/wp\/v2\/license?post=476"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}