The invisibilization of health promotion in Australian public health initiatives

Abstract

The field of health promotion has arguably shifted over the past thirty years from being socially proac- tive to biomedically defensive. In many countries this has been accompanied by a gradual decline, or in some cases the almost complete removal of health promotion designated positions within Government health departments. The language or discourse used to describe the practice and disci- pline of health promotion is reflective of such changes. In this study, critical discourse analysis was used to determine the representation of health promotion as a practice and a discipline within 10 Australian Government weight-related public health initiatives. The analysis revealed the invisibiliza- tion of critical health promotion in favour of an agenda described as ‘preventive health’. This was achieved primarily through the textual practices of over lexicalization and lexical suppression. Excluding document titles, there were 437 uses of the terms health promotion, illness prevention, dis- ease prevention, preventive health, preventative health in the documents analysed. The term ‘health promotion’ was used sparingly (16% of total terms), and in many instances was coupled with the term ‘illness prevention’. Conversely, the terms ‘preventive health’ and ‘preventative health’ were used ex- tensively, and primarily used alone.