Emerging issues for health promotion
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This section focuses specifically on models of disease and prevention; the social context of individual choice including issues for individuals, families and society; and lastly public involvement and the democratic deficit in relation to science. Issues arising in the context of new genetics cut at the heart of health promotion but in contradictory and ambivalent ways. Perhaps these mirror some of the ambivalences within health promotion itself, especially in terms of its relation to medicine, its adoption or eschewing of a disease model, an emphasis on lifestyle and personal responsibility, as well as a concern for population health. The new genetics and health promotion may bring to the fore contradictions inherent in late modern societies, where reification of the individual, able to make life choices and ‘colonise their futures’ (Giddens 1991) exists alongside continuing discrimination and exclusions (Bauman 1997) as well as environmental risks of society’s own making (Beck 1992). Nelkin and Lindee (1995: 191) note that popular culture embraces a discourse of genetic responsibility that constitutes a ‘set of ideals about a perfect health culture’, again mirroring rather than challenging some of the assumptions and values within health promotion.