Demarking a cordon therapeutique through Vancouver’s Liquor License Moratorium for the Downtown Eastside: 1973 - 1988

Masuda J.

This paper situates a ten-year period of political upheaval in addressing the problem of Single Room Occupancy (SRO) housing in Vancouver, Canada, within an epistemic transformation of public health. Until 1970, the Vancouver Health Department exemplified a colonial history of public health in establishing the city’s skid road as a cordon sanitaire. But the 1970s saw a sudden fading of the Department’s authority just as a more collaborative approach to housing policy was emerging. The sunsetting of sanitary enforcement was driven in part by the arrival of a “new public health” that became primarily concerned with defining public health problems and solutions through the regulation of racialized bodies and behaviors—a cordon thérapeutique. By the 1980s, this shift constituted an epistemic and regulatory abandonment of SRO housing, leading to the accelerated deterioration of the entire housing stock and costing incalculable human suffering and the loss of lives.

Sommers J.

This article examines ways in which images and ideas about masculinity have been implicated in the social construction of Vancouver's Downtown Eastside. In the 1950s and 1960s, this was the city's skid-road district, a location where damaged masculinity, represented by the figure of the derelict, was linked causally to the deterioration of the central-city landscape. The derelict was constituted as a figure of abjection that marked the outside boundary of respectable masculinity, and his presence provided a rationale for urban renewal. During the 1970s and the 1980s, community groups contested the representation of skid road. They attempted to reconstruct the area as the Downtown Eastside, a working-class neighborhood and community that was symbolized by another male figure: the aging, retired resource industry worker. This image was derived from the memory and experience of the people who lived there. But because it rested on the appropriation and reworking of the same association between masculinity and...

Lupton D.

Risk is a concept with multiple meanings and is ideologically loaded. The author reviews the literature on risk perception and risk as a sociocultural construct, with particular reference to the domain of public health. Pertinent examples of the political and moral function of risk discourse in public health are given. The author concludes that risk discourse is often used to blame the victim, to displace the real reasons for ill-health upon the individual, and to express outrage at behavior deemed socially unacceptable, thereby exerting control over the body politic as well as the body corporeal. Risk discourse is redolent with the ideologies of mortality, danger, and divine retribution. Risk, as it is used in modern society, therefore cannot be considered a neutral term.

HANCOCK T.

The Lalonde Report was published in 1974, and was the first significant government report to suggest that health care services were not the most important determinant of health. After reviewing the evidence, the report suggested that there were four "health fields"--lifestyle, environment, health care organization, human biology--and that major improvements in health would result primarily from improvements in lifestyle, environment and our knowledge of human biology. Lalonde also indicated a broad understanding of the determinants of health in subsequent speeches. While the report was greeted sympathetically at the time, it did not have all that significant an impact in Canada. It was criticised on a number of grounds, in particular that it paid too much attention to lifestyle and too little attention to environment. Furthermore, because health is a provincial responsibility in Canada, while the report was a federal report, there was no mechanism readily available to implement the recommendations of the report. The report was nonetheless widely hailed outside Canada, and similar (and often better) reports were published in Britain, the USA, Sweden and elsewhere. The report remains a highly regarded contribution to the transformation in thinking about health that has occurred in the past decade.(ABSTRACT TRUNCATED AT 250 WORDS)

Sobell M.B., Sobell L.C.

A behavior therapy for alcoholism was designed based on the rationale that alcoholic drinking is a discriminated, operant response. Treatment emphasized determining setting events for each subject's drinking and training equally effective alternative responses to those situations. Seventy male, hospitalized, Gamma alcoholics were assigned to a treatment goal of either nondrinking ( N =30) or controlled drinking ( N =40). Subjects of each group were then randomly assigned to either an experimental group receiving 17 behavioral treatment sessions or a control group receiving only conventional treatment. Treatment of experimental groups differed only in drinking behaviors allowed during sessions and electric shock avoidance schedules. Nondrinker experimental subjects shaped to abstinence, while controlled drinker experimental subjects practiced appropriate drinking behaviors with little shaping, a result attributed to instructions. Follow-up measuring drinking and other behaviors found that experimental subjects functioned significantly better after discharge than control subjects, regardless of treatment goal. Successful experimental subjects could apply treatment principles to setting events not considered during treatment, suggesting the occurrence of rule learning. Results are discussed as evidence that some “alcoholics” can acquire and maintain controlled drinking behaviors. Tra ditional treatment of alcoholics may be handicapped by unvalidated beliefs concerning the nature of the disorder.