Health for everyone?: An investigation of health conduct, health discourse and social inequality

Abstract

Project aim: To investigate how is the health discourse challenged by social inequality? Background: It is paradoxical that Danish public health promotion claims to support the WHO’s health difinition in which health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, while simultaneously health promotion and the studies that form the basis of this seems narrowly focused at health-related behavior and KRAM factors such as diet, smoking, alcohol and exercise. Health promotion aims at a behavioral pattern that is both intentionally and rationally planned out – and for that purpose a question of free will. Thereby, the citizens become responsible for their own health and illness. In that way, health promotion becomes a question of educating the population to a right way of living by following norms articulated by the government - hence, “healthy life/living” merges with “the way of live” or “the good life”. Purpose: The purpose of this thesis is to convey a widespread image of the total correlations of health-related ele-ments in lifestyle and set of social background factors among citizens in The Central Denmark Region, and thereby create a frame of reference for the further discussion of the adopted health discourse. This thesis is organized over these four intermediate aims: 1. To shed light on patterns in health conduct and how these patterns are grouped identical or in contrary to each others 2. To analyze how these patterns relate to social inequality 3. To investigate the possibility of devising ideal typical groups of citizens – alike in manners of health conduct and social background 4. To discuss the actual approach to health promotion within the ruling health discourse in matters concerning both planning initiatives as well as the underlying research Method: The analysis uses data from Public Health Investigation Questionnaire as its starting point (How are you ? 2010) provided in The Central Denmark Region in 2010. Multiple Correspondence Analysis is used to create a space for health conduct and thereby contextualize Health conduct related to e.g. social background factors. The analysis is extended with Cluster Analysis, which enables the creation of groups that are statistically and internally alike in regards to health conduct and social background while differing externally. Theoretical frame: Pierre Bourdieus offers with his Theory of Practice an overall frame of reference for understanding health conduct. Bourdieu’s conceptual framework provides an alternative to the public health discourse’s focus on rational behaviour; understanding why different human beings act and react differently when it comes to healthy lifestyle, and why this is related to social inequality. In the eyes of Bourdieu, behaviour is a product of embedded physical structures (habitus) within a set of opportunities obtained along with social standing/status and more overall structures of society. Hereby, Bourdieu challenges the focus of Public Health Promotions on individual choices in health life style. Conclusion: Health conduct is habitual. There seems to be clearly defined groups with similar behavioural patterns related to position in social space. When health programmes address health behaviour as knowledge-based rational choice it gives preferential treatment to the privileged citizens, who base their health conduct on knowledge, while simultaneously overlooking the less privileged groups of citizens, who base their health behaviour on other things if at all involved in their health. Thus, health promotion discursively constructs the way of life of the privileged as the legitimate lifestyle. Hence, it is constituent for the social inequality in health.

A master thesis from Aalborg University

Health for everyone?: An investigation of health conduct, health discourse and social inequality

[Sundhed for alle? : En undersøgelse af sundhedsadfærd, sundhedsdiskurs og social ulighed]