Health lifestyle theory and the convergence of agency and structure

This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in several disciplines, but this approach neglects the structural dimensions of such lifestyles and has limited applicability to the empirical world. The direction of this article is to present a theory of health lifestyles that includes considerations of both agency and structure, with an emphasis upon restoring structure to its appropriate position. The article begins by defining agency and structure, followed by presentation of a health lifestyle model and the theoretical and empirical studies that support it.     

Lifestyles,and Risk Perception Consumer Behavior

In this article, the concept of lifestyle is traced to its early roots in personality psychology and in marketing. In the latter field, many commercial marketing firms have made strong claims as to the explanatory power of lifestyle dimensions, often based on procedures which have been kept secret, but researchers have seldom been able to verify such claims. In spite of this, the approach is very popular, has wide credibility and is often given very favorable media coverage. Probably because of this, it is often considered as a very important and promising approach by administrators working with the regulation of risk and risk communication. It may also be credible in some quarters because it affords a way of ‘explaining’ risk perception as being non-rational. In this paper, we give results from an empirical study of nuclear waste risk perception which is related to a basic risk perception model and three approaches to lifestyles: Kahle's List of Values, a Swedish adaptation of the ‘Agoramétrie’ approach suggested by a group of French researchers, and Dake and Wildavsky's Cultural Theory dimensions. It was found that nuclear waste risk perception could be modeled successfully with risk attitudes and perception data (basic model about 65% of the variance explained), but that lifestyle dimensions added virtually nothing to the explanatory power of the model. Lifestyle dimensions in isolation only explained a minor part of the variance.     

Der Wandel der Konsumstruktur in Deutschland – ein Indiz für die Individualisierung von Lebensstilen oder doch die Folge soziodemografischer Entwicklungen?The change of consumption patterns in Germany – an evidence of the individualization of lifestyles or the effect of socio-demographic changes?

Following the results of different empirical studies the consumption patterns of German households changed significantly during the last decades. While this change was attributed to a dissolving correlation between lifestyle and social status for a long time, more and more studies focus on the relationship of lifestyle and socio-demographic criteria again. This report analyses the effects of social composition regarding age, income and households types on the use of income between 1978 and 2008. The results of the decomposition analysis reveal that the socio-demographic components cannot explain the change of consumption patterns in Germany. Rather it seems that different social conditions during socialisation affect lifestyles and should be considered when analysing consumption patterns.     

Governmentality and Lifestyle Studies

In recent years, a research focus on lifestyles has drawn considerable attention from many quarters. Within this area, the influence of several European and continental intellectual currents not widely embraced in American sociology can be detected, some traceable to the work of Michel Foucault. This article will provide a summary and overview of one area of lifestyle sociology that is touched by Foucault's broad influence on the social sciences, particularly his theories on governmentality. Governmentality studies consider the manner in which personal autonomy and self-responsibility is conveyed to individuals as an ongoing life-project. Through the lens of governmentality studies, everyday lifestyle choices of individuals are viewed as elements of larger projects of self-development, implemented by therapeutic discourses of risk management, self-realization, and enhanced personal well-being. After a summary of debates within the sociology of lifestyle informed by governmentality theories, commentary and recommendations will be offered on new directions in governmentality research focusing on subjective well-being or 'happiness' as a feature of contemporary lifestyles and as an object of sociological research. A brief survey of new research comprising the interdisciplinary field of 'happiness studies' suggests a new direction not only for lifestyle research, but for governmentality studies as well.     

Joint and Separated Lifestyles in Couple Relationships

A survey among 1,523 married and cohabiting couples in the Netherlands is used to describe the extent to which couples have lifestyles characterized by separate leisure pursuits. Four types of leisure are examined: visiting friends and family, entertainment, outdoor recreation, and indoor leisure. For these activities, we find that contemporary couples cannot be characterized as highly individualized. Next, we analyze why some couples have a more separated lifestyle than others. Hypotheses are developed about the life cycle of the couple, the couple's work life, social and cultural homogamy, and value orientations. Multivariate analyses show that life cycle factors are an important determinant of separate lifestyles, whereas evidence for the role of values and homogamy is modest. We also present evidence revealing the time constraints that children and work schedules pose for realizing a joint lifestyle, but we do not find that spouses in dual‐earner couples generally operate more separately than do other couples.     

Social accountability as social movement outcome: Protests in a Chinese city

ABSTRACT

Social accountability is a concept that has been used much in development studies and democratic theory to study informal ways for civil society to achieve social change and hold governments accountable. Surprisingly, it has been far less used in social movement scholarship and we argue that social accountability, understood as a combination of answerability, legal claim attainment, and sanction, is a useful way to examine social movement outcomes in China. Social accountability directs the focus of research towards the target of protest and not only whether the protest resulted in policy changes or not. Based on field work in 2013–2015, this article examines four cases of social protests in the Chinese city of Hangzhou. In line with previous research we find that when citizen claims accord with government policies and protesters are well-organized, local authorities tend to accommodate the protesters’ claims. However, answerability and sanction do not always follow the same pattern. Answerability can be relatively high also when legal claims are unsuccessful. This means that cases that are commonly seen as unsuccessful protests because the legal demands were not accommodated may still result in partial social accountability. In addition to the presentation of original empirical findings, the study makes a theoretical contribution by linking the two research fields of social movement and social accountability, which will be of interest to a wider scholarly audience.     

Medical malpractice,social structure,and social control

The origin and handling of doctor-patient conflict can be understood with reference to the sociological aspects of professional health care. This premise is explored by applying Black's theory of social control to the empirical evidence concerning malpractice litigation in the United States. The vertical, organizational, and relational distances between the health care provider and the patient are particularly relevant for predicting when malpractice claims will be made and how they will be resolved. These social-structural variables help explain several patterns in the American malpractice experience, including the aggregate increase in claim rates over the past four decades; the persistence of toleration as the modal response to medical injury; why poorer patients are less suit-prone than higher income patients; why surgical specialties have higher claim rates than general practice and psychiatry; why hospitals are sued disproportionately less often than individual doctors; and the relatively high frequency of prodefendant decisions when lawsuits are decided by a judge or jury.An earlier version of this paper was presented at the annual meeting of the American Sociological Association in Pittsburgh, Pennsylvania, August 1992.     

The (Non)Accumulation of Capital: Explicating the Relationship of Structure and Agency in the Lives of Poor Black Men

The concepts of habitus and capital are crucial in the research tradition of social and cultural reproduction. This article applies both terms to an analysis of aspects of the life histories of low-income African American men. In exploring how their past experiences relate to their present-day statuses as nonmobile individuals, this article also revisits and redefines the utility of habitus and capital as conceptual devices for the study of social inequality. It expands the empirical terrain covered by the concept of capital to include that which allows low-income individuals to manage their existence in socioeconomically disadvantaged communities while also hindering their mobility in the broader social world. One implication of this approach is an improved cultural analysis of low-income individuals. The improvement lies in that their behavior can be better understood as reflections of their readings of social reality, which are based upon the material and ideational resources that they have accumulated throughout their lives, and not simply as manifestations of flawed value-systems or normative orientations.     

Problems of the Healthy Lifestyle Discourse

Strategies for the prevention of disease and the promotion of health have a long history of individual-level interventions with the promotion of ‘healthy lifestyles’ being the primary target. The focus at an individual level devoid of social context has provoked a sociological critique of the prevailing healthy lifestyle discourse. This critique emphasises the social causes of health-related attitudes and behaviours in society, and the ideology of individual responsibility and ‘victim blaming’ that an individualist approach entails. At the same time, the prevailing notion of ‘health’ has been scrutinised within the framework of health promotion stressing a definition emphasising well-being and quality of life. This ‘positive’ definition of health broadens the possible reach of ‘healthy lifestyles’. Theoretical models emphasising structural aspects of the lifestyle construct have been produced. In this article, it is argued that while these models are based on the work of Bourdieu and his concept of habitus, they nevertheless overlook the importance of power and symbolic dominance in relation to the construction of ‘healthy’ and the understanding of lifestyles.     

The intergenerational transmission of health-risk behaviors: adolescent lifestyles and gender moderating effects.

The present longitudinal study of 330 adolescents used structural equation models to investigate whether (1) health-risk lifestyles exist among adults and adolescents, (2) parents' health-risk behaviors influence adolescents' health-risk behaviors, and (3) intergenerational transmission occurs by way of a health-risk lifestyle, by direct transmission of specific behaviors, or through both mechanisms. To address these questions, we estimated several models. The findings were generally supportive of the expectations. Results of single factor measurement models provided modest evidence for the existence of an underlying health-risk lifestyle factor among parents and adolescents. Results of structural equation models also demonstrated that parents' health-risk behaviors were transmitted to adolescents both at the lifestyle factor level and the unique component level. These associations prevailed even after controlling for family social status. However, parents' health-risk lifestyles mediated the effect of family social status on adolescents' lifestyles, net of the direct effect of family social status on adolescents' lifestyle. In these two-parent families, the effects of parents' health-risk lifestyles on adolescents seems to have gender symmetry. The findings of the separate models for boys and girls demonstrated that (1) fathers' health-risk lifestyle affected only boys' health-risk lifestyle, whereas (2) mother's health-risk lifestyle affected only girls' health-risk lifestyle. A similar gender moderating effect was not found for specific health-risk behaviors. Implications of these findings for future research and theoretical development are discussed.     

Social interaction distance and stratification

There have been calls from several sources recently for a renewal of class analysis that would encompass social and cultural, as well as economic elements. This paper explores a tradition in stratification that is founded on this idea: relational or social distance approaches to mapping hierarchy and inequality which theorize stratification as a social space. The idea of 'social space' is not treated as a metaphor of hierarchy nor is the nature of the structure determined a priori. Rather, the space is identified by mapping social interactions. Exploring the nature of social space involves mapping the network of social interaction--patterns of friendship, partnership and cultural similarity--which gives rise to relations of social closeness and distance. Differential association has long been seen as the basis of hierarchy, but the usual approach is first to define a structure composed of a set of groups and then to investigate social interaction between them. Social distance approaches reverse this, using patterns of interaction to determine the nature of the structure. Differential association can be seen as a way of defining proximity within a social space, from the distances between social groups, or between social groups and social objects (such as lifestyle items). The paper demonstrates how the very different starting point of social distance approaches also leads to strikingly different theoretical conclusions about the nature of stratification and inequality.     

Rethinking Post-Fordism: The Meaning of Workplace Flexibility

Social scientists increasingly claim that work structures based on the mass production or "Fordist" paradigm have grown obsolete, giving way to a more flexible, "post-Fordist" structure of work. These claims have been much disputed, however, giving rise to a sharply polarized debate over the outcome of workplace restructuring. I seek to reorient the debate by subjecting the post-Fordist approach to theoretical and empirical critique. Several theoretical weaknesses internal to the post-Fordist approach are identified, including its uncertain handling of "power" and "efficiency" as factors that shape work organizations; its failure to acknowledge multiple responses to the crisis of Fordism, several of which seem at odds with the post-Fordist paradigm; and its tendency to neglect the resurgence of economic dualism and disparity within organizations and industries. Review of the empirical literature suggests that, despite scattered support for the post-Fordist approach, important anomalies exist (such as the growing authority of "mental" over manual labor) that post-Fordism seems powerless to explain. In spite of its ample contributions, post-Fordist theory provides a seriously distorted guide to the nature of workplace change in the United States. Two alternative perspectives toward the restructuring of work organizations are sketched—neoinstitutionalist and "flexible accumulation" models—which seem likely to inspire more fruitful lines of research on the disparate patterns currently unfolding within American work organizations.     

The Mechanisms of Social Exclusion in Modern Society: The Dilemma of Active Labor Market Policy*

In this article, I examine the social exclusion approach that has influenced social policy in Europe, and demonstrate the effectiveness of this approach in explaining the emergence of new forms of inequality in modern society. First, I consider recent studies of social exclusion to show two important points: the paradigm shift from poverty to social exclusion and the introduction of a new policy framework of social inclusion. At the same time, I examine the inherent dilemma of social exclusion in response to radical critics of the social exclusion approach. Next, I point out an internal dilemma in the active labor market policies prioritized today by European Union member states. This dilemma is that these policies make the unemployed more vulnerable by forcing them into paid work. I then show how the enhancement of social networks in local communities and the provision of assistance to support cultural identity can serve as a buffer to compensate for the destructive influence of the economic dimension of social inclusion. In addition, I point out that citizenship as rights claiming is indispensable to social inclusion for all. Finally, drawing on the analysis outlined above, I conclude that a multi-tiered mechanism of social inclusion can reasonably be considered the most effective framework in a precarious society where people bear various risks in the era of globalization.     

Duality of departmental specializations and PhD exchange: A Weberian analysis of status in interaction using multilevel exponential random graph models (mERGM)

Weber proposes that lifestyle similarities preserve status by producing interactional closure between status similar actors. I investigate this theory on academic status hierarchies by conceptualizing sub-disciplinary specializations as departmental lifestyles and PhD exchange networks as interdepartmental interactions. Multilevel exponential random graph models (mERGM) reveal that the more specializations departments share, the more likely they are to exchange personnel. On the flip side, departments that do not share specializations are less likely to exchange doctoral candidates. Moreover, shared specializations are key determinants of closure between elite departments. These results support Weber’s theory and suggest that shared specializations preserve existing patterns of inequality between elite and non-elite departments.     

IS THERE SUCH A THING AS AN ONLINE HEALTH LIFESTYLE?

The purpose of this paper is to examine the use of the Internet for health-related purposes and whether this usage is part of larger pattern of health-promoting behaviors, or health lifestyle. Pierre Bourdieu's concept of habitus provides the key theoretical concept that links health lifestyle and the digital inequality framework to explain how social conditions (i.e. social status and quality of Internet access) influence attitudes and behaviors. Path analysis is used to examine the relationship between key endogenous variables on attitudes, health behavior, health status, and online health-related activities, while controlling for demographics and other factors. Data comes from the National Cancer Institute's 2007 Health Information National Trends Survey. The results demonstrate that online health behaviors can be usefully conceptualized as elements of health lifestyle. The combination of health lifestyle and digital inequality provides a broader theoretical framework that highlights the importance of social conditions to influence people's Internet habitus and routine health-promoting behaviors. The combination of health lifestyle and digital inequality provides a useful theoretical framework for future research investigating persistent social disparities in health and the potential for the growing reliance on information and communication technologies to contribute to socially patterned health outcomes.     

The problem of social generations: a critique of the new emerging orthodoxy in youth studies

Over the previous seven years the application of a social generation paradigm or ‘theory’ has gained increasing currency as a method in analysing young people's relationship with the life course. Whilst not a new concept or approach its resurgence and reconfiguration to ‘new’ times has seen some writers positioning it as a ‘new orthodoxy’ or ‘consensus’ within youth studies. In this it is seen as providing a conceptual framework that better helps us understand the complexity of circumstances and conditions that shape youth identities in late modern society. In this paper we examine and explore the underlying assumptions and claims that are made by those advocating the social generational paradigm, raising questions and seeking further clarification on a number of key themes. We accept youth studies needs to move beyond ‘old models’ that define and understand social context as a simply a tension between ‘structure or/and agency’ or as a ‘flavour’ to social action. To conclude therefore we propose the need to have an approach that is ecological and both accepts ‘social change’ and ‘continuity’ as critical parts of the life course, one that recognises the nature and influence of power and social reproduction, especially for different social classes, in shaping the experience of being young.     

Envy, malice and Pareto efficiency: An experimental examination

Economists have long speculated that envy and malice play important roles in economic decisions. Surprisingly little empirical evidence has been offered in support of such claims. This paper uses experimental and multinomial logit techniques to estimate the effects of envy and malice in economic decisions involving Pareto efficiency. Envy and malice turn out to be powerful motivations with strong differential impacts across countries and relative positions. In some cases, opposition to Pareto gains reaches 60%. Behind a veil of ignorance, however, opposition falls to 10% overall. Pareto efficiency thus garners its greatest support under conditions which can lay claim to greatest legitimacy, those free of situational and personal bias. “... the greater part of human actions have their origin not in logical reasoning but in sentiment. This is particularly true for actions that are not motivated economically.... Man, although impelled to act by nonlogical motives, likes to tie his actions logically to certain principles; he therefore invents these a posteriori in order to justify his actions.” V. Pareto in The rise and fall of the elites (1968, p. 27) Received: 2 February 2000/Accepted: 6 November 2000     

Health Social Movements in the United States: An Overview

This article reviews the literature on health social movements (HSMs) and provides an overview of their main conceptual, theoretical and empirical underpinnings. Health social movements is not a single paradigm but spans several decades’ worth of theoretical and research activity in the areas of social movements, medical sociology and social studies in science. Case studies of HSMs have been accumulating for years, and several new collections of papers attempt to systematize the various strands of health social movements research to answer questions about their origins, different strategic and political approaches to social change, their trajectories and consequences. We provide a selective overview of the literature on health social movements that explore these questions, while distinguishing between health social movements seeking greater access to healthcare, those focusing on health disparities and inequality, and those challenging the underlying science of health and healthcare. We conclude with some suggestions for the direction of future studies.