This article considers some implications of the new health consciousness and movements--holistic health and self-care--for the definition of and solution to problems related to "health." Healthism represents a particular way of viewing the health problem, and is characteristic of the new health consciousness and movements. It can best be understood as a form of medicalization, meaning that it still retains key medical notions. Like medicine, healthism situates the problem of health and disease at the level of the individual. Solutions are formulated at that level as well. To the extent that healthism shapes popular beliefs, we will continue to have a non-political, and therefore, ultimately ineffective conception and strategy of health promotion. Further, by elevating health to a super value, a metaphor for all that is good in life, healthism reinforces the privatization of the struggle for generalized well-being.
The pursuit of health has become a highly valued activity in modern and contemporary life, commanding enormous resources and generating an expansive professionalization and commercialization along with attendant goods, services and knowledge. Health has also become a focal, signifying practice. As a 'key word', health is constructed in relation to social structures and experience and systematically articulated with other meanings and practices. Although the cogency of health as a practical concept is largely a product of the enormous influence of modern medicine, medical conceptions have never been able to contain the irrepressible proliferation of meanings associated with health. The meaningful - and ideological - practices of health can be illustrated by comparing three periods in American culture: (1) the late 19th and early 20th century; (2) the 1970s and 1980s; and (3) the first years of the 21st century.
This article describes the emergence of an ideology which blames the individual for her or his illness and proposes that, instead of relying on costly and inefficient medical services, the individual should take more responsibility for her or his health. At-risk behavior is seen as the problem and changing life-style, through education and/or economic sanctions, as the solution. The emergence of the ideology is explained by the contradictions arising from the threat of high medical costs, popular expectations of medicine along with political pressures for protection or extension of entitlements, and the politicization of environmental and occupational health issues. These contradictions produce a crisis which is at once economic, political and ideological, and which requires responses to destabilizing conditions in each of these spheres. These ideological initiatives, on the one hand, serve to reorder expectations and to justify the retrenchment from rights and entitlements for access to medical services, and, on the other, attempt to divert attention from the social causation of disease in the commercial and industrial sectors.
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