A theoretical proposal for the relationship between context and disease

Abstract

Studies of`context' are increasingly widespread. These studies often become entrenched in methodological debates rather than being conceptually satisfying. We suggest that part of the problem lies in an inappropriate use of`classic' methods used by epidemiologists to study context and that it may be useful to study, instead, the relationship between agency (the ability for people to deploy a range of causal powers), practices (the activities that make and transform the world we live in) and social structure (the rules and resources in society). We utilise two examples from the current literature to illustrate these problems; the study of lifestyles and social inequalities in disease outcomes. We develop the notion of collective lifestyles as a tentative solution, inspired by Pierre Bourdieu's theory of social action, Anthony Giddens' structuration theory and Amartya Sen's capability theory. Collective lifestyles are defined as an expression of a shared way of relating and acting in a given environment. It is proposed that context is created by relationships between people.

A Life Course Perspective on Health Trajectories and Transitions

“…It is acknowledged that "counterposing agency with structure is a misplaced and false dichotomy" (Dannefer and Daub 2009, p. 20). Instead, they can be recursive (Frohlich et al 2001) and the question is the extent to which either one is dominant in a particular situation (Cockerham 2007). Cultural health capital theory focuses on the specific situation of health care interactions.…”

Status, taste and distinction in consumer culture: acknowledging the symbolic dimensions of inequality

“…Yet despite plausible claims that culture can be understood as fundamental to human social life, its influence over health and wellbeing may be less than obvious. With some exceptions [23] 5 [24] , a theoretically informed understanding of the relationship between contemporary culture and wellbeing has been absent from public health. More recently, an interest in this relationship has emerged [25] [26] .…”

O conhecimento científico e tecnológico como evidência para políticas e atividades regulatórias em saúde

“…Em um extremo, o modelo biomédico dominante tende a focar as causas das doenças nos mecanismos biológicos internos do organismo humano ou no máximo nas causas proximais (germes, fatores ambientais específicos, ou prá-tica de determinados comportamentos) e que se expressariam por distúrbios nas funções orgânicas normais; no outro extremo, há modelos que identificam as causas das doenças na estrutura da sociedade (Breilh, 1989). Entre esses extremos, permeiam-se diversos outros modelos de causalidade (Frohlich et al 2001). Não por acaso, as políticas de saúde atuais gravitam em torno do primeiro grupo de modelos de causalidade.…”