Health Capital Why are they running?
Health Capital – how do we
understand body strategies and
investments in the Nordic
welfare States?
A theoretical contribution
Health capital oslo larsen, harsløv cutchin
30 years ago
•
•
•
•
•
•
health trend - boom
training, running
fitness
diet counseling
..
..
Health capital oslo larsen, harsløv cutchin
Flow or Investment?
Psychological: “flow-experience”
Biomedical: Endorphins ("endogenous morphine")
• Sociological: Are use of plastic surgery,
monitoring of the body, diet/physical
training- investment (distinctive)
strategies?
• Large differences high/low positioned (30 years,
smoking, diet, training, surgery..)
• As the society is changing (transformation
of society – withdrawal of the welfare state
and
also
change
of
professions)?
Health capital oslo larsen, harsløv cutchin
Health Capital!..
• a possible new capital?
• The body and the Health within the last 20-30
(and even more last 10) years are turning to be
seen upon in a new way:
• The body is an object of investment with even
more and more energy and resources
(economic, cultural, social including TIME
invested in it?
Health capital oslo larsen, harsløv cutchin
Field – and - capital
– Change of the “marked” (the social space/ the social
field) that creates this type of health capital.
– marriage market
– recruitment market
– labour marked
– health insurance market
– housing market
– leisure market
– ..
– ..
Health capital oslo larsen, harsløv cutchin
Outlines of explanations
Health capital oslo larsen, harsløv cutchin
”genesis of a taste for health”
• 1) An immersion in a wider field of
symbolic manipulation (Bourdieu 1985).
• Science and, in particular, health science has,
over time, supplanted religion symbols in the
social space, installing psychologists,
psychoanalysts, doctors, sexologists, ‘life
coaches’, body therapists, nature
healers/therapists, and instructors as the ‘new
priesthood’ (Bourdieu's phrase).
• These positions take part in the struggle to provide
the ‘laity’ with advice about how to live via health,
healing, and spiritual and bodily care.
Health capital oslo larsen, harsløv cutchin
”genesis of a taste for health”
– 2) Another feature affecting the taste for
health relates to how the ingestion of food and
beverages over time, established as a
relatively autonomous field of knowledge
such as 'eating', becomes 'nutrition'.
– 3) A third feature relates to how ritual games
and festive entertainment – again in a
historical perspective – are transformed into
'sport' and, along the way, established as a
competitive
field (Bourdieu 1981).
Health capital
oslo larsen, harsløv cutchin
”genesis of a taste for health”
– 4) More capitalism, the reduction –
withdrawal/pulling out, of the state; from
–
–
–
–
different welfare areas. State is more administering systems than
running them.
Individualisations – the shaping of a subject: Patients/clients as
subjects (patient organisations)
Identity change of subject; “We are all Pre-patients” (Rose 2009)
Change of policy; NPM more republican-conservative government
More pressure on the health care system (people get older;
‘invention’ of new diseases; more diseases/treatment; little increase in
workforce/production; relative - reduced resources)
• Private industry (hospitals), More prioritizing in health care system
(classification of patients, “Triage”, new phenomenon is waiting
time/latency in relation to medical treatment and surgery- Relative
privileging of the privileged and relative dis-privileging of the dis-privileged
Health capital
oslo -groups
social
larsen, harsløv cutchin
The state and - what is healthy?
– Meta-field - large effect on the health field - via
production of classifications ex: on the social world,
including one’s own body, its physiognomy, skin, size,
weight etc.
– Classifications translated to cognitive perceptions
associated with the body, such as healthy or
unhealthy, normal or pathological, nice or disgusting,
fit or unfit.
• The effect of the state’s efforts is hardly noticed as the state
‘creates a political doxa, that is, an array of official
classifications that become practical, taken-for-granted
understandings of the social order’ (Bourdieu quoted in
Health capital
oslo - 2004, p. 13).
Swartz
larsen, harsløv cutchin
What is health capital
Health capital oslo larsen, harsløv cutchin
3 forms of health capital
• embodied state,
• body level, ‘performance’, incl. ‘normality’ in terms of
serum cholesterol, body mass index..
• objectified form;
• related to physical artifacts such as buildings, health
and medical technologies, and treatments and
services.
• institutionalized form
• as in health legislation, instructions, health certificates,
professional certification (diet-instructor..) and titles,
authorized ‘health theories’.
Health capital oslo larsen, harsløv cutchin
The embodied state
• Individual and group investment
Health capital oslo larsen, harsløv cutchin
Investment – and distinction
• Dominant social groups will act and look
‘natural’ when investing in the body as
their values are naturalized,
– similar to how upper middle class dominate the school
and educational system (Bourdieu and Passeron 1977).
• Some dominated social groups do
‘overinvest’ in the body (fitness, muscles,
diet and surgery).
• The dominant social groups perceive this
as vulgar, ‘not appropriate’ or as bizarre
Health capital oslo larsen, harsløv cutchin
Violence - power
• Symbolic violence (inner domination):
• Dominated positions - view their own physiognomy as out
of proportion, inadequate – and associated poor health with
bad moral and poor choices. (state-authorized definitions
of body mass index, body proportions, size and weight)
• Physical violence (outer domination):
• Long-term unemployed people / people on sick leave
required to participate in physical training as a condition
for receiving benefits, as has been the case in Denmark in
the 2000s (cf. Horneman-Møllers chapter in this volume).
• Also: Job and obesity-smoking-BMI-alcohol.
• Hospital treatment and surgery, obesity..
Health capital oslo larsen, harsløv cutchin
health capital, inequality and connection to risk
• Health investment - also a strategy to
reduce one’s risk of morbidity and
mortality
– (even if, as we have emphasized, health capital does not
necessarily translate into health improvements).
• The fact that higher-positioned groups
have further distinguished themselves by
reducing risk more than lower-positioned
groups means that social risk in the Nordic
societies has, and is likely to continue to
become, more unequally distributed.
Health capital oslo larsen, harsløv cutchin
• To sum up..
• Certain social groups tend to stabilize or improve social position in
the social space in new ways, and we ask how and how can it be?
• We argue that new types of investment strategies are actualized in
the body, not only as ‘cultural’ but also as healthy?
– Individual investment strategies in health capital are constituted
as a response to changes in the state, to changes in the health
system, and to changes in other fields
• Health capital is an extra “card” in the social game and it makes a
distinctive difference. When agents are equal in possession and
composition of capital (income, education and networks) health
capital can make the distinctive difference – to get a job or to stay
on the labor market etc.
Health capital oslo larsen, harsløv cutchin
Field – and - capital
– We – some- ‘Diet’, ‘Run’, ‘Jog’..
– to ‘get a wife’, a ‘job’, a ‘house’, a ‘health
insurance’..
– It is the change of the “marked” (the social space/ the
social field) that creates this type of health capital.
– marriage marketrecruitment market labour marked
health insurance market
housing market
leisure market
–
Health capital oslo larsen, harsløv cutchin