Health Promotion and the Personal Conduct of (Everyday) Life Kasper A. Kristensen Research Centre for Health Promotion Assistant Professor, PhD Roskilde University kak@ruc.dk Main Points THE RISING FIELD OF HEALTH PROMOTION RESEARCHING HEALTH AND PRACTICES OF HEALTH PROMOTION IN EVERYDAY LIFE POINTS OF CONCERN THE RISING FIELD OF HEALTH PROMOTION A historical surge in concepts and practices of health Moral and political debates Core institutions Ways of life Forms of subejctivity Put into practice Policies Organizational changes Health Care Private market of health goods and services Intimate evaluation of self and others Individual strategies for health “Health” as a contested concept The greater good? Medicine, hygiene and social planning Suspect? Power/Knowledge Inequality, exclusion and domination Government/Regulation Technological, rational and individualized reasoning Battlefield of the bodies and of the selves Absence of disease historical influence of the medical science Pathogenic perspective (Antonovsky) Biomedicine (Rose) A ”positive” health concept The good life, care for the self (philosophical/religious) “A complete state of well-being” (UN, 1946) Antonovsky: Salutogenesis Life quality ”A ressource for everyday life” Health: “To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective for living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” (Ottawa Charter; WHO, 1986) Health Promotion: “Health promotion is the process of enabling people to increase control over, and to improve, their health….[] Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life styles to well being “ (Ottawa Charter; WHO, 1986) Practice and theory in health promotion Field of Practice Field of Theory (McQueen) Policy Area Perspective/Orientation Micro Pragmatic Individual Behavioral, cognitive Administrative, community Macro Community, national Researching health and practices of health promotion in everyday life Where the individual engages with the social world Domain of subjective experience and activity The domain of reproductive/productive life processes Social cultural patterns of activities Ctr: Health behavior Health Habits Lifestyle The domain of the practitioner Where practices are received and have an impact A place for critique/counteractivity Points of concern The question of perspective? The question of participation? The question of scale? The assumption of regularity? The question of perspective Privileged observer? 1st person perspectives embodied experience Chronic pain Capacity to reach individual goals (Wackerhausen, 1994) The question of participation Participation in social structures of practice (Dreier, 2009) Ressource for everyday living: Manage social participation Stress Psychosocial conflicts Mental health Participation Resources, social rights, recognitions The question of scale Time: 24/7 timescale The social reproduction, social organization, rituals Growth and production Experiences, activities over larger timescales - competencies - struggles - illness - recovery/rehabilitation Subjective horizon of significance The question of scale II Space: The place-/setting-/institutionbound Local, immediate, context Mobility Disability Being in place/moving in and through places Migration Pathways to marginalization The assumption of regularity Routine Habit Taken for granted Projects! Life long learning Career Success/failure Health promotion: Making everyday life into a project! Sustaining change after the project The personal conduct of life The personal conduct of life (Holzkamp, 1998, Dreier, 2008, Kristensen, 2008) Building a theory and methodology that researches health and practices of health promotion in peoples lives from a 1st person perspective Participation in social structures of practice following experiences and activities of growth and learning over time and space Projects, variations and conflicts in daily life A worst case scenario? Expert privileged perspective Locally confined 24/7 discipline Individualized Habitual/Regularity