The individual and the State as agents responsible for the production of healthy societies: a thematic analysis from the perspective of health professionals in Catalonia (Spain)

https://doi.org/10.18294/sc.2017.1002

Published 11 April 2017 Open Access


Valeria Santoro Lamelas PhD in Psychology. Associate professor. Social Psychology Department, Universitat de Barcelona, Spain. image/svg+xml




Abstract views
1511
Metrics Loading ...



Keywords:

Public Health, Health Promotion, Decision Making, Social Responsibility, Health Knowledge, Attitudes, Practice, Spain


Abstract


This article aims to analyze the meanings upon which health promotion intervention practices are based, and the consequences of these meanings in the identification of responsibilities in health. The passage of Catalonia’s Public Health Law 18/2009 facilitated the development of the Demonstrative Project of the Public Health Agency, in the framework of which fieldwork for the Plan for Health Education and Promotion in Children and Adolescents in La Garrotxa (region of Catalonia) was carried out. In this way, 20 interviews with key informants were conducted. Through a thematic analysis, it was found that the State and the individual are identified as the primary agents responsible for the production of healthy societies. It was also evidenced that, in the articulation between the discourses referring to free and rational decision-making and those referring to the social, political and economic environment, different approaches towards responsibility are construed, with effects related to the potentiation (or lack thereof) of the State as a guarantor of the population’s health in opposition to blaming of the individual.

References


1. Palomo L, Ortún V, Benavides FG, Márquez-Calderón S. La salud pública frente a los efectos secundarios del progreso. Gaceta Sanitaria. 2006;20(Supl 1):209-221.

2. Catford J. Health promotion's record card: How principled are we 20 years on? Health Promotion International. 2004;19(1):1-4.

3. Llorca E, Amor MT, Merino B, Márquez FJ, Gómez F, Ramírez R. Ciudades saludables: una estrategia de referencia en las políticas locales de salud pública. Gaceta Sanitaria. 2010;24(6):435-436.

4. Kickbusch I. Responding to the health society. Health Promotion International. 2007;22(2):89-91.

5. Kickbusch I. Health governance: The health society. In: McQueen D, Kickbusch I, (ed.). Health and modernity: The role of theory in health promotion. New York: Springer; 2007.

6. Foucault M. Nacimiento de la biopolítica. Madrid: Ediciones AKAL; 2009.

7. Devisch I, Vanhuele S. Foucault at the bedside: a critical analysis of empowering a healthy lifestile. Journal of Evaluation in Clinical Practice. 2015;21:427-432.

8. Greco M. Thinking beyond polemics: approaching the health society through Foucault. Osterreichische Zeitschrift fur Soziologie. 2009;34(2):13-27.

9. Marta CB, Teixeira ER. Genealogia do cuidado na perspectiva foucaultiana. Fundamental Care Online. 2016;8(3):4749-4756.

10. Rabinow P, Rose N. Thoughts on the concept of biopower today [Internet]. 2003 [citado 28 feb 2016]. Disponible en: http://tinyurl.com/h4a7znx

11. Catalunya. Llei 18/2009, del 22 d'octubre, de salut pública. Diari Oficial de la Generalitat de Catalunya. 2009;(5495):81070-81116.

12. Santoro Lamelas V. La salud pública en el continuo salud-enfermedad: un análisis desde la mirada profesional. Revista de Salud Pública. 2016;18(4):530-542.

13. Vázquez F. La memoria como acción social: Relaciones, significados e imaginario. Barcelona: Paidós Ibérica; 2001.

14. Gergen KJ. Toward transformation in social knowledge. New York: SpringerVerlag; 1982.

15. Iñiguez L. Nuevos debates, nuevas ideas y nuevas prácticas en la psicología social de la era 'post-construccionista'. Athenea Digital. 2005;(8). doi: 10.5565/rev/athenead/v1n8.235.

16. Wetherell M, Potter J. Análisis del discurso y la identificación de los repertorios interpretativos. En: Gordo López AJ, Linaza JL, (comp.). Psicologías, discursos y poder (PDP). Madrid: Visor; 1996.

17. Garay A. Poder y subjetividad: Un discurso vivo [Tesis de doctorado]. Bellaterra: Universidad Autónoma de Barcelona; 2001.

18. Ruiz Olabuénaga JI. Metodología de la investigación cualitativa. Bilbao: Publicaciones de la Universidad de Deusto; 2012.

19. Denzin NK, Lincoln YS. Handbook of qualitative research. Londres: Sage; 2000.

20. Holstein JA, Gubrium JF. The active interview. Londres: Sage; 1995.

21. Rubin HJ, Rubin IS. Qualitative interviewing: The art of hearing data. Los Angeles: Sage; 2005.

22. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.

23. Coffey A, Atkinson P. Encontrar el sentido a los datos cualitativos: Estrategias complementarias de investigación. Medellín: Contus; 2003.

24. Gurrieri L, Brace-Govan J, Previte J. Neoliberalism and managed health: fallacies, façades and inadvertent effects. Journal of Macromarketing. 2014;34(4):532-538.

25. Kenny KE. The biopolitics of global health: Life and death in neoliberal time. Journal of Sociology. 2015;5(1):9-27.

26. Castiel DL, Santos Ferreira M, Ribeiro de Morales D. Os riscos e a promoção do autocontrole na saúde alimentar: moralismo, biopolítica e crítica parresiasta. Ciência & Saúde Coletiva. 2014;19(5):1523-1532.

27. Ibáñez T. La Gobernanza: pieza clave del neoliberalismo avanzado. Libre Pensamiento [Internet]. 2012 [citado 16 abr 2016]. Disponible en: http://tinyurl.com/h7xz83q

28. Mayes C. Governing through choice: Food labels and the confluence of food industry and public health discourse to create "healthy consumers". Social Theory & Health. 2014;12:376-395.

29. Crawshaw P. Governing at a distance: Social marketing and the (bio)politics of responsibility. Social Science & Medicine. 2012;74(1):200-207.

30. McNay L. Self as enterprise: Dilemmas of control and resistance in Foucault's The Birth of Biopolitics. Theory, Culture and Society. 2009;26 (6):55-77.

31. Cronin JM, McCarthy M, Dalaney M. Deconstructing consumer discipline: How self-management is experience in the market place. European Journal of Marketing. 2015;49(11/12):1902-1922.

32. Castiel DL. O acesso aos Campos Elísios: a promoção da saúde ampliada e as tecnologias de melhoramento em busca da longevidade (e da inmortalidade). Saúde e Sociedade. 2015;24(3):1033-1046.

33. Dumas A, Robitaille J, Jette SL. Lifestile as a choice of necessity: young women, health and obesity. Social Theory & Health. 2014;12(2): 138-158.

34. Rose N, O'Malley P, Valverde M. Gubernmamentality. Annual Review of Law and Social Science. 2006;6:83-104.

35. Rose N. Powers of freedom: Reframing political thought. Cambridge: Cambridge University Press; 1999.

36. Greco M, Stenner P. Happiness and the Art of Life: Diagnosing the psychopolitics of wellbeing. Health Culture and Society. 2013;5(1). doi: 10.5195/hcs.2013.147.

37. Cockerham WC. Bourdieu and an update of health lifestyle theory. In: Medical Sociology on the Move: New Directions in Theory. Dordrecht: Springer; 2013.

38. Foucault M. Tecnologías del yo y otros textos afines. Barcelona: Paidós Ibérica; 1990.

39. Rose N. Governing the soul: The shapong of the private self. New York: Routledge; 1990.