Social Theory & Health

, Volume 16, Issue 4, pp 361–378 | Cite as

The healthy lifestyle in longevity narratives

  • Chrystal JayeEmail author
  • Jessica Young
  • Richard Egan
  • Rebecca Llewellyn
  • Wayne Cunningham
  • Peter Radue
Original Article


What does the term ‘healthy lifestyle’ mean to middle-aged adults (54–65 years)? Participants in an interview study about longevity described the ‘healthy lifestyle’ largely in terms of diet, exercise and prevention, and avoidance behaviours. It was evident that the healthy lifestyle was an ideal that required participants to make many choices in their daily lives based on what they considered to be ‘right’ and ‘good’. In describing their adherence to a healthy lifestyle, we argue that participants’ perspectives reveal contemporary discourses of healthism that are characterised by self-responsibility, as well as notions of risk and consequence. These discourses represent normalising moral technologies that shape citizens’ behaviours and reflect Liechter’s (1997) new secular morality. Participants engaged variously with these technologies ranging from ambivalence, zealousness, negotiation, bargaining, and resistance. Family doctors play a critical role in helping people to navigate the disciplinary apparatus of normalising moral technologies that underpin the healthy lifestyle.


Healthism Healthy lifestyle New Zealand 



This study was funded by a University of Otago Research Grant.


  1. Ayo, N. 2012. Understanding health promotion in a neoliberal climate and the making of health conscious citizens. Critical Public Health 22 (1): 99–105.CrossRefGoogle Scholar
  2. Beck, U. 1992. Risk society: Towards a new modernity. London: Sage.Google Scholar
  3. Borkan, J. 1999. Immersion/crystallisation. In Doing qualitative research, 2nd ed, ed. B. Crabtree, and W. Miller, 179–194. London: Sage.Google Scholar
  4. Bourdieu, P. 1990. In other words: Essays toward a reflexive sociology. Translated by M. Adamson. Stanford, CA: Stanford University Press.Google Scholar
  5. Bunton, R., and R. Burrows. 1995. Consumption and health in the ‘epidemiological’ clinic of late modern medicine. In The sociology of health promotion: Critical analyses of consumption, lifestyle and risk, ed. R. Bunton, S. Nettleton, and R. Burrows, 206–222. New York: Routledge.CrossRefGoogle Scholar
  6. Burrows, L., and J. Wright. 2007. Prescribing practices: Shaping healthy children in schools. The International Journal of Children’s Rights 15 (1): 83–98.CrossRefGoogle Scholar
  7. Cassel, E. 1991. The nature of suffering and the goals of medicine. New York: Oxford University Press.Google Scholar
  8. Cheek, J. 2008. Healthism: A new conservatism? Qualitative Health Research 18 (7): 974–982.CrossRefGoogle Scholar
  9. Cockerham, W.C. 2005. Health lifestyle theory and the convergence of agency and structure. Journal of Health and Social Behavior 46: 51–67.CrossRefGoogle Scholar
  10. Conrad, P. 1992. Medicalization and social control. Annual Review of Sociology 18: 209–232.CrossRefGoogle Scholar
  11. Conrad, P., and K.K. Barker. 2010. The social construction of illness: Key insights and policy implications. Journal of Health and Social Behavior 51 (Suppl 1): S67–S79.CrossRefGoogle Scholar
  12. Crawford, R. 1980. Healthism and the medicalization of everyday life. International Journal of Health Services 10 (3): 365–388.CrossRefGoogle Scholar
  13. Crawford, R. 1984. A cultural account of “health”: Control, release, and the social body. In Issues in the political economy of health care, ed. J. McKinley, 60–103. New York: Tavistock.Google Scholar
  14. Crawford, R. 2004. Risk ritual and the management of control and anxiety in medical culture. Health: An Interdisciplinary Journal for the Social Study of Health Illness and Medicine 8: 505–528.CrossRefGoogle Scholar
  15. Crawford, R. 2006. Health as meaningful practice. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 10 (4): 401–420.CrossRefGoogle Scholar
  16. Daykin, N., and J. Naidoo. 1995. Feminist critiques of health promotion. In The sociology of health promotion: Critical analyses of consumption, lifestyle and risk, ed. R. Brunton, S. Nettleton, and R. Burrows, 59–69. New York: Routledge.CrossRefGoogle Scholar
  17. Douglas, J. 1995. Developing anti-racist health promotion strategies. In The sociology of health promotion: Critical analyses of consumption, lifestyle and risk, ed. R. Bunton, S. Nettleton, and R. Burrows, 70–77. New York: Routledge.CrossRefGoogle Scholar
  18. Evans, J., E. Rich, B. Davies, and R. Allwood (eds.). 2008. Education, disordered eating and obesity discourse: Fat fabrications. London, New York: Routledge.Google Scholar
  19. Fitzgerald, F.T. 1994. The tyranny of health. New England Journal of Medicine 331 (3): 196–198.CrossRefGoogle Scholar
  20. Foucault, M. 1973. The birth of the clinic: An archaeology of medical perception. London: Tavistock.Google Scholar
  21. Foucault, M. 1977. Discipline and punish: The birth of the prison. New York: Vintage.Google Scholar
  22. Foucault, M. 1981. The order of discourse. In Untying the text: A post-structuralist reader, ed. R. Young, 48–78. Boston: Routledge.Google Scholar
  23. Foucault, M. 1983. The subject and power. In Michel foucault: Beyond structuralism and hermeneutics, ed. H. Dreyfus, and P. Rabinow, 208–226. Chicago: University of Chicago Press.Google Scholar
  24. Foucault, M. 1988. Technologies of the self. In Technologies of the self: A seminar with michel foucault, ed. L. Martin, H. Gutman, and P. Hutton, 16–49. London: Tavistock Publications.Google Scholar
  25. Foucault, M. 1990 The history of sexuality, vol. 1. Translated by R. Hurley. New York: Vintage Books.Google Scholar
  26. Fugelli, P. 2006. The zero-vision: Potential side effects of communicating health perfection and zero risk. Patient Education and Counseling 60: 267–271.CrossRefGoogle Scholar
  27. Fullagar, S. 2002. Governing the healthy body: Discourses of leisure and lifestyle within Australian health policy. Health 6 (1): 69–84.CrossRefGoogle Scholar
  28. Giddens, A. 1991. Modernity and self-identity: Self and society in the late modern age. Cambridge: Polity Press.Google Scholar
  29. Goldman, R.E., D.R. Parker, C.B. Eaton, J.M. Borkan, R. Gramling, R.T. Cover, and D.K. Ahem. 2006. Patients’ perceptions of cholesterol, cardiovascular disease risk, and risk communication strategies. The Annals of Family Medicine 4 (3): 205–212.CrossRefGoogle Scholar
  30. Grace, V.M. 1991. The marketing of empowerment and the construction of the health consumer: A critique of health promotion. International Journal of Health Services 21 (2): 329–343.CrossRefGoogle Scholar
  31. Greenhalgh, T., and S. Wessely. 2004. ‘Health for me’: A sociocultural analysis of healthism in the middle classes. British Medical Bulletin 69: 197–213.CrossRefGoogle Scholar
  32. Harvey, D. 2007. Neoliberalism as creative destruction. The Annals of the American Academy of Political and Social Science 610: 21–44.CrossRefGoogle Scholar
  33. Katz, S. 1997. Secular morality. In Morality and health, ed. A. Brandt, and P. Rozin, 279–330. New York: Routledge.Google Scholar
  34. Kristensen, D.B., M. Lim, and S. Askegaard. 2016. Healthism in Denmark: State, market, and the search for a “moral compass”. Health 20 (5): 485–504.CrossRefGoogle Scholar
  35. Larner, W. 1997. “A means to an end”: Neoliberalism and state processes in New Zealand. Studies in Political Economy 52: 7–38.CrossRefGoogle Scholar
  36. Leichter, H. 1997. Lifestyle correctness and the new secular morality. In Morality and health, ed. A. Brandt, and P. Rozin, 359–378. New York: Routledge.Google Scholar
  37. Llewellyn, R., C. Jaye, W. Cunningham, J. Young, R. Egan, and P. Radue. 2017a. Living into death: A case for an iterative, fortified and cross-sector approach to advance care planning. Anthropology and Medicine 24 (2): 1–16.Google Scholar
  38. Llewellyn, R., W. Cunningham, C. Jaye, J. Young, R. Egan, and P. Radue. 2017b. “Why worry about something you can’t control?” Negotiated risk, longevity and health behaviours. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 21 (3): 259–277.CrossRefGoogle Scholar
  39. Llewelyn, R., C. Jaye, R. Egan, W. Cunningham, J. Young, and P. Radue. 2016. Cracking open death: Death conversations in primary care. Journal of Primary Health Care 8 (4): 303–311.CrossRefGoogle Scholar
  40. Lupton, D. 2013. Quantifying the body: Monitoring and measuring health in the age of mhealth technologies. Critical Public Health 23 (4): 393–403.CrossRefGoogle Scholar
  41. MacEachen, E. 2000. The mundane administration of worker bodies: From welfarism to neoliberalism. Health, Risk and Society 2 (3): 315–327.CrossRefGoogle Scholar
  42. Merleau-Ponty, M. 1962. The phenomenology of perception. Translated by C. Smith. New York: Routledge and Kegan Paul.Google Scholar
  43. Nettleton, S., and R. Bunton. 1995. Sociological critiques of health promotion. In The sociology of health promotion: Critical analyses of consumption, lifestyle and risk, ed. R. Bunton, S. Nettleton, and R. Burrows, 41–58. New York: Routledge.Google Scholar
  44. O’Brien, M. 1995. Health and lifestyle: A critical mess? Notes on the dedifferentiation of health. In The sociology of health promotion: Critical analyses of consumption, lifestyle and risk, ed. R. Bunton, S. Nettleton, and R. Burrows, 191–205. New York: Routledge.CrossRefGoogle Scholar
  45. Peterson, A., and R. Bunton (eds.). 1997. Foucault, health and medicine. New York: Routledge.Google Scholar
  46. Reis, S., A. Biderman, R. Mitki, and J.M. Borkan. 2007. Secrets in primary care: A qualitative exploration and conceptual model. Journal of General Internal Medicine 22 (9): 1246–1253.CrossRefGoogle Scholar
  47. Rose, N. 1999. Governing the soul: The shaping of the private self. London: Free Association Books.Google Scholar
  48. Rysst, M. 2010. “Healthism” and looking good: Body ideals and body practices in Norway. Scandinavian Journal of Public Health 38 (Suppl 5): 71–80.CrossRefGoogle Scholar
  49. Schwandt, T.A. 1994. Constructivist, interpretist approaches to human inquiry. In Handbook of qualitative research, ed. N.K. Denzin, and Y.S. Lincoln, 118–137. Thousand Oaks, CA, US: Sage.Google Scholar
  50. Shield, R.R., R.E. Goldman, D.A. Anthony, N. Wang, R.J. Doyle, and J. Borkan. 2010. Gradual electronic health record implementation: New insights on physician and patient adaptation. The Annals of Family Medicine 8 (4): 316–326.CrossRefGoogle Scholar
  51. Shilling, C. 1993. The body and social theory. London: Sage.Google Scholar
  52. Stenhouse, J. 2009. Religion and society. In The New Oxford history of New Zealand, ed. G. Brynes, 256–323. Melbourne: Oxford University Press.Google Scholar
  53. Ward, K. 2006. Towards 2015: The future of mainline Protestantism in New Zealand. Journal of Beliefs and Values 27 (1): 13–23.CrossRefGoogle Scholar
  54. Wiest, A.L., D. Andrews, and M. Giardina. 2015. Training the body for healthism: Reifying vitality in and through the clinical gaze of the neoliberal fitness club. Review of Education, Pedagogy, and Cultural Studies 37 (1): 21–40.CrossRefGoogle Scholar
  55. World Health Organisation. 1986 Ottawa Charter for health promotion. Paper presented at the First International Conference on Health Promotion, 17–21 November 1986, Copenhagen.Google Scholar
  56. Yen, L. 1995. From Alma Ata to Asda—and beyond: A commentary on the transition in health promotion services in primary care from commodity to control. In The sociology of health promotion: Critical analyses of consumption, lifestyle and risk, ed. R. Bunton, S. Nettleton, and R. Burrows, 24–37. New York: Routledge.CrossRefGoogle Scholar

Copyright information

© Macmillan Publishers Ltd., part of Springer Nature 2018

Authors and Affiliations

  • Chrystal Jaye
    • 1
    Email author
  • Jessica Young
    • 1
  • Richard Egan
    • 2
  • Rebecca Llewellyn
    • 2
  • Wayne Cunningham
    • 3
  • Peter Radue
    • 1
  1. 1.Department of General Practice and Rural HealthUniversity of OtagoDunedinNew Zealand
  2. 2.Department of Preventive and Social MedicineUniversity of OtagoDunedinNew Zealand
  3. 3.Royal College of Surgeons in Ireland - Medical University of BahrainAdilyaBahrain

Personalised recommendations