Bourdieu's concept of habitus describes a set of tastes and dispositions operating according to a class homology -for example, a working-class preference for utility, or a bourgeois orientation toward luxury. In the United States, Holt found that high cultural capital consumers were characterized by their cosmopolitanism, idealism, connoisseurship, and affinity for the exotic and authentic. In this article, we use Holt's analysis as a comparative case, finding an altered high cultural capital habitus incorporating environmental awareness and sustainability principles, in a configuration that has been called ethical or ''conscious consumption.'' Using both quantitative survey data of self-described conscious consumers as well as four qualitative case studies, we argue that ethical consumers are overwhelmingly high cultural capital consumers, and that high cultural capital consumption strategies have shifted since Holt's study in the mid1990s. We show that on a number of dimensions -cosmopolitanism, idealism, and relation to manual labor -a new high cultural capital consumer repertoire privileges the local, material, and manual, while maintaining a strategy of distinction. While the critical literature on conscious consumers has suggested that such practices reflect neo-liberal tendencies that individualize environmental responsibility, our findings suggest that such practices are hardly individual. Rather, they are collective strategies of consumptionwhat we have termed an emerging high cultural capital ''eco-habitus.''
As the prevalence of “conscious” consumption has grown, questions have arisen about its relationship to political action. An influential argument holds that political consumption individualizes responsibility for environmental degradation and “crowds out” genuine forms of activism. While European and Canadian empirical research contradicts this perspective, finding that conscious consumption and political engagement are positively connected, no studies of this relationship have been conducted for the United States. This article presents ordinary least squares (OLS) regression models for two datasets, the 2004 General Social Survey and a detailed survey of approximately 2,200 conscious consumers conducted by the authors, to assess the nature of the relationship between conscious consumption and political activism. The authors find that measures of conscious consumption are significantly and positively related to political action, even when controlling for political involvement in the past. The results suggest that greater levels of political consumption are positively related to a range of political actions.
Objectives To evaluate previously independent older patients discharged to skilled nursing facilities (SNFs) and identify risk factors for failure to return home and death and development of a predictive tool to determine likelihood of adverse outcome. Background Little is known about the likelihood of return to home, and higher than expected mortality rates in SNFs have recently been described, which may represent an opportunity for quality improvement. Methods Retrospective cohort of older hospitalized patients discharged to SNFs during 2007 to 2009 in 5 states using Centers for Medicare & Medicaid Services linked minimum data set data from SNFs. We assessed mortality, hospital readmission, discharge to home, and logistic regression models for predicting risk of each outcome. Results Of 416,997 patients, 3.8% died during the initial SNF stay, 28.6% required readmission, and 60.5% were ultimately discharged home. Readmission to a hospital was the strongest predictor of death in the years after SNF admission (unadjusted hazard ratio, 28.2; 95% confidence interval, 27.2–29.3; P < 0.001). Among all patients discharged to SNFs, 7.8% eventually died in an SNF and overall 1-year mortality was 26.1%. Risk factors associated with mortality and failure to return home were increasing age, male sex, increasing comorbidities, decreased cognitive function, decreased functional status, parenteral nutrition, and pressure ulcers. Conclusions A large proportion of older patients discharging to SNFs never return home. A better understanding of the natural history of patients sent to SNFs after hospitalization and risk factors for failure to return to home, readmission, and death should help identify opportunities for interventions to improved outcome.
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