Theories of practice and public health: understanding (un)healthy practices

Abstract

Psychological understandings and individualistic theories of human behaviour and behaviour change have dominated both academic research and interventions at the 'coalface' of public health. Meanwhile, efforts to understand persistent inequalities in health point to structural factors, but fail to show exactly how these translate into the daily lives (and hence health) of different sectors of the population. In this paper, we suggest that social theories of practice provide an alternative paradigm to both approaches, informing significantly new ways of conceptualising and responding to some of the most pressing contemporary challenges in public health. We introduce and discuss the relevance of such an approach with reference to tobacco smoking, focusing on the life course of smoking as a practice, rather than on the characteristics of individual smokers or on broad social determinants of health. This move forces us to consider the material and symbolic elements of which smoking is comprised, and to follow the ways in which these elements have changed over time. Some of these developments have to do with the relation between smoking and other practices such as drinking alcohol, relaxing and socialising. We suggest that intervening in the future of smoking depends, in part, on understanding the nature of these alliances, and how sets of practices co-evolve. We conclude by reflecting on the implications of taking social practices as the central focus of public health policy, commenting on the benefits of such a paradigmatic turn, and on the challenges that this presents for established methods, policies and programmes.

Re-assessing vulnerability to foodborne illness: pathways and practices

“…Indeed, exploring practices in situ makes visible both the complex relationship between what people say they do and what they are observed to do, as well as the 'linguistic incongruence' arising from the absence of a language with which to express or translate one's experiences (DeVault, 1990) or, indeed, to articulate the knowledge which underpins a particular practice which may have co-evolved with other practices over time (Blue, Shove, Carmona, & Kelly, 2016) and take place without conscious thought or reflection (Power, 2003).…”

A new measure of unhealthy school environments and its implications for critical assessments of health promotion in schools

“…Fletcher, Bonell, Sorhaindo, & Rhodes, 2009;Jamal et al, 2013). This research recognises that smoking and drug use are best considered as practices not merely behaviours, with social meanings specific to certain times and place and which can be transformed and not merely enacted by those engaging in them; resonating with recent conceptual work published in Critical Public Health (Blue, Shove, Carmona, & Kelly, 2016).…”

“…The recognition that smoking and drug use etc. are best regarded as socially located and meaningful social practices, with meanings specific to certain times and place, and not merely behaviours (Blue et al, 2016), means they may be implicated in student responses to school very differently across time and place. Thus, in addition to quantitative research examining how well the theory appears to predict patterns of such practices in different settings, qualitative research is also needed to provide insights into questions of process and meanings.…”

Facilitating Low-Carbon Living? A Comparison of Intervention Measures in Different Community-Based Initiatives

“…Such developments have been based on the recognition that practices do not exist in isolation and are linked together through time and space. They co-evolve to either become incompatible or closely coupled, as such linkages are characterized "as either in harmony or in conflict" ( [55] (p. 2), drawing on [56]). For instance, a change to a vegetarian diet can re-configure people's cooking and shopping practices and, potentially, connected mobility routines.…”