Health Capital - Why are they running?

1. Health Capital -Why are they running? Health Capital – how do we understand body strategies and investments in the Nordic welfare States? A theoretical contribution

2. 30 years ago • health trend - boom • training, running • fitness • diet counseling • .. • ..

3. Flow or Investment? Psychological: “flow-experience” Biomedical: Endorphins ("endogenous morphine") • Sociological: Are use of plastic surgery, monitoring of the body, diet/physical training- investment (distinctive) strategies? • Large differences high/low positioned (30 years, smoking, diet, training, surgery..) • As the society is changing (transformation of society – withdrawal of the welfare state and also change of professions)?

4. Health Capital!.. • a possible new capital? • The body and the Health within the last 20-30 (and even more last 10) years are turning to be seen upon in a new way: • The body is an object of investment with even more and more energy and resources (economic, cultural, social including TIME invested in it?

5. Field – and - capital • Change of the “marked” (the social space/ the social field) that creates this type of health capital. • marriage market • recruitment market • labour marked • health insurance market • housing market • leisure market • .. • ..

6. Outlines of explanations

7. ”genesis of a taste for health” • 1) An immersion in a wider field of symbolic manipulation (Bourdieu 1985). • Science and, in particular, health science has, over time, supplanted religion symbols in the social space, installing psychologists, psychoanalysts, doctors, sexologists, ‘life coaches’, body therapists, nature healers/therapists, and instructors as the ‘new priesthood’ (Bourdieu's phrase). • These positions take part in the struggle to provide the ‘laity’ with advice about how to live via health, healing, and spiritual and bodily care.

8. ”genesis of a taste for health” • 2) Another feature affecting the taste for health relates to how the ingestion of food and beverages over time, established as a relatively autonomous field of knowledge such as 'eating', becomes 'nutrition'. • 3) A third feature relates to how ritual games and festive entertainment – again in a historical perspective – are transformed into 'sport' and, along the way, established as a competitive field (Bourdieu 1981).

9. ”genesis of a taste for health” • 4) More capitalism, the reduction – withdrawal/pulling out, of the state; from different welfare areas. State is more administering systems than running them. • Individualisations – the shaping of a subject: Patients/clients as subjects (patient organisations) • Identity change of subject; “We are all Pre-patients” (Rose 2009) • Change of policy; NPM more republican-conservative government • More pressure on the health care system(people get older; ‘invention’ of new diseases; more diseases/treatment; little increase in workforce/production; relative - reduced resources) • Private industry (hospitals), More prioritizing in health care system (classification of patients, “Triage”, new phenomenon is waiting time/latency in relation to medical treatment and surgery- Relative privileging of the privileged and relative dis-privileging of the dis-privilegedsocial groups

10. The state and - what is healthy? • Meta-field - large effect on the health field - via production of classifications ex: on the social world, including one’s own body, its physiognomy, skin, size, weight etc. • Classifications translated to cognitive perceptions associated with the body, such as healthy or unhealthy, normal or pathological, nice or disgusting, fit or unfit. • The effect of the state’s efforts is hardly noticed as the state ‘creates a political doxa, that is, an array of official classifications that become practical, taken-for-granted understandings of the social order’ (Bourdieu quoted in Swartz 2004, p. 13).

11. What is health capital

12. 3 forms of health capital • embodied state, • body level, ‘performance’, incl. ‘normality’ in terms of serum cholesterol, body mass index.. • objectified form; • related to physical artifacts such as buildings, health and medical technologies, and treatments and services. • institutionalized form • as in health legislation, instructions, health certificates, professional certification (diet-instructor..) and titles, authorized ‘health theories’.

13. The embodied state • Individual and group investment

14. Investment – and distinction • Dominant social groups will act and look ‘natural’ when investing in the body as their values are naturalized, • similar to how upper middle class dominate the school and educational system (Bourdieu and Passeron 1977). • Some dominated social groups do ‘overinvest’ in the body (fitness, muscles, diet and surgery). • The dominant social groups perceive this as vulgar, ‘not appropriate’ or as bizarre

15. Violence - power • Symbolic violence (inner domination): • Dominated positions - view their own physiognomy as out of proportion, inadequate – and associated poor health with bad moral and poor choices. (state-authorized definitions of body mass index, body proportions, size and weight) • Physical violence (outer domination): • Long-term unemployed people / people on sick leave required to participate in physical training as a condition for receiving benefits, as has been the case in Denmark in the 2000s (cf. Horneman-Møllers chapter in this volume). • Also: Job and obesity-smoking-BMI-alcohol. • Hospital treatment and surgery, obesity..

16. health capital, inequality and connection to risk • Health investment - also a strategy to reduce one’s risk of morbidity and mortality • (even if, as we have emphasized, health capital does not necessarily translate into health improvements). • The fact that higher-positioned groups have further distinguished themselves by reducing risk more than lower-positioned groups means that social risk in the Nordic societies has, and is likely to continue to become, more unequally distributed.

17. To sum up.. • Certain social groups tend to stabilize or improve social position in the social space in new ways, and we ask how and how can it be? • We argue that new types of investment strategies are actualized in the body, not only as ‘cultural’ but also as healthy? • Individual investment strategies in health capital are constituted as a response to changes in the state, to changes in the health system, and to changes in other fields • Health capital is an extra “card” in the social game and it makes a distinctive difference. When agents are equal in possession and composition of capital (income, education and networks) health capital can make the distinctive difference – to get a job or to stay on the labor market etc.

18. Field – and - capital • We – some- ‘Diet’, ‘Run’, ‘Jog’.. • to ‘get a wife’, a ‘job’, a ‘house’, a ‘health insurance’.. • It is the change of the “marked” (the social space/ the social field) that creates this type of health capital. • marriage marketrecruitment market labour marked health insurance markethousing marketleisure market