The Open University since 2006
Alternatively you can skip the navigation by pressing 'Enter'.
Exodus: Our Journey To Europe: EPISODE 1Wednesday, 27th July 2016 02:45 - BBC TwoEpisode 1 begins as hundreds of thousands of refugees from Syria arrive in the Turkish port of Izmir. Read more: Exodus: Our Journey To Europe: EPISODE 1
Discovery: The Truth About Success And Failure In Medicine: Going Lean: Heath and the Toyota WayAvailable until Tuesday, 25th July 2017 00:00What is lean healthcare? Kevin Fong explores Read more: Discovery: The Truth About Success And Failure In Medicine: Going Lean: Heath and the Toyota Way
Thinking Allowed July 2016: Food bank Britain, Food poverty in EuropeAvailable for over a year
Full Steam Ahead: Episode oneAvailable until Monday, 22nd August 2016 17:30
Exodus: Our Journey To Europe: EPISODE 3Available until Friday, 19th August 2016 01:15
OpenLearn Live: 26th July 2016Why does taking a trip between Camden and Clapham make a person legally significant? Then more... Read more: OpenLearn Live: 26th July 2016
Full Steam AheadIt’s Full Steam Ahead for historians Ruth Goodman, Alex Langlands and Peter Ginn as they bring... Read more: Full Steam Ahead
Employment relations and employee engagementThis free course, Employment relations and employee engagement, looks at raising levels of... Try: Employment relations and employee engagement now
Managing my moneyThis free course, Managing my money, allows you to gain the skills to manage your personal... Try: Managing my money now
What factors influence our health? A lot of attention is focused on people's behaviour - their decisions to smoke, drink, over-eat and so on - with strong messages about the changes needed to become healthier. But people's behaviour is influenced by circumstances and events, friends and family, education, job prospects, income, housing and environment. In this free course, Factors that influence health: An introduction, we look at how these factors, these wider social determinants, work together to influence our health for good or ill.
After studying this course, you should be able to:
- demonstrate a knowledge and understanding of the social determinants of health
- demonstrate an ability to identify, use and critically evaluate different types of health information.
- Learning outcomes
- 1 Exploring the factors that influence health
- 2 Age, sex and hereditary factors
- Current section: 3 Individual lifestyle factors
- 4 Social and community influences
- 5 Living and working conditions
- 6 General social and environmental conditions
- 7 Investigating health inequalities
- Keep on learning
Study this free course
Enrol to access the full course, get recognition for the skills you learn, track your progress and on completion gain a statement of participation to demonstrate your learning to others. Make your learning visible!
3 Individual lifestyle factors
As you have seen above, emphasis on individual lifestyle as a determinant of health can be seen in most policies and strategies. In recent years the concept of a ‘healthy lifestyle’ has achieved considerable popular currency but, like many such concepts, the term can be widely used in many different contexts and can come to mean different things. Davison et al. provide a useful definition of ‘lifestyle’ which they describe as: ‘the aspects of health related behaviours and conditions which entail an element of personal action at the individual level ... strongly associated with the possibility of individual choice and the triumph of self control over self indulgence’ (Davison et al., 1992, p. 675).
The main issues addressed usually include diet and physical activity, tobacco and alcohol use, drug intake and sexual activity, although, at various times, other issues have also fallen within this rubric, for example, exposure to the sun and use of seat belt or child car seat.
Many attempts to promote public health have focused on the individual and their lifestyle, and this seems to be a fairly common-sense approach. After all, it could be argued that if individuals ate a little less and took more exercise, then they would be less likely to become obese. If they smoked less and drank less alcohol they would be at a reduced risk of long-term conditions such as heart disease or cirrhosis, and if individuals engaged in safe sex, then they would be less likely to become infected with HIV or other sexually transmitted infections. Individual behaviour can play an important part in health and illness, so maintaining a healthy lifestyle could well be simply a matter of self-control. However, as outlined below, lifestyle accounts have been challenged on several counts.
Thinking point: how far is maintaining a healthy lifestyle simply a matter of self-control?
At a practical level, research has shown that it is very difficult to change individual behaviour. Although there have been some instances of success (e.g. the national HEA campaign to prevent cot deaths in the 1990s), there is still considerable debate about how far health can be improved through targeting individual behaviour. For example, although smoking has declined over time, a recent Omnibus Survey (Lader and Goddard, 2004) of smoking behaviour found that nearly 80 per cent of current smokers had tried (unsuccessfully) to give up smoking; and of these, 46 per cent had received advice on smoking cessation.
Many theories and models have been developed to help explain individual health behaviours. However, one of the key problems facing those promoting public health is the failure of many individuals to follow healthy lifestyle advice. Two key explanations have been put forward to explain this. The first rests on the notion that the public are ‘victims of their own ignorance’ (Davison et al., 1992) and that with increased health education and advice, they will begin to embrace healthier lifestyles. This was the notion underpinning the government’s HIV/AIDS prevention campaign in the late 1980s (see Figure 3).
The second explanation draws on the idea that individuals can believe that health is largely determined by external factors, therefore denying the relevance of individual behavioural change. Psychologists draw on the health ‘locus of control’ (Rotter, 1954) to describe the general expectancy that behaviour either is or is not directly related to health outcomes. An internal locus of control relates to the individual’s feeling of control over health, whereas an external locus of control relates to factors outside of the individual’s control. For example, a study of stress among mothers caring for children with intellectual impairments found an internal locus of control to be a protective factor (Hassall et al., 2005). A study of perceived risk for breast cancer also noted that women with an internal locus of control were more likely to engage in protective health behaviours such as attending screening (Rowe et al., 2005). The significance of this internal locus of control underpins the ‘Take Control Campaign’ launched by Epilepsy Action, which seeks to encourage all those with epilepsy to take control so as to achieve better management of their condition. ‘Take Control’ wrist bands formed part of the campaign (Figure 4).
The notion of taking control underpins many contemporary attempts within the public, private and voluntary sectors to promote public health. However, taking control is subject to the ability to take responsibility for health and to make choices, both of which are governed by power relations. In other words, not everyone is free to make decisions and choices, since individual choice and control can be constrained both by other people and by the factors that influence health.
While targeting individual behaviour might seem to be common sense, it is important to recognise that distinct patterns of behaviour can be found among different social groups. For example, Table 1 shows that people in routine and manual occupations are more likely to smoke than people with non-manual occupations. Figure 5 shows changing patterns of excessive alcohol consumption, demonstrating that younger people are more likely to drink to excess and that women are now more likely to drink excessively in comparison to previous years.
Lifestyle accounts draw on notions of individual choice. However, if patterns of behaviour are considered – for example, those identified above – it is easy to see that ‘choice’ is not just an individual matter, but a social one. It is important to ask why young women are drinking to excess and why men in manual occupations are twice as likely to smoke as men in managerial or professional occupations. The rhetoric of choice and the ‘right to choose’ have become embedded in policy and practice. Writing specifically about reproductive choice, for example, Petchesky (1980) argues that, to be meaningful, the right to choose must carry with it the enabling conditions that will make that right concretely realisable and universally available:
The ‘right to choose’ means very little when women are powerless ... women make their own reproductive choices, but they do not make them just as they please; they do not make them under conditions which they themselves create but under social conditions and constraints which they, as mere individuals, are powerless to change.
Table 1 Prevalence of cigarette smoking, by sex and socio-economic classification, 2001–2004
|Percentage Smoking cigarettes||Bases = 100 per cent|
|Managerial and professional occupations||17||17||16||16||586||647||625||637|
|Routine and manual occupations||33||34||36||30||651||675||606||630|
|Never worked and long-term unemployed||26||22||30||29||68||135||142||114|
|Managerial and professional occupations||20||16||15||18||544||574||564||527|
|Routine and manual occupations||27||30||34||29||802||799||686||734|
|Never worked and long-term unemployed||14||24||20||20||131||203||207||197|
|Managerial and professional occupations||18||16||16||17||1132||1221||1189||1165|
|Routine and manual occupations||30||32||34||29||1452||1474||1291||1365|
|Never worked and long-term unemployed||19||23||24||23||199||338||349||311|
So, although lifestyle might be a factor that influences health, it is also important to focus on wider influences and the context within which individual ‘choice’ takes place.
Copyright & revisions
Originally published: Friday, 12th February 2016
Last updated on: Friday, 12th February 2016
- Creative-Commons: The Open University is proud to release this free course under a Creative Commons licence. However, any third-party materials featured within it are used with permission and are not ours to give away. These materials are not subject to the Creative Commons licence. See terms and conditions. Full details can be found in the Acknowledgements and our FAQs section.
- This site has Copy Reuse Tracking enabled - see our FAQs for more information.
If you enjoyed this, why not follow a feed to find out when we have new things like it? Choose an RSS feed from the list below. (Don't know what to do with RSS feeds?)
Remember, you can also make your own, personal feed by combining tags from around OpenLearn.
All our alternative formats are free for you to download, for more information about the different formats we offer please see our FAQs. The most frequently used are Word (for accessibility), PDF (for print) and ePub and Kindle to download to eReaders*.
- Word (1.2 MB)
- PDF (2.8 MB)
- ePub 3.0 (953 KB)
- ePub 2.0 (954 KB)
- Kindle (391 KB)
- RSS (194 KB)
- HTML (761 KB)
- SCORM (760 KB)
- OUXML Package (29 KB)
- OUXML File (89 KB)
- IMS Common cartridge
- Moodle backup (570 KB)
*Please note you will need an ePub and Mobi reader for these formats.