a School of Public Health, Faculty of Community and Health Sciences , University of the Western Cape , Bellville , South Africa.
b Faculty of Arts and Design , Durban University of Technology , Durban , South Africa.
Int J Qual Stud Health Well-being. 2019 Dec;14(1):1603518. doi: 10.1080/17482631.2019.1603518.
Healthiness is constructed, in Western culture, as a moral ideal or supervalue. This paper will interrogate the assumption that health and the pursuit of healthiness is always and unquestionably positive, by exploring how discourses of health and freedom interact to reinforce the current inequalities and detract from social transformation.
Twenty young South African adults were interviewed about their understandings and experiences of health. These discussions were analysed using Foucauldian discourse analysis.
Participants constructed healthiness as facilitating the experience of freedom, while at the same time being dependent on a personal orientation towards freedom (as opposed to merely submitting to dominant health authorities). Freedom discourses also played a role in connecting health to neoliberal discourses idealizing economic productivity and hard work. Participants were able to construct a self that is active, productive, valuable, hopeful, and self-assured when talking about health using discourses of freedom. However, these discourses also functioned to moralise and idealise healthiness, which contributed to blaming poor health on its sufferers.
Health/freedom discourses can further reinforce the neoliberal value of individual responsibility by constructing self-improvement and self-work as the solution to ill-health, thereby contributing to victim-blaming and weakening support for public health interventions.
在西方文化中，健康被构建为一种道德理想或超价值。本文通过探讨健康和追求健康的话语如何相互作用，以加强当前的不平等，并削弱社会变革，来质疑健康和追求健康总是且无疑是积极的这一假设。
对 20 名南非年轻成年人进行了关于他们对健康的理解和经验的访谈。使用福柯的话语分析方法对这些讨论进行了分析。
参与者将健康视为促进自由体验的因素，同时也依赖于个人对自由的取向（而不是仅仅服从于占主导地位的健康权威）。自由话语在将健康与理想化经济生产力和努力工作的新自由主义话语联系起来方面也发挥了作用。参与者在谈论健康时，能够使用自由话语构建一个积极、富有成效、有价值、有希望和自信的自我。然而，这些话语也起到了将健康理想化和理想化的作用，这导致将健康不良归咎于其患者。
健康/自由话语可以通过将自我提升和自我工作构建为改善健康状况的解决方案，进一步加强新自由主义个人责任的价值观，从而导致对受害者的指责，并削弱对公共卫生干预措施的支持。
