Practical knowledge about health: an interplay between lay and science rationalities
Ferreira da Silva, Luisa
Social Sciences Cemri - Universidade Aberta Porto, Portugal
Health promotion aims the enlargement of individuals´ability to make healthy choices. Scientific knowledge about risks for health is nowadays well disseminated. However several studies confirm there is a big hiatus between about "healthy" knowledge and healthy practices (D'Houtaud e Field 1989; Calnan and Williams 1991; Blaxter 1998).
This paper is about the interiorisation of "healthy" as a norm for life, namely, the norms of food and exercise and the promotion of health in old age.
A qualitative study through in-depth interviews with a sample of 81 Portuguese adults. Material analysis is referred to "grounded theory" (Glaser e Strauss cit by Gerhardt 1989): interviewee´s discourses are the basis for analysis without previous categories; analysis is interpretation authorised by previous social theory that is systematically reviewed. Facts are viewed in the context of symbolic context and social structure in order to enlight what is being transmitted by them in the process of communication (Geertz 1989).
The lay meaning for healthy contains the essential knowledge of medical information about healthy lifestyles. But lay healthy meaning is a subjective meaning where cultural values, popular concepts, living conditions and modern ideology are associated to rational norms in order to adapt knowledge to practical life; individual choice is fashioned by structural conditions and social values; popular ideas about health and the body together with modern ideals of youth and body construction prevent from the logic expectation of ageing and illness; experience supports popular beliefs against epidemiology.
Results show that lay rationalities are different from scientific rationality. This allows some conclusions as regards public health policies. From the individual point of view, education for health needs to take in account the way people think and live and their reasons for living those ways: health is a support for happiness and not its equivalent. From the collective point of view health promotion must consider the importance of changes in social environment.