ABSTRACT
We look to medicine to provide us with key symbols for constructing a framework of meaning-a mythology of our state of being.
(Comaroff 1982:55)
Since the mid-1970s, there has been a turn towards health in the United States and in other western cultures. The pursuit of health has become an important activity, especially for the American middle class. Millions of people have become concerned about their health and have changed their behaviour in order to protect or improve it. Millions more continue to act as always or with minor changes but now with an awareness that such behaviour puts them ‘at risk’. In either case, health has become an important topic in everyday conversation, reflecting an extraordinary expansion of medical, political, and educative discourses about health hazards and ways to protect individuals and populations against them. There are several kinds of health discourse. My topic is health promotion, by which I mean the set of discourses and practices concerned with individual behaviours, attitudes, dispositions or lifestyle choices said to affect health. Protecting and improving individual health appear to be prototypical acts of practical reason and personal responsibility-a matter of common sense. The appearance is based on the assumption that, given accurate medical information about hazards to health and naturally desiring to live a long life free from debilitating disease, the rational person will act to avoid unnecessary dangers and adopt healthy behaviours. Yet, there is a parallel appearance. No matter how much or how little is undertaken in the name of health, we all know that the attempt falls short. Health promotion is an imperfect practice, an experience of conflicting urges and varied outcomes. Few of us live consistently healthy lifestyles and those who approach that ideal seem to be engaged in an unhealthy obsession. In short, we are both ambivalent and inconsistent in following the rules of health. As an interviewee told me in the early 1980s, ‘there are other things, you know’. It is this entire set of signifying practices-characteristic of our present age-that begs interpretation.
