Angelina Jolie syndrome has been frequently mentioned in the media recently, implying increased attention to the probability of dangerous diseases. This results not only in the vigilant monitoring of health, but also in possible attempts to prevent even hypothetical diseases, including by means of surgery on a healthy body. The famous case of the actress, who underwent a preventive mastectomy, is symptomatic of this obsession and fits into the healthism concept.
However, Angelina Jolie’s story is an extreme manifestation of the ‘new understanding of health’. More widespread displays of healthism include the boom in diets, fitness, plastic surgery and organic food, as well as the popularity of mobile apps for health monitoring. Such ‘body worship’ is extensively supported by beauty salons, manufacturers of bioactive supplements and ‘superhealthy’ food, fitness and yoga centres, and, ultimately, even healthcare officials in many countries.
Popular healthcare policy today often shifts the responsibility for health from healthcare institutions to individuals themselves, and shifts the focus from treatment to prevention, including prevention of even purely hypothetical pathologies, Evgenia Golman explained in her paper ‘New Health Consciousness in Policy and Everyday Life: Origins, Main Directions for Problematization’, which was published in HSE’s the Journal of Social Policy Studies (in Russian).
Preventive medicine undoubtedly helps prevent many diseases and can saves a lot of resources for families and the state. But if ‘calculation’ of sicknesses and idealization of beauty and healthy body standards are understood improperly, in a purely commercial way, they can lead to mass neurosis and a social obsession with complying to healthist fashion. The most dangerous thing is that such an approach stigmatizes everythingl that doesn’t fit in with the model of a ‘healthy lifestyle’.
‘Health’ is becoming a social and moral imperative, and ‘unhealthiness’ can become a source of stigmatization – this is the source of one of today’s social clashes, Evgenia Golman believes. In other words, a reasonable willingness to stay healthy is carried to absurd levels in public discourse, and particularly, in mass media. A young, beautiful and slim body is becoming not just a ‘glossy’ cult, but a measure for an individual’s socio-economic position and even their ‘value’ for society. Everything that doesn’t fit into healthist standards (from excessive weight to face features) can become an object for discrimination.
Meanwhile, healthism is gaining momentum globally. Such an equivocal policy has too many incentives, from consumer society culture, competition in the ‘marriage market’, and women’s gender roles (care about their attractiveness and health of their family), to health care policies in many countries. Golman emphasizes such sources of healthism as ‘the politicization of health and economic feasibility of lower health care costs’, social transformations, such as the cult of individualism, as well as ‘medicalization of everyday life’. All these factors lead to health becoming a ‘desired status’, a prestigious and necessary lifestyle.
This would seem reasonable if it stayed there. But in its extreme forms, healthism turns into an ‘individual’s regular supervision of their body’. A person not only obsessively monitors every bodily manifestation, but starts detecting signs of imaginary sicknesses. Such an attitude may display positively, in fitness and careful attitude to eating, but, when idealized, it may determine a boost of ‘moral panic and the feeling of somatic vulnerability’.
If healthist understanding of health becomes popular in a society, it may result in ‘moral evaluation of an individual depending on their involvement in certain practices [of a healthy lifestyle]’.
And such evaluation may evolve both from health care institutions and social advertising, and from the people communicating with the individual. ‘The less an individual complies with contemporary standards of a healthy lifestyle (healthy nutrition, exercise etc) and appearance (slim and attractive body), the more they risk being negatively evaluated in terms of their personal and professional qualities’, Evgenia Golman noted.
In the traditional family model, women bear the responsibility for caring about the family’s well-being and health. This model is supplemented with the imperatives of healthism, which is especially popular among women and dictates norms of beauty and health. ‘Double pressure from gender stereotypes and healthist canons promotes a feeling of guilt and growing stress in women’, the expert said.
And since all this takes place in the context of the modern popular habit of linking health with attractiveness, the categories of the ‘internal body’ (functioning of organs and systems) and ‘external body’ merge. As a result, the goal of healthcare becomes not only to feel well, but also to look good.
New medical technologies have partly become a goal in themselves. Their penetration into various spheres of life has led to further medicalization of everyday life. For example, ‘surveillance medicine’ developed during the 20th century. Such a model of healthcare ‘requires the dissolution of the distinct clinical categories of healthy and ill as it attempts to bring everyone within its network of visibility’, said Evgenia Golman, quoting the British sociologist David Armstrong. This surveillance increases the number of technologies and medicines used daily. This means that a person is seen as a patient a priori.
High-technology medicine often speaks the language of probabilities, trying to calculate possible threats in advance. This leads to the appearance of ‘patients without symptoms’ (a term by British sociologist Andrew Webster). Nevertheless, they lead a life-long regime of health monitoring.
And the ‘healthy lifestyle’ has been successfully commercialized today. For example, fitness bracelets are very popular, which monitor the level of physical activity and the quality of sleep. Other special mobile apps have a similar purpose.
One way or another, one of the results of such a health cult is that overweight people, any vulnerable social strata who can’t afford fitness and healthy food, as well as disabled individuals, are excluded from the ‘group of conscious people’. In these terms, the researcher emphasizes, healthism is close to eugenics, which equals health to ‘patriotism and respectability, and which gives ground to segregation, ageism, and even racism’.
Similarities between the ‘new health consciousness’ and eugenics can be seen particularly clearly in the ethical issues of the ‘new genetics’, especially related to testing embryos, Golman believes. Total diagnostics of genetic disorders in embryos increases the probability of abortion. The problem is that medicine is under threat of changing its focus from a ‘therapeutic role to eliminating what it can’t cure’, the researcher shares the opinion of David Le Breton, a French sociologist and anthropologist.
The development of ‘new genetics’ also opens the potential for ‘gene engineering related to detecting “bad genes” responsible for certain diseases, and promising to exclude them from DNA in future’, Evgenia Golman added.
Social expertise is needed for healthist discourse, the researcher concluded. It’s necessary to study the controversial possible effects of such ideas. There is a high risk that the intrusive propaganda of a ‘healthy lifestyle’ will negatively influence socially vulnerable demographic groups and discriminate against them.