Employing the concepts of risk and governance, this paper develops a specific theoretical and critical perspective on the discourse of health promotion. The paper begins by examining some problems with the influential formulations of risk offered by Ulrich Beck and Anthony Giddens. It then discusses some recent Foucaultian contributions on the topics of risk and governance, and particularly the work of Robert Castel, which draw attention to the role of risk discourse and self-regulatory techniques of governance in those societies exhibiting a form of rule known as 'neo-liberalism'. The paper examines health promotion in the light of the new preventive strategies of social administration that have emerged in these societies and that target the 'at risk' individual and utilise the agency of subjects in processes of self-regulation. It explores some implications of the new risk discourse for the self, and raises some questions about the politics of the enterprise of health promotion as a whole.
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References
1.
Ashton, J. and H. Seymour (1988) The New Public Health: The Liverpool Experience MiltonKeynes: Open University Press .
2.
Beck, U. (1992) Risk Society: Towards a New ModernityLondon: Sage.
3.
Beck, U. (1995) Ecological Politics in an Age of RiskCambridge: Polity Press.
4.
Beck, U., A. Giddens, and S. Lash (1994) Reflexive Modernization: Politics, Tradition and Aesthetics in the Modern Social OrderCambridge: Polity Press.
5.
Bita, N. (1993) 'Bid for fitness bonus under private cover' The Australian 30 April: 2.
6.
Bunton, R. (1992) 'More than a woolly jumper: Health promotion as social regulation'Critical Public Health3(2): 4-11.
7.
Burchell, G. (1993) 'Liberal government and techniques of the self'Economy and Society22(3): 267-82.
8.
Castel, R. (1991) 'From dangerousness to risk', in G. Burchell, C. Gordon and P. Miller (eds) The Foucault Effect: Studies in GovernmentalityHemel Hempstead: Harvester Wheatsheaf: 281-98.
9.
Commonwealth of Australia (1993) Goals and Targets for Australia's Health in the Year 2000 and Beyond, Report prepared for the Commonwealth Department of Health, Housing and Community Services by D. Nutbeam, M. Wise, A. Bauman, E. Harris and S. Leeder, Department of Public Health, University of Sydney, Canberra: AGPS.
10.
Commonwealth of Australia (1994) Better Health Outcomes for Australians: National Goals, Targets and Strategies for Better Health Outcomes Into the Next CenturyCanberra: AGPS.
11.
Crawford, R. (1994) 'The boundaries of the self and the unhealthy other: Reflections on health, culture and AIDS' Social Science and Medicine38(10): 1347-65.
12.
Cruikshank, B. (1993) 'Revolutions within: Self-government and self-esteem ' Economy and Society22(3): 327-44.
13.
Douglas, M. (1990) 'Risk as a forensic resource' Daedalus119(4): 1-16.
14.
Douglas, M. (1992) Risk and Blame: Essays in Cultural TheoryLondon: Routledge.
15.
Douglas, M. and A. Wildavsky (1982) Risk and CultureOxford: Basil Blackwell.
16.
Dutton, K.R. (1995) The Perfectible Body: The Western Ideal of Physical DevelopmentLondon: Cassell.
17.
Finkelstein, J. (1991) The Fashioned SelfCambridge : Polity Press.
18.
Freeman, R. (1991) 'The idea of prevention: A critical review' in S. Scott, G. Williams, S. Platt and H. Thomas (eds), Private Risks and Public DangersAldershot: Avebury: 34-56.
19.
Fujimura, J.H. and D.Y. Chou (1994) 'Dissent in science: Styles of scientific practice and the controversy over the cause of AIDS'Social Science and Medicine38(8): 1017-35.
20.
Giddens, A. (1991) Modernity and Self-Identity: Self and Society in the Late Modern AgeStanford: Stanford University Press.
21.
Glassner, B. (1989) 'Fitness and the postmodern self'Journal of Health and Social Behaviour30(2): 180-91.
22.
Gordon, C. (1991) 'Governmental rationality: An introduction' in G. Burchell, C. Gordon and P. Miller (eds) The Foucault Effect: Studies in GovernmentalityHemel Hempstead : Harvester Wheatsheaf: 1-51.
23.
Greco, M. (1993) 'Psychosomatic subjects and the "duty to be well": Personal agency within medical rationality'Economy and Society22(3): 357-72.
24.
Kawachi, I. and N. Pearce (1991) 'Aluminium in the drinking water—is it safe ?' Australian Journal of Public Health15(2): 84-7.
25.
Koval, R. (1986) Eating Your Heart Out: Food, Shape and the Body IndustryRingwood: Penguin.
26.
Labonte, R. (1990) 'Empowerment: Notes on professional and community dimensions'Canadian Review of Social Policy26: 64-75.
27.
Lash, S. (1994) 'Reflexivity and its doubles: Structure, aesthetics, community' in U. Beck, A. Giddens and S. LashReflexive Modernization: Politics, Tradition and Aesthetics in the Modern Social OrderCambridge: Polity Press : 110-73.
28.
Lash, S. and J. Urry (1994) Economies of Signs and SpaceLondon: Sage.
29.
Lash, S. and B. Wynne (1992) 'Introduction' in U. BeckRisk Society: Towards a New ModernityLondon: Sage: 1-8.
Luhmann, N. (1993) Risk: A Sociological TheoryNew York: Walter de Gruyter.
32.
McMichael, A.J. and G.D. Slade (1991) 'An element of dental health? Fluoride and dental disease in contemporary Australia'Australian Journal of Public Health, 15(2): 80-3.
33.
National Health Strategy (1993) Pathways to Better Health Issues Paper No. 7 (March), Canberra: AGPS.
34.
Rose, N. (1993) 'Government, authority and expertise in advanced liberalism', Economy and Society22(3): 283-99.
35.
Rose, N. and P. Miller (1992) 'Political power beyond the state: Problematics of government'British Journal of Sociology, 43(2): 173-205.
36.
Scott, S. and G. Williams (1991) 'Introduction' in S. Scott, G. Williams, S. Platt and H. Thomas (eds) Private Risks and Public DangersAldershot : Avebury: 1-7.
37.
Waldby, C., S. Kippax and J. Crawford (1995) 'Epidemiological knowledge and discriminatory practice: AIDS and the social relations of biomedicine' The Australian and New Zealand Journal of Sociology31(1): 1-14.
38.
Wallerstein, N. (1993) 'Empowerment and health: The theory and practice of community change'Community Development Journal28(3): 218-27.
39.
Yeo, M. ( 1993) 'Toward an ethic of empowerment for health promotion'Health Promotion International8(3): 225-35.
