The New Public Health: Health and Self in the Age of Risk

227 Pages·1996·15.869 MB·English

by  Alan Petersen and Deborah Lupton

THE NEW PUBLIC HEALTH

THE NEW
PUBLIC HEALTH
Health and self
in the age of risk
Alan Petersen and
Deborah Lupton
SAGE Publications
London · Thousand Oaks · New Delhi
ISBN 0-7619-5403-1 (hbk)
ISBN 0-7619-5404-X (pbk)
© Alan Petersen and Deborah Lupton, 1996
First published 1996 by
Allen & Unwin, Australia
Reprinted 2000
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or criticism or review, as permitted under the Copyright , Designs and
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British Library Cataloguing in Publication data
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Printed digitally and bound in Great Britain by
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Contents
Acknowledgments vii
Introduction ix
1 The new public health: a new morality? 1
2 Epidemiology: governing by numbers 27
3 The 'healthy' citizen 61
4 Risk discourse and 'the environment' 89
5 The 'healthy' city 120
6 The duty to participate 146
Conclusion 174
References 182
Index 199

Acknowledgments
This book was made possible with the assistance and support of many
people and institutions. Alan would like to thank Andrew Lyon (Co-
ordinator, Glasgow Healthy City Project), Ruth Stern (Coordinator,
Camden Healthy Cities Project), Julie Taylor (Coordinator, Liverpool
Healthy City 2000), Dr Greg Goldstein (WHO, Geneva), Heather
McDonald (WHO, Geneva), Stephen Barton (Faculty of Health Sei-
ences, Hinders University of South Australia), Antoinette Ackermann,
and Linda Petersen and staff at the Healthy Cities Project Office in
Copenhagen for giving willingly of their time and for providing items
of information on the Healthy Cities project. He would particularl y like
to acknowledge the generosity and support of Dr Margaret Reid and the
Department of Public Health at the University of Glasgow for allowing
him the opportunity to share some of his early ideas with others at the
Lilybank Seminar and for providing office space during the period of his
stay in Glasgow. Lynne Hunt, of Edith Cowan University, Western
Australia, introduced him to Margaret, for which he is grateful.
Alan would also like to thank the following people with whom he
discussed aspects of the work while in the UK in 1995: Dr Robin Bunton,
Dr Lesley Jones, Dr Sarah Nettleton, Roger Burrows, Dr David Armstrong,
Professor Nikolas Rose, Dr Ade Keans, Jill Russell, Dr Graham Hart and
Dr Simon Carter. Closer to home, he would like to thank everyone in
the Sociology Program, Murdoch University, Western Australia, for pro-
viding such a supportive and stimulating environment; Associate
Professor Patricia Harris for reading and offering feedback on his earlier
draft chapters (the usual disclaimer applies); Dr Charles Waddell
(Department of Anthropology, University of Western Australia) for his
constant encouragement; and Murdoch University, which funded a
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viii THE NEW PUBLIC HEALTH
period of study leave in which he was able to undertake research and
meet the above people. Finally, he would like to thank Ros Porter, who
has accompanied him on his journeys and has been a constant source
of support.
Deborah thanks her previous place of work, the University of West-
ern Sydney, Nepean, for granting study leave for the first semester of
the 1995 academic year, during part of which she wrote the first drafts
of her chapters. She also thanks Gamini Colless for his continuing
support of her work. We both thank Elizabeth Weiss from Allen &
Unwin for her guidance on this project.
Both authors contributed in equal measure to this book. Alan wrote
Chapters 5 and 6 and most of Chapter 1 and Deborah wrote Chapters 2,
3 and 4, with each of us editing drafts of the other's work. The Introduction
and Conclusion are joint efforts.
Introduction
'Lose weight!' 'Avoid fat!' 'Stop smoking!' 'Reduce alcohol intake!' 'Get
fit!' 'Practise safe sex!' 'Play safe!' In contemporary Western societies the
health status and vulnerability of the body are central themes of exist-
ence. Individuals are expected to take responsibility for the care of their
bodies and to limit their potentia l to harm others through taking up
various preventive actions. Increasingly they are also expected, as part
of their responsibilities of citizenship, to manage their own relationship
to the risks of the environment, which are seen to be everywhere and
in everything. With the emergence of concerns about ecological crisis,
we have all been forced to confront the global nature of threats to both
self and society and to consider what we, individually , can do to protect
our health and that of our fellow citizens. Everyone is being called upon
to play their part in creating a 'healthier', more 'ecologically sustainable'
environment through attention to 'lifestyle' and involvement in variou s
collective and collaborative endeavours. All these concerns, expectations
and projects come together in, and are articulated through, an area of
expert knowledge and action that has come to be known as 'the new
public health'.
The new public health takes as its foci the categories of 'population'
and 'the environment', conceived of in their widest sense to include
psychological, social and physical elements. With the development of this
perspective, few areas of personal and social life remain immune to scrutiny
and regulation of some kind. Given the scope of the new public health,
and its impact on virtually all aspects of everyday life, there has been
surprisingly little critical analysis of its underlying philosophies and its
practices. The new public health has been warmly embraced by people of
diverse backgrounds and political persuasions. It has been represented as
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