Abstract
This article seeks to advance our understanding of the convergence of physical activity and public health through a novel theorization drawing upon, applying and developing figurational sociological principles of Norbert Elias. More specifically, we focus on four core aspects of Elias’ theoretical corpus: interdependencies; forethought (as an aspect of civilizing processes); the interaction of “fact” and emotion in socially determining knowledge; and finally, the hinge. As such, we argue that contemporary interest in physical activity health promotion can be attributed to the amalgamation of distinctive figurations of interdependency ties; an associated development in the internalization of human self-control; conceptions of ‘truth’, which derive from a combination of scientific evidence, ideological desires and the gratification brought from the ‘holding’ of such beliefs; and the intersection of social and biological processes on the human body. This paper advances existing figurationally informed theoretical analyses of health and medicine, in highlighting the essential interconnectivity of Elias’s key ideas. This approach is, in turn, more faithful to Elias’ advocacy of a radically relational sociological perspective. The result is both an original conceptualization of this increasingly significant social phenomenon, and a more explicit elucidation of the distinctive Eliasian framework through which future theoretically informed empirical research into contemporary health and medicine can be developed.
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References
Allen, D., L. Griffiths, and P. Lyne. 2004. Understanding complex trajectories in health and social care provision. Sociology of Health and Illness 26: 1008–1030.
AMRC. 2015. Exercise: The miracle cure and the role of the doctor in promoting it. London: Academy of Medical Royal Colleges.
Andersen, L.B., J. Mota, L. Di Pietro. 2016. Update on the global pandemic of physical inactivity. The Lancet 388 (10051): 1255–1256.
Aronowitz, R. 2009. The converged experience of risk and disease. The Milbank Quarterly 872: 417–442.
Atkinson, M. 2008. Triathlon, suffering and exciting significance. Leisure Studies 27: 165–180.
Atkinson, M. 2012. Norbert Elias and the body. In Routledge handbook of the body, ed. B.S. Turner, 49–61. New York: Routledge.
Atkinson, M. 2018. Elias’s contribution to the sociology of the body: The rediscovery of the hinge. In Excitement processes: Norbert Elias’s unpublished works on sports, leisure, body, culture, ed. J. Haut, P. Dolan, D. Reicher, and R. Sánchez García, 287–303. Wiesbaden: Springer.
Ayo, N. 2012. Understanding health promotion in a neoliberal climate and the making of health conscious citizens. Critical Public Health 22: 99–105.
Baarts, C., and I. Pederson. 2009. Derivative benefits: Exploring the body through complementary and alternative medicine. Sociology of Health and Illness 315: 719–733.
Barlosius, E., and A. Philipps. 2015. Felt stigma and obesity: Introducing the generalized other. Social Science and Medicine 130: 9–15.
Bauman, Z. 2000. Liquid modernity. Cambridge: Polity Press.
Beck, U. 1992. Risk society: Towards a new modernity. London: Sage Publications.
Bell, K., and Green, J. 2016. On the perils of invoking neoliberalism in public health critique. Critical Public Health 26: 239–243.
Berryman, J. 2010. Exercise is medicine: A historical perspective. Current Sports Medicine Reports 94: 1–7.
Binkley, S. 2009. The civilizing brand: Shifting shame thresholds and the dissemination of consumer lifestyles. European Journal of Cultural Studies 121: 21–39.
Brown, P., M.A. Elston, and J. Gabe. 2015. From patient deference towards negotiated and precarious informality: An Eliasian analysis of English general practitioners’ understandings of changing patient relations. Social Science and Medicine 146: 164–172.
Burkitt, I. 1993. Overcoming metaphysics: Elias and Foucault on power and freedom. Philosophy of the Social Sciences 23: 50–72.
Chesham, R.A., J.N. Booth, E.L. Sweeney, G.C. Ryde, T. Gorely, N.E. Brooks, and C.N. Moran. 2018. The Daily Mile makes primary school children more active, less sedentary and improves their fitness and body composition: A quasi-experimental pilot study. BMC Medicine. https://doi.org/10.1186/s12916-018-1049-z.
Conveney, J., and R. Bunton. 2003. In pursuit of the study of pleasure: Implications for health research and practice. Health 72: 161–179.
Crawford, R. 1980. Healthism and the medicalization of everyday life. International Journal of Health Services 103: 365–388.
De Swaan, A. 1989. The reluctant imperialism of the medical profession. Social Science and Medicine 2811: 1165–1170.
Dopson, S., and I. Waddington. 1996. Managing social change: A process-sociological approach to understanding change within the National Health Service. Sociology of Health and Illness 184: 525–550.
Dunning, E., and J. Hughes. 2013. Norbert Elias, sociology and the human crisis: Interdependence, power, process. Cambridge: Polity.
Elias, N. 1978. What is sociology?. London: Hutchinson.
Elias, N. 1982. The civilizing process: State formation and civilization. New York: Pantheon.
Elias, N. 1983. The court society. Oxford: Basil Blackwell.
Elias, N. 1985. The loneliness of the dying. Oxford: Basil Blackwell.
Elias, N. 1987a. Involvement and detachment. Oxford: Blackwell.
Elias, N. 1987b. On human beings and their emotions: A process-sociological essay. Theory, Culture and Society 4: 339–361.
Elias, N. 1987c. The retreat of sociologists into the present. Theory, Culture Society 4: 223–247.
Elias, N. 1991a. The society of individuals. Oxford: Basil Blackwell.
Elias, N. 1991b. The symbol theory. London: Sage.
Elias, E. 1998. Technization and civilization. In The Norbert Elias reader, ed. J. Goudsblom and S. Mennell, 212–229. Oxford: Blackwell.
Elias, N. 2000. The civilizing process: Sociogenetic and psychogenetic investigations. Oxford: Blackwell Publishers.
Elias, N. 2018. The ‘Rediscovery’ of the body. In Excitement processes: Norbert Elias’s unpublished works on sports, leisure, body, culture, ed. J. Haut, P. Dolan, D. Reicher, and R. Sánchez García, 277–285. Wiesbaden: Springer.
Elias, N., and E. Dunning. 1986. Quest for excitement: Sport and leisure in the civilizing process. Oxford: Blackwell.
Elias, N., and J. Scotson. 1994. The established and the outsiders: A sociological inquiry into community problems, 2nd ed. London: Sage.
Evans, A.B., A. Carter, G. Middelton, and D.C. Bishop. 2016. Personal goals, group performance and ‘social’ networks: Participants’ negotiation of virtual and embodied relationships in the ‘Workplace Challenge’ physical activity programme. Qualitative Research in Sport, Exercise and Health 8: 301–318.
Evans, B., R. Colls, and K. Hörschelmann. 2011. ‘Change4Life for your kids’: Embodied collectives and public health pedagogy. Sport, Education and Society 16: 323–341.
Flores, R., and P. Brown. 2018. The changing place of care and compassion within the English NHS: An Eliasean perspective. Social Theory and Health 16: 156–171.
Freund, P. 2015. Norbert Elias and Erving Goffman: Civilised-dramaturgical bodies, social status and health inequalities. In The Palgrave handbook of social theory in health, illness and medicine, ed. F. Collyer, 158–173. London: Palgrave Macmillan.
Gibson, K. 2018. Laboratory production of health and performance: An ethnographic investigation of an exercise physiology laboratory. Sport in Society. https://doi.org/10.1080/17430437.2018.1435002.
Glassner, B. 1990. Fit for postmodern selfhood. In Symbolic interactionism and cultural studies, ed. H. Becker and M. McCalls. Chicago: Chicago University Press.
Goudsblom, J. 1986. Public health and the civilizing process. The Milbank Quarterly 642: 161–188.
Henderson, H.E., A.B. Evans, J. Allen-Collinson, and N.A. Siriwardena. 2018. The ‘wild and woolly’ world of exercise referral schemes: Contested interpretations of an exercise as medicine programme. Qualitative Research in Sport, Exercise and Health 10 (4): 505–523.
Horrocks, C., and S. Johnson. 2014. A socially situated approach to inform health and wellbeing. Sociology of Health and Illness 362: 175–186.
Jane, B., and K. Gibson. 2017. Big Food’s sponsorship of physical activity promotion programmes: Part of the solution or conflict of interest? Journal of Public Health. https://doi.org/10.1093/pubmed/fdx065.
Kay, T. 2016. Bodies of knowledge: Connecting the evidence bases on physical activity and health inequalities. International Journal of Sport Policy and Politics 84: 539–557.
Lobelo, F., M. Stoutenberg, and A. Hutber. 2014. The exercise is medicine global health initiative: A 2014 update. British Journal of Sports Medicine 48 (22): 1627–1633.
Lupton, D. 1995. The imperative of health. Public health and the regulated body. London: Sage.
Malcolm, D. 2017. Sport, medicine and health: The medicalization of sport?. London: Routledge.
Malcolm, D., and K. Gibson. 2018. Figurational sociological approaches to sport, exercise and health. In Figurational research in sport, leisure and health, ed. D. Malcolm and P. Velija, 168–181. London: Routledge.
Malcolm, D., M. Orme, M. Morgan, and L. Sherar. 2017. Chronic Obstructive Pulmonary Disease (COPD), Illness narratives and Elias’s sociology of knowledge. Social Science Medicine 192: 58–65.
McKenzie, S. 2013. Getting physical: The rise of fitness culture in America. Lawrence, KS.: University Press of Kansas.
Mowles, C. 2011. Planning to innovate. Designing change or caught up in a game? Perspectives in Public Health 1313: 119–123.
Nesti, M. 2016. Exercise for health: Serious fun for the whole person? Journal of Sport and Health Science 5: 135–138.
Nettleton, S. 2007. Retaining the sociology in medical sociology. Social Science and Medicine 65: 2409–2412.
Neville, R.D. 2013. Exercise is medicine: Some cautionary remarks in principle as well as in practice. Medicine, Health Care and Philosophy 16: 615–622.
Nutbeam, D. 2008. What would the Ottawa Charter look like if it were written today? Critical Public Health 18 (4): 435–441.
Offer, A. 2006. The challenge of affluence. Self-control and well-being in the United States and Britain since 1950. Oxford: Oxford University Press.
Pinnell, P. 1996. Modern medicine and the civilising process. Sociology of Health and Illness 181: 1–16.
Popay, J., M. Whitehead, and D. Hunter. 2010. Editorial: Injustice is killing people on a large scale—But what is to be done about it. Journal of Public Health 322: 148–149.
Porter, D. 1999. Health, civilization and the state: A history of public health from ancient to modern times. London: Routledge.
Powell, K., M. Thurston, and D. Bloyce. 2014. Local status and power in area-based health improvement partnerships. Health 18: 561–579.
Powell, K., M. Thurston, and D. Bloyce. 2017. Theorising lifestyle drift in health promotion: Explaining community and voluntary sector engagement practices in disadvantaged areas. Critical Public Health 275: 554–565.
Pronger, B. 2002. Body fascism: Salvation in the technology of physical fitness. Toronto: University of Toronto Press.
Pullen, E., and D. Malcolm. 2018. Assessing the side-effects of the ‘Exercise Pill’: The paradox of physical activity health promotion. Qualitative Research in Sport, Exercise and Health. 10 (4): 493–504. https://doi.org/10.1080/2159676X.2017.1388833.
Sallis, R.E. 2009. Exercise is medicine and physicians need to prescribe it! British Journal of Sports Medicine 43 (1): 3–4.
Shilling, C. 2013. The body and social theory, 3rd ed. London: Sage.
Smith, D. 2001. Norbert Elias and modern social theory. London: Sage.
Smith, A. 2016. Exercise is recreation not medicine. Journal of Sport and Health Science 5: 129–134.
Stuij, M. 2011. Explaining trends in body weight: Offer’s rational and myopic choice vs Elias’ theory of civilizing processes. Social History of Medicine 243: 796–812.
Stuij, M., and R. Stokvis. 2015. Sport, health and the genesis of a physical activity policy in the Netherlands. International Journal of Sport Policy and Politics 7: 217–232.
Thing, L.F., M. Hybholt, A. Jensen, and L. Ottesen. 2017. Football Fitness’: Constraining and enabling possibilities for the management of leisure time for women. Annals of Leisure Research 20 (4): 427–445.
van Krieken, R. 1998. Norbert Elias. London: Routledge.
Waddington, I. 2000. Sport, health and drugs: A critical sociological perspective. London: E & FN Spon.
Weber, M. 1968. Economy and society: An outline of interpretive sociology. New York: Bedminster Press.
Wen, C.P., and X. Wu. 2012. Stressing harms of physical inactivity to promote exercise. The Lancet 3809838: 192–193.
Williams, O., and K. Gibson. 2018. The poisoned Elixir: Inactivity, inequality and intervention. Qualitative Research in Sport, Exercise and Health 10 (4): 412–428. https://doi.org/10.1080/2159676X.2017.1346698.
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Gibson, K., Malcolm, D. Theorizing physical activity health promotion: towards an Eliasian framework for the analysis of health and medicine. Soc Theory Health 18, 66–85 (2020). https://doi.org/10.1057/s41285-019-00098-w
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DOI: https://doi.org/10.1057/s41285-019-00098-w