NPRI
UK Society for Behavioural Medicine 9th Annual Scientific Meeting
“Behavioural Medicine: From Laboratory to Policy”
University of Oxford Examination Schools
Monday 9 and Tuesday 10 December 2013
NPRI
UK Society for Behavioural Medicine 9th Annual Scientific Meeting
“Behavioural Medicine: From Laboratory to Policy”
Keynote Speaker
Professor Judith Green
Changing social practice: a view from
sociology
Judith Green
Changing social practice:
A view from sociology
Improving health worldwide
www.lshtm.ac.uk
Percentage of adults who cycle in London, by gender and ethnicity (London Travel Demand Survey)
A public health
‘problem’
We are increasingly sedentary
Some evidence of an association with obesity
Everyday travel could be more ‘active’
Public health efforts to change behaviour: encourage walking and cycling
Few successful interventions and social inequalities in ‘active travel’
Mobility and social
practice
What happens if we see travel mode choice not as ‘health behaviour’ but as ‘social practice’?
Question moves from: What are individuals’ motivations, perceptions of risks and benefits, barriers to change?’
To:
• How are our cultural/material/social worlds organised so that practices are normal, legitimate, possible, marginal?
• What are the conditions of possibilities for change?
Ralph
Glasser:
From
Glasgow to
Oxford
I wheeled the bike out of our flat on the third, top floor of the Gorbals tenement, and leaned it against the iron stairhead railing… I would carry the bike down the winding stairs and ride away, further than I had ever travelled, to take up the scholarship …
Cycling, London,
early 21st
century
“ …my friends joke that it’s very middle class, that it sort of fits in with the lifestyle of gardening, listening to Radio 4, eating organic food and cycling … It makes me feel smug … I’m not hurting the environment, I’m not going to get fat’”
(Charlotte, reported in Steinbach et al Soc
Sci Med 2011)
Cycling is a social practice, not a behaviour
• Field: structured social space (eg: sports, health, opera)
• Capital: not just financial – also cultural, social, physical etc (these have exchange value)
• Habitus: a set of dispositions formed in fields (eg: assumptions about gender, aesthetic taste, food preferences)
• Doxa: set of taken for granted beliefs, assumptions about the world (‘tacit knowledge’)
• Hexis: how these beliefs are embodied (eg: how women or men sit, or walk)
Social practice is:
Habitus + Capital in a particular Field
(Lack of) cultural capital
• I'm a Muslim female, I don't think it would be culturally accepted if I were to [cycle] ... people would raise their eyebrows … people would think I was really tight because I'm probably obviously saving on the pennies (Jasmine)
• So basically, it’s people can’t afford to drive that actually will cycle … I can recall even walking, for example, and having people from my community saying “Why are you walking?” (Lester)
• When you’ve made it, you buy a car not a bicycle (Leanne)
‘Reasons’ and tacit
knowledge
Shila: So if you’re using the bicycle, what about the children? How are you going to bring them to school? You have, ride the bicycle, and where are the kids? [all laugh] Where do you put them? So, that’s not a good idea! Deepa: And another thing is that, because everyone lives in a flat, and there’s not enough space, so where would you put your bike?
Anjali: And it’s not useful for us because we, if we wear a jilbab, how are we going to ride a bike?
Dispositions and risk:
congruent 1
TAKING Risks can bolster embodied male identity:
“It’s a bit of adrenalin; it’s good for a moment… I’m a hardened cyclist, I won’t have people just cutting me up… I might consider myself a bit of a, what they might call an urban warrior on a bike” (Russ)
Dispositions and
risk: congruent 2
MANAGING RISKS can allow performance of independent female identities:
I think men can be a deterrent to women actually ... I don’t care, I’m not interested in what [husband] thinks now, I just get on my bike… if I listened to him I wouldn’t do it, do you know what I mean? ... I try to be assertive when I’m cycling, I feel that you have to have a confidence (Kelly)
Dispositions and
risk: incongruent
The risks of ‘assertive contagion’ do not fit some (gendered) identities:
“I do see those people and you can tell they're professional cycle commuters because they adopt the other attitude that I think almost you can see in their faces they've gone from feeling vulnerable to being aggressive to other people… that kind of psychological thing, thinking about that could actually change you to be an aggressive person.” (Abigail)
When and how does
practice change?
A case study
Candy, a Black British woman, 30s, living in inner London
Rosalind, a White British woman in her 50s, living in outer London
Both motivated by health, wanting to learn a new skill
Left beginners’ course with ability to balance and move
Rosalind’s story
“The friend who hadn’t cycled for ten years, now she’s thinking of getting a bike … and my Yoga teacher […] she said, oh, I will definitely sign up for it”
Candy’s story
“I’ve only done it once […] but I’ve just been seeing some horrible things with buses and bikes, and I’m just like, I think I’m really quite frightened to go on the road, so that’s probably what’s stopping me from doing it. I was finding it difficult to start off, once I start I hope I can pedal and get around ... I just found it difficult to start off, get my head and feet working together”
Rosalind:
Change enacted
• There is a group of “cycling ladies” in the park with whom “I went up to Cleveley, and over to the pub”
• “My husband comes with me because I’m not so steady doing hand signals”
• “I consider myself a cyclist now”
Candy:
Change thwarted
“Well I need to get it to the park, and you know? And then, well I haven’t got the time to go to the park, and if I get home it’ll be like six and stuff, also with the kids, round my area there’s a lot of kids who take over the park, and I don’t want to be the adult trying to learn how to ride a bike, you know what I mean? It’s all these factors, no I’ll go on a bus instead, or go out instead”.
Implications for
increasing cycling
• Asking about ‘barriers’ will elicit ‘barriers’: not the less easily articulated elements of habitus
• ‘Health’ motivates; but is rarely a priority
• Addressing explicit ‘barriers’ in promotion is risky
• We need to look at ‘fields’: encouraging leisure cycling, for instance, to increase the number of commuters
Implications for
behaviour change
• Avoid naive reading of ‘barriers’ to change
• ‘Behaviours’ are not separable from the inter-relationships of field and habitus
• If we want to change practice, may be productive to look at what conditions of possibility exist for change
Conclusion
• Understanding why people do what they do, and the (material, cultural and social) circumstances in which change what they do involves more than taking accounts at face value (putting ‘behaviour’ in its place).
• Once we understand why people do what they do, we can look at when, why and how they change (putting ‘health’ in its place)
• We can then identify how social practices more or less congruent with health are likely to be fostered
Acknowledgements
This paper draws on work from projects undertaken by the Transport and Health Group, LSHTM, funded by Transport for London, NHS Camden and Dept of Health. I thank: colleagues in the group, particularly Rebecca Steinbach and Phil Edwards; and Sarah Nettleton, University of York.
Some of the data reported here has been published in the following articles:
Nettleton S and Green J. (forthcoming) Thinking about changing mobility practices: how a social practice approach can help. Sociology of Health and Illness
Steinbach R, Green J, Datta J, and Edwards P. (2011) Cycling and the city: a case study of how gendered, ethnic and class identities can shape healthy transport choices Social Science and Medicine 72: 1123-1130
NPRI
UK Society for Behavioural Medicine 9th Annual Scientific Meeting
“Behavioural Medicine: From Laboratory to Policy”
