The social life of health behaviors: The political economy and cultural context of health practices

The role of biocultural approaches in assessing interventions for maternal weight and gestational weight gain

Public health and other researchers express growing concern for the role of maternal adiposity and gestational weight gain in driving the obesity epidemic and health disparities based on race and class. Biocultural scholars must continue to contribute to conversations on how best to address issues of population health including the developmental context of obesity, drawing from both evolutionary and social theory. I discuss a number of intervention studies designed to address gestational weight gain in low-income and minority women and consider the degree to which they address the social, political, and economic context, and developmental history of mothers. I further examine the potential for these interventions, focused on the individual behavior of mothers, to contribute to stigma based on socially defined race, class, and body shape and size, and to draw attention away from the powerful economic interests that contribute to and benefit from the obesity epidemic. I end with a discussion of the value of developmental systems theory for thinking critically about obesity and other health interventions.

Thrifting for More: Savings and Aspirations in Health Care Sharing Ministries after the Affordable Care Act

The Affordable Care Act (ACA) of 2010 includes health care sharing ministries (HCSMs) on the list of religious exemptions to the individual mandate. HCSMs are non-profit, faith-based organizations that share in the cost of medical bills but are not actually insurance. Precisely because HCSMs are not beholden to any of the ACA's insurance reforms, they have the advantage of costing less. Based primarily on in-depth interviews, I argue that thrift is the preeminent moral discourse that anchors the HCSM world. For members, thrift in health care is understood as a moral good and as a practice that offers possibilities for benefiting connected others and generating life fulfillment, or what Taylor refers to as "fullness." I suggest that a focus on thrift raises questions about how Americans make determinations about worth in health care and how they construct health care-seeking as deeply attached to their visions of how they want life to be.