The Social Life of Health Behaviors: The Political Economy and Cultural Context of Health Practices

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Relocating health behaviors within a political-economic framework, this article utilizes health behavior and health insurance governance perspectives to showcase the complexities of cultural and economic factors (e.g., job lock, wage differentials, social location, and health insurance status) that influence choices in efforts to mitigate the financial burden of health risk. By exploring the financial links to health behaviors that emerged through ethnographic participant observation and semistructured interviews with community and union members of the United Steelworkers and Retail, Wholesale, and Department Store Union in a metropolitan Central Appalachian community in 2007–8, this article argues for expanding the health behaviors concept to include a broader array of actions individuals and families take to better their health and well-being in the context of neoliberal shifting of risk management to individuals through increased consumer market-based cost-sharing health insurance disincentives. In so doing, this article argues for the importance of social and political-economic context in health behaviors and in evaluating health policy, including the Affordable Care Act.