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This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in several disciplines, but this approach neglects the structural dimensions of such lifestyles and has limited applicability to the empirical world. The direction of this article is to present a theory of health lifestyles that includes considerations of both agency and structure, with an emphasis upon restoring structure to its appropriate position. The article begins by defining agency and structure, followed by presentation of a health lifestyle model and the theoretical and empirical studies that support it.
An important but undeveloped area of theoretical discourse in medical sociology pertains to the relative contributions of agency and structure in determining health lifestyles. Medical sociologists have paid little attention to the agency-structure problem, yet it is clearly central to theoretical discussions of health and lifestyles (Pescosolido, McLeod, and Alegría 2000; Williams 1995). No contemporary theoretical perspective denies that either agency or structure is unimportant; rather, the debate centers on the extent to which one or the other is dominant. Proponents of structure emphasize the power of structural conditions in contouring individual dispositions and behavior along socially prescribed lines, while advocates of agency accentuate the capacity of individual actors to choose their behavior regardless of structural influences. When applied to health lifestyles, the question is whether the decisions people make with respect to diet, exercise, smoking, and the like are largely a matter of individual choice or are principally shaped by structural variables such as social class position and gender?
THE NEED FOR A HEALTH LIFESTYLE THEORY
It is the purpose of this article to examine the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists. The need for a health lifestyle theory is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. Perhaps this is truer today than in the past. Whereas people may have more or less taken their health for granted in previous historical eras, this is presently not the case. Health...