'Just do it': An analysis of accounts of control over health amongst lower socioeconomic status groups

Abstract

Recent interest in health inequalities research has focused upon psychosocial factors such as a sense of control. Previous work has sought to measure or describe personal beliefs about control over health without addressing the contradictory and rhetorical dimensions of such accounts. These issues are explored through an analysis of interviews with 30 lower socioeconomic status (SES) participants drawn from two qualitative studies of health inequalities. Key findings concern the rhetorical construction and interweaving of two contrasting positions regarding control over health: fatalism and positive thought. Fatalistic talk provided a means by which participants acknowledged their limited control over health, although not in an exclusively negative manner. Talk about thinking positively enabled participants to present themselves as having agency in the face of adversity. The creative interweaving of these two positions in accounts of control over health enabled participants to navigate the moral imperative of responsibility for health in the context of adverse and capricious circumstance. By foregrounding the social character of accounts of control the significance of moral and ethical dimensions for health inequalities research and practice are highlighted.