Publication year: 2011
Source: Social Science & Medicine, In Press, Accepted Manuscript, Available online 29 July 2011
Alfred, Rütten , Peter, Gelius
The recent debate in public health about the “inequality paradox” mirrors a long-standing dispute between proponents of structuralist approaches and advocates of action theory. Both views are genuine perspectives of health promotion, but so far they have not been adequately linked by health promotion theory. Using Anthony Giddens’s concepts of structure and agency seems promising, but his theory has a number of shortcomings that need to be amended if it is to be applied successfully to health promotion. After briefly assessing Giddens’ theory of structuration, this paper proposes to add to it both the concept of structural change as proposed…
Highlights: ► Builds a multi-level model of structure and agency from approaches by Giddens, Sewell and Ostrom. ► Applies this model to health promotion and to central claims of the Ottawa Charter. ► Uses a local-level health promotion project to illustrate the explanatory power of the model. ► Interaction of structure and agency on multiple levels helped establish women-only hours at a municipal swimming pool.