Stanley John Blue

Theories of practice and public health: understanding (un)healthy practices

Psychological understandings and individualistic theories of human behaviour and behaviour change have dominated both academic research and interventions at the ‘coalface’ of public health. Meanwhile, efforts to understand persistent inequalities in health point to structural factors, but fail to show exactly how these translate into the daily lives (and hence health) of different sectors of the population. In this paper, we suggest that social theories of practice provide an alternative paradigm to both approaches, informing significantly new ways of conceptualising and responding to some of the most pressing contemporary challenges in public health. We introduce and discuss the relevance of such an approach with reference to tobacco smoking, focusing on the life course of smoking as a practice, rather than on the characteristics of individual smokers or on broad social determinants of health. This move forces us to consider the material and symbolic elements of which smoking is comprised, and to follow the ways in which these elements have changed over time. Some of these developments have to do with the relation between smoking and other practices such as drinking alcohol, relaxing and socialising. We suggest that intervening in the future of smoking depends, in part, on understanding the nature of these alliances, and how sets of practices co-evolve. We conclude by reflecting on the implications of taking social practices as the central focus of public health policy, commenting on the benefits of such a paradigmatic turn, and on the challenges that this presents for established methods, policies and programmes.

Understanding disabling barriers: a fruitful partnership between Disability Studies and social practices?

Abstract Disabled people are regularly denied their human rights, since policies and laws are hard to translate literally into practice. This article aims to make connections between social practice theories and Disability Studies, in order to understand the problems faced by disabled people, using different methods to look in detail at how practices are shaped and how disabled people get excluded. Disabled people are active agents in making change, both informally on an everyday basis and through formal actions. Thus we also suggest that the insights of disabled people could bring a fresh perspective to social practice theories, by troubling the taken-for-granted in our everyday lives.

Institutional rhythms:combining practice theory and rhythmanalysis to conceptualise processes of institutionalisation

The practice turn in social theory has renewed interest in conceptualising the temporal organisation of social life as a way of explaining contemporary patterns of living and consuming. As a result, the interest to develop analyses of time in both practice theories and practice theory-based empirical research is increasing. Practice theorists draw on theories of time and ideas about temporal rhythms to explain how practices are organised in everyday life. To date, they have studied how temporal experiences matter for the coordination of daily life, how temporal landscapes matter for issues of societal synchronisation, and how timespace/s matter for the organisation of human activity. While several studies refer to, draw on, and position themselves in relation to ideas about temporal rhythms, those working with theories of practice have yet to fully utilise the potential of Lefebvre’s rhythmanalysis for explaining the constitution of, and more specifically, changes within, social life. I argue that rhythmanalysis can be effectively combined with practice theory to better articulate the ways in which practices become connected through what I describe as processes of institutionalisation. I argue that this combination requires repositioning the role of time in theories of practice as neither experience, nor as landscape, but, building on Schatzki’s work on The Timespace of Human Activity, as practice itself. Drawing on Lefebvre’s concepts of arrhythmia and eurhythmia, and developing Parkes and Thrift’s notion of entrainment, I illustrate how institutional rhythms, as self-organising, open, spatiotemporal practices emerge, endure, and evolve in ways that matter for both socio-temporal landscapes and temporal experiences.

Maintaining physical exercise as a matter of synchronising practices : experiences and observations from training in Mixed Martial Arts

Abstract This paper is concerned with the establishment, maintenance, and decline of physical exercise practices. Drawing on experiences and observations taken from a carnal ethnography and rhythmanalysis of the practices involved in training in Mixed Martial Arts (MMA), I argue that maintaining this physical exercise practice is not straightforwardly an outcome of individual commitment, access to facilities, or the availability of free time. It rather depends on the synchronisation of practices: those of MMA, those that support MMA, and those that more broadly make up everyday life. This research suggests that increasing rates of physical activity might be better fostered through facilitating the integration of combinations of healthy activities into everyday life.

Reducing Demand for Energy in Hospitals : Opportunities for and Limits to Temporal Coordination

This chapter describes some of the ways that demand for energy is made in hospitals. It develops an account of energy demand as the outcome of the organisation of connected working practices that constitute the regular provision of healthcare. Drawing on interview data taken from an ethnographic study of institutional rhythms and the organisation of working practices in hospitals, it describes how changes in the material arrangements, professional boundaries and temporalities that underpin hospital life affect the fixity and flexibility of connections between practices in ways that matter for the potential for large institutions to achieve demand side response and to foster the design of new and less resource-intensive ways of working.