Volume 114, August 2014, Pages 66–72
Highlights
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- Explores how social class shapes health beliefs.
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- Demonstrates the contextual basis of the construction & enactment of health beliefs.
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- Reveals the complexity of fatalism and agency, overturning their dichotomy.
Abstract
Existing
literature characterizes fatalism as a passive reaction to health in
the face of powerlessness and constructs agency as a more activist
perspective based in self-efficacy and control. Frequently studied
together, researchers extol agency as the appropriate approach to
decision-making around health, while discouraging fatalistic outlooks.
Despite associating such beliefs with social classes—agency with high
socioeconomic status (SES) groups and fatalism with low SES groups—there
is little research that compares health beliefs across class groups. By
examining the medicalized condition of infertility among women of both
high and low SES, this study examines how social class shapes
reactions to health and illness. Through 58 in-depth interviews with
infertile women in the U.S., we reveal the complexity of fatalism and
agency and the reasons behind that complexity. We first examine the
commonalities among SES groups and their mutual use of fatalism. We then
demonstrate the nuance and continuity between the health beliefs
themselves—fatalism can be agentic and agency can be achieved through
fatalism. In other words, we disrupt the binary construction of health
beliefs, their conflation with social class, and the static application
of health beliefs as psychological attributes, ultimately exposing the
classist basis of the concepts. Doing so can result in improved patient
care and reduced health inequalities.
Keywords
- Health beliefs;
- Fatalism;
- Agency;
- Infertility;
- Women's health;
- Reproduction
Copyright © 2014 Elsevier Ltd. All rights reserved.
