Economic rationalisation of health behaviours: the dangers of attempting policy discussions in a vacuum.
When analysing the health behaviours of any group of people, understanding the constraints and possibilities for individual agency as shaped by the broader societal context is critical. In recent decades, our understanding of the ways in which physical and social environments influence health and health behaviours has expanded greatly. The authors of a recent analysis of Australian Aboriginal health data using an economic 'rational choice model,' published in this journal, claim to make a useful contribution to policy discussions relating to Aboriginal health, but neglect context. By doing so, they neglect the very factors that determine the success or failure of policy change. Notwithstanding the technical sophistication of the analyses, by ignoring most relevant determinants of health, the conclusions misrepresent the lives of Aboriginal and Torres Strait Islander people and therefore risk perpetuating harm, rather than improving health.
Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5001, Australia. Electronic address: rachel.reilly@sahmri.com.
Rachel
R
Reilly
Onemda VicHealth Koori Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Vic 3010, Australia. Electronic address: rowleyk@unimelb.edu.au.
Kevin
K
Rowley
Onemda VicHealth Koori Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Vic 3010, Australia. Electronic address: jnluke@unimelb.edu.au.
Joanne
J
Luke
Onemda VicHealth Koori Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Vic 3010, Australia. Electronic address: jdoy6@bigpond.com.
Joyce
J
Doyle
Centre for Health and Society, Melbourne School of Population and Global Health, The University of Melbourne, Vic 3010, Australia. Electronic address: rebecca.ritte@unimelb.edu.au.
Rebecca
R
Ritte
Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5001, Australia.
Rebekah
R
O'Shea
Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5001, Australia. Electronic address: alex.brown@sahmri.com.
Alex
A
Brown
D001315:Australia; D002755:Choice Behavior; D015438:Health Behavior / Q000208:ethnology*; D006291:Health Policy; D006801:Humans; D008019:Life Style / Q000208:ethnology; D018803:Models, Economic; D011050:Policy Making; D064890:Social Determinants of Health / Q000208:ethnology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
Aboriginal health; Australia; Health inequalities; Health policy; Lifestyle; Rational choice model; Research ethics; Social determinants