The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.

Revisiting the behavioral model and access to medical care: does it matter?

The present historical moment may seem a particularly inopportune time to review Bowling Alone, Robert Putnam's latest exploration of civic decline in America. After all, the outpouring of volunteerism, solidarity, patriotism, and self-sacrifice displayed by Americans in the wake of the September 11 terrorist attacks appears to fly in the face of Putnam's central argument: that \"social capital\" -defined as \"social networks and the norms of reciprocity and trustworthiness that arise from them\" (p. 19)'has declined to dangerously low levels in America over the last three decades. However, Putnam is not fazed in the least by the recent effusion of solidarity. Quite the contrary, he sees in it the potential to \"reverse what has been a 30to 40-year steady decline in most measures of connectedness or community.\"' As an example of how the current \"war on terrorism\" could generate a durable civic renewal, Putnam points to the burst in civic practices that occurred during and after World War II, which he says \"permanently marked\" the generation that lived through it and had a \"terrific effect on American public life over the last half-century.\" 3 If Americans can follow this example and channel their current civic

Bowling alone: The collapse and revival of American community

Ten per cent of the world’s school-aged children are estimated to be carrying excess body fat (Fig. 1), with an increased risk for developing chronic disease. Of these overweight children, a quarter are obese, with a significant likelihood of some having multiple risk factors for type 2 diabetes, heart disease and a variety of other co-morbidities before or during early adulthood. The prevalence of overweight is dramatically higher in economically developed regions, but is rising significantly in most parts of the world. In many countries the problem of childhood obesity is worsening at a dramatic rate. Surveys during the 1990s show that in Brazil and the USA, an additional 0.5% of the entire child population became overweight each year. In Canada, Australia and parts of Europe the rates were higher, with an additional 1% of all children becoming overweight each year. The burden upon the health services cannot yet be estimated. Although childhood obesity brings a number of additional problems in its train – hyperinsulinaemia, poor glucose tolerance and a raised risk of type 2 diabetes, hypertension, sleep apnoea, social exclusion and depression – the greatest health problems will be seen in the next generation of adults as the present childhood obesity epidemic passes through to adulthood. Greatly increased rates of heart disease, diabetes, certain cancers, gall bladder disease, osteoarthritis, endocrine disorders and other obesityrelated conditions will be found in young adult populations, and their need for medical treatment may last for their remaining life-times. The costs to the health services, the losses to society and the burdens carried by the individuals involved will be great. The present report has been written to focus attention on the issue and to urge policy-makers to consider taking action before it is too late. Specifically, the report:

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-789X.2004.00133.x

Obesity in children and young people: a crisis in public health.

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.

/pdf/using-social-and-behavioural-science-to-support-covid-19-25vr5kyvxt.pdf

Using social and behavioural science to support COVID-19 pandemic response.

Too far to walk : maternal mortality in context

This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in several disciplines, but this approach neglects the structural dimensions of such lifestyles and has limited applicability to the empirical world. The direction of this article is to present a theory of health lifestyles that includes considerations of both agency and structure, with an emphasis upon restoring structure to its appropriate position. The article begins by defining agency and structure, followed by presentation of a health lifestyle model and the theoretical and empirical studies that support it.

Health Lifestyle Theory and the Convergence of Agency and Structure

The Social Determinants of Chronic Disease.

Using a probability sample of 660 adults in Illinois, this study focuses on the relationship between age and perceived health status. According to age stratification theory, age groups need to be analyzed as age-specific entities that exist in relation to other sets of age groups. Following this perspective these data examine differences across the spectrum of adult age groups in this sample in regard to self-assessments of health. Number of symptoms was the strongest predictor of perceived health status employed in this analysis, followed by age, education, and race. It was found that those persons belonging to age groups over the age of 60 tend to perceive their own health in a significantly more positive fashion than members of younger adult age groups. The more educated elderly persons and those with the fewest symptoms, however, were most likely to hold this perception. One important area in which people appear to adjust their perception in later life is in their evaluation of personal health status.

Aging and Perceived Health Status

The intent of this article is to move beyond the work of Weber and construct a concept of health lifestyles applicable to the current phase of modernity. Beginning with the early twentieth-century ...

Conceptualizing contemporary health lifestyles : Moving beyond Weber

Preface 1 The Social Causation of Health and Disease 2 Theorizing about Health and Disease 3 Health Lifestyles 4 The Power of Class 5 Class and Health: Explaining the Relationship 6 Age, Gender, and Race/Ethnicity as Structural Variables 7 Living Conditions and Neighborhood Disadvantage 8 Health and Social Capital Concluding Remarks References Index

William C. Cockerham

Papers

Health Lifestyle Theory and the Convergence of Agency and Structure

The Social Determinants of Chronic Disease.

Aging and Perceived Health Status

Conceptualizing contemporary health lifestyles : Moving beyond Weber

Social Causes of Health and Disease