I like a pint.

On occasion, I may be found in ‘The Sloop’ in St Ives, or the ‘Pilchard Press’ in the same seaside town.

I like a pasty. A proper Cornish pasty stuffed with succulent steak wrapped in short crusty pasty oozing with gravy.

I am certainly not alone in liking a pint and a pasty. I rather suspect the majority of the male population in Cornwall also indulge. Women can be seen to like a pasty as well. It is not just a male thing of course. But if we are making generalisations, then the women will more often swap the pint for a half, or a wine.

This is very highly patterned behaviour, observable and measurable. The question for sociologists is this: Is the phenomenon of pint and pasties merely an aggregate of individual decision making or is there something social going on behind our backs? Are any of us being invisibly steered by a ‘social force’ that makes the drinking of a pint and the eating of a pasty almost inevitable, given a certain set of social circumstances in time and in place? To what degree are we making autonomous decisions out of free will as rational individuals?

This question should also be asked by those who feel strongly that we should all be taking individual responsibility for health, that we only have ourselves to blame if we eat too much, drink too much and fail to run a marathon. However, it is the case that those most in support of the ‘lifestyle responsibility’ point of view are those least able or likely to ask that question, and for the same reason for why we drink beer and eat pasties.

They utterly fail to account for ‘structured agency’.

Social ‘Forces’ or ‘Structures’

Are there social ‘forces’, is there a non-material reality that acts upon us?

In The Rules of Sociological Method (The Free Press, 1982, pp. 35-36) Émile Durkheim writes:

“The proposition which states that social facts must be treated as things…stirred up the most opposition. It was deemed paradoxical and scandalous for us to assimilate to the realities of the external world those of the social world. This was singularly to misunderstand the meaning and effect of this assimilation, the object of which was not to reduce the higher forms of being to the level of lower ones but…to claim for the former a degree of reality at least equal to that which everyone accords to the latter….we do not say that social facts are material things, but that they are things just as are material things, although in a different way.”

Durkheim famously wrote about suicide and noted patterns in the data. He saw differences in rates between Catholics and Protestants. This was a social fact, that not unlike a material thing can affect human behaviour.

Ever since social theory has tried to understand human behaviour as arising either from structures in which individual agency disappears into society so that we become products of society. Or, much later, postmodernist theory went the other way to suggest that individual agency disappears into language – that language and not society is what constructs reality. If you can’t speak of it then it does not exist.

Having read the work of Margaret Archer and Roy Bhaskar, the sociologist Graham Scambler argues for a different way that neither gives undue emphasis on society or language.

Humans, I have contended elsewhere, are simultaneously the products of biological, psychological and social mechanisms whilst retaining their agency. Acknowledgement must be made also of the sometimes mundane and sometimes dramatic interruptions of contingency. Thus, humans can be said to be biologically, psychologically and socially ‘structured’ without being structurally determined”.    (Graham Scambler 2013).

This is a theory of ‘structured’ human agency which tries to explain why we do what we do: to smoke, drink alcohol, to eat too much, to be sedentary or even to drive recklessly. We need a theory of human agency to assist in understanding our decision making, and for example differentials in health outcomes.

By ‘contingency’, I think Scambler refers to the existence of random, unpredictable events and developments that impact upon our exercise of agency. An example is the explosion of social media into our lives, the effects of which, on our choices to act, we are yet to fully understand.

‘Structured Agency’

The theory of Structured Agency rests upon three propositions:

1. Ontological Realism: There exists both a natural world and a social world independent of our knowledge of them. There is such a thing as society in which powerful global actors take decisions that affect the health of billions and in which social structures exist to encourage beer drinking. Society predates us and ‘exists’ whether we believe it does or not. Just as with gravity, we cannot see it but we can measure its effects. The realities of my social world include a very long history of beer as a taken for granted social glue, as a much-valorised product, a much-promoted product, and in my younger days as a rite of passage towards both adulthood and masculinity. My social world involves the existence of breweries and pubs and masculine bonding. My social world also excludes strictures against drinking beer, however I have experienced a social setting in which it is frowned upon. The social world in which I now live affects my decision making daily, mostly unconsciously. It does not determine it, as I can always exercise agency, but in my context, the effects are very strong. Whether I acknowledge these social facts is irrelevant to whether I drink beer or not. These then are the social mechanisms operating behind my back. I’ll leave the psychological and biological mechanisms for another day.

2. Epistemological Relativism: what we can know is unavoidably a function of time and place. This knowledge is also fallible and is ‘socially constructed’ by us in our everyday lives.  For example, many of those who believe that the ‘moral underclass’ is responsible for the ills they experience, do so based in a knowledge that has been created within the time and place(s) of their lives. If I do not know of any sociological theory then I cannot begin to fully understand my own behaviours at this point in time in this society. I will be unable to exercise a sociological imagination and therefore I am more likely to ‘know’ that people are weak-willed and that they should just take responsibility. I may even ‘know’ that alcoholism is a mainly physical addiction. I may not know it as a psycho-social phenomenon related to early childhood trauma.

3. Judgmental Rationality: Despite knowledge being socially constructed by our position in time and place, we can decide between alternative theories and discourses, for example about poverty and health, on rationally compelling grounds, if we so wish to do so.  If we wish to do so! For many of us we do not wish to do so, we’d rather lazily victim blame, to stigmatise, in order to distance ourselves from the morally weak, to feel superior or to attribute our own health solely down to the exercise of our superior human agency. We do not want to or are not willing to exercise judgmental rationality and we do not seek out alternative theories and evidence about human behaviour. Instead, we chant the mantra ‘take responsibility’ as the go-to message and policy.

Archer’s contribution

In her ‘trilogy’ (Archer 2000, 2003, 2012), we are asked to think about human agency in the context of social structure and culture and how reflexivity (our inner conversations) mediates the relationship between objective social conditions and human agency. Archer here rejects completely the notion that there is no such thing as society existing ‘outside’ of individual human actors, and thus Archer is rooted in ‘Ontological Realism’. 

However, it is arguable that the dominant discourse around health outcomes and lifestyles, as seen for example just about everywhere, does just that. In focusing on the individual and expecting behaviour change as the main thrust for policy, the discourse downplays, ignores, forgets, the role of powerful social actors and the ‘behind our backs’ social and political mechanisms at play. The Grenfell Tower fire is an extreme example of how ‘behind our backs’ decisions result in death, and underpins arguments that socio-economic policies can kill through mechanisms of institutional and structural violence. Try exercising agency for better health while living in a fire trap. 

A ‘behind our backs’ (unseen or unacknowledged) mechanism is our social class position as it affects our daily decisions whether we acknowledge it or not.

For example, the surface reasons we give for smoking: we smoke because we like it, because our friends do, because we can’t stop, we have a fatalistic attitude to life, because we underestimate the risk, because relatives smoked and died at an old age. We see these factors and we acknowledge them.

We don’t see class; we don’t invoke ‘social class’ as a reason, despite the evidence that smoking is more common if we earn less than £10,000 or are looking for work. Note that around 1 in 4 in routine and manual occupations smoke compared to 1 in 10 in managerial and professional occupations according to the ONS ‘Adult Smoking in the UK 2018 data. 

We prefer not to fully understand the history of tobacco growth, production, distribution and marketing as it operated today. We acknowledged the role of the tobacco industry and lobby, and more recently legislated to protect public health after a struggle.

However, we still individualise smoking, extracting it from its socio-political context and we then indulge in a little stigmatising and shaming of smokers, often a process which has a more than a whiff of middle-class snobbery about it. Is it really the case that middle-class people have stronger willpower or is it that they have a whole suite of positive assets that makes it easier for many of them either not to start smoking or to give it up?

The ‘Moral Underclass

The ‘Moral Underclass Discourse’ is rooted in a view of human agency that separates out the individual from structures and cultures and expects rational action – the weighing up of the pros and cons of action. This is the Enlightenment’s ‘man of modernity’ – the utility maximising rational actor, and while it may seem a very crude outline of the theory of human action that perhaps no one today adheres to, I would argue it implicitly underpins many a policy decision and media exhortation to people to ‘take responsibility’. 

We will hear echoes of this voice when we hear such statements as “only the individual should and can take responsibility for health”, “there is no such thing as society, just individuals and families” and rational injunctions to “Just say No”, “I stopped smoking, then so can you”. The uncritical acceptance of the ‘sovereign individual’ lays the foundation for victim-blaming and shaming, for if there is no social structure or culture what else is there to blame for their poverty and health inequalities except the behaviour of the ‘moral underclass’ themselves? This view argues that we stand alone, making foolish choices about smoking, food, exercise and alcohol. This is just ‘common sense’. The actions of powerful global actors who have a vested interest in making profits rather than in public health are ignored or dismissed. 

As for the role of personal agency in the adoption of unhealthy behaviours, I do not erase the primacy of human action and decision making. However, we must refer to the context, the culture and structures in which people live their lives. I contend that social structures, for example of class, ethnicity, gender, and cultures do have ‘causal’ mechanisms (ontological realism) but we engage reflexivity, and perhaps some judgemental rationality, to choose a course of action. 

Beer: a moment’s critical reflection and knowledge of the population’s habits in relation to class, ethnicity and gender will easily reveal the contexts in which beer drinking is made easier, the cultures that inhibit or encourage beer drinking and the social structures which facilitate the production, distribution and marketing of beer. you might want to imagine what sort of society exists in which beer drinking is non-existent, what contexts, cultures and structures would there be? I am not destined to drink beer, the existence of non-drinkers is testament to that fact, but I was highly structured into doing so, and continue to be so.

We retain our agency but not in the circumstances of our own choosing.

Some will exercise their agency to resist the drift towards adopting sedentary lifestyles, others will be not able to do so quite so easily. Biological, psychological and social mechanisms impact on our decision making but we might still be able to exercise our ‘judgmental rationality’. I suggest, however, that people who are poorly paid, stressed, demoralised, devalued, stigmatised, shamed, and ill-educated might finder harder to do so as the knowledge they draw upon (epistemic relativism) may be inadequate and the social, economic and political pressures they face (their ‘ontological realism’) may be too high. Too many people may be what Archer refers to as ‘fractured reflexives’ who find it difficult to make sense of their experiences or think about healthy routes out of poverty and distress.