The meaning of health: Differences between cohorts and between users of biomedicine and complementary/alternative medicine

The purpose of this study is to examine the meaning of health among Americans. Three groups are identified: those who use Complementary and Alternative Medicine (CAM) as an important method of treating illness or maintaining health, those who are intermediate users of CAM, and those who use primarily Biomedicine (care delivered by medical doctors). Along with examining differences in the understanding of health between CAM, Intermediate and Biomedicine users, the study also examines the extent to which cohort membership in the Boom and Silent generations may be reflected in the construct “health” and its associated dimensions. This qualitative study uses the life course perspective and agency-structure theory, to understand the construction of health and how it differs between cohorts and between the health care use groups.; A screening survey was used to identify potential respondents and to classify them into appropriate categories. Qualitative data was collected from 31 semi-structured interviews with persons who had used a biomedical or a CAM practitioner in the 12 months before the interview. Data were analyzed using the grounded theory approach.; The study identified eight dimensions of health widely held by respondents: Body, Mind, Autonomy, Mind-Body Interaction, “Silver Blaze” (the absence of disease), Relationships, Religion, and Homoeostasis. Five dimensions are further subdivided into important subdimensions or aspects. The cultural or cognitive domain of health is found to be broader and more uniformly held than previous studies have suggested.; The study demonstrates that both individual agency and social structure strongly influence the various meanings of health. Some dimensions are more strongly related to agency or to structure, but all demonstrate the intertwining relationship of agency and structure. While life course theory suggests that different generations construct meaning in different ways, this study finds remarkable similarities between Silent and Boom generation constructions of health. The similar health-related events to which both cohorts have been exposed are reviewed along with changes in mass media. It is suggested that the similarity in meanings of health between cohorts and medical use groups reflects the society-wide distribution of health concepts. This distribution is held to be like the distribution of social values. The various lay dimensions of health are proposed as a significant means of joining professional and political health policy discussions to the experiences and meanings of the lay public.