Lifestyle drift and the phenomenon of ‘citizen shift’ in contemporary UK health policy

Oli Williams, Simone Fullagar

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Despite political change over the past 25 years in Britain there has been an unprecedented national policy focus on the social determinants of health and population-based approaches to prevent chronic disease. Yet, policy impacts have been modest, inequalities endure and behavioural approaches continue to shape strategies promoting healthy lifestyles. Critical public health scholarship has conceptualised this lack of progress as a problem of ‘lifestyle drift’ within policy whereby ‘upstream’ social contributors to health inequalities are reconfigured ‘downstream’ as a matter of individual behaviour change. While the lifestyle drift concept is now well established there has been little empirical investigation into the social processes through which it is realised as policies are (re)formulated and implementation is localised. Addressing this gap we present empirical findings from an ethnography conducted in a deprived English neighbourhood in order to explore: (i) the local context in the process of lifestyle drift and; (ii) the social relations that reproduce (in)equities in the design and delivery of lifestyle interventions. Analysis demonstrates how and why ‘precarious partnerships’ between local service providers were significant in the process of ‘citizen shift’ whereby government responsibility for addressing inequity was decollectivised.

Original languageEnglish
Pages (from-to)20-35
Number of pages16
JournalSociology of Health and Illness
Issue number1
Early online date2 Aug 2018
Publication statusPublished - 1 Jan 2019


  • advanced liberalism
  • England
  • health Inequalities
  • obesity
  • physical activity
  • social determinants of health

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health


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