A psychosocial study of cardiovascular diseases, health behaviours and risk perception among retail pharmacy workers in Johannesburg, South Africa
This thesis is based on a descriptive and exploratory psychosocial study which investigates the underlying factors that shape cardiovascular diseases, health behaviours and risk perception among retail pharmacy workers in Johannesburg, South Africa. It further examines help-seeking behaviours and the meanings attached to ‘The Body’, self and identity as related to symbolic interactionism. A review of literature presents a background to the local and global context and engages classic and contemporary discourses and debates on health, illness and chronic diseases. The unique context of non-communicable diseases in South Africa is interrogated by utilising the Integrative Model of Behavioural Prediction as a guiding theoretical framework. A mixed methods research design incorporated (i) a survey (N=400) and (ii) in-depth follow-up interviews (N=60). Data were analysed using descriptive statistics and thematic content analyses for deeper reflections on the topic. The findings revealed that cardiovascular disease knowledge and risk perception is shaped by one’s family, community, workplace, colleagues and the media. It found that workers have an understanding of cardiovascular diseases, the problem, however, is that individual risk perception is overlooked. Social networks, cultural norms and gender contributed to the public framings of bodies and the sociocultural anxieties surrounding juxtapositions – thin/fat, healthy/unhealthy, acceptable/unacceptable, good/bad – prominent in ‘Othering’ deliberations. These illuminated the symbolic and material dimensions of how workers conceptualise their bodies. ‘Good’ health behaviours were associated with physical attractiveness, social acceptance and health improvement and maintenance. ‘Bad’ health behaviours were linked to time constraints, long working hours, financial stress and family responsibilities. The discussion and conclusion consolidate the study’s sociological significance and the multi-layered aspects of health, illness and chronic diseases. This thesis challenges sociocultural expectations of ‘The Body’ in ways which contrast some of the available literature in Africa. It further contributes to the existing knowledge on non-communicable diseases while introducing innovative ways of (re)thinking about chronic conditions and the practical implications as related to the study. The pertinent issues raised regarding non-communicable disease diagnosis, management and treatment, as well as food consumption and body weight perceptions complicate an ever-changing South African risk society. This thesis, therefore, paves the way for further research on the perceived and actual cardiovascular disease risks in the South African context.
A Doctoral dissertation submitted to the Faculty of Humanities and the School of Social Sciences in fulfilment of the requirements for the degree of Doctor of Philosophy (Ph.D.) in Health Sociology 2016