Economic rationality and health and lifestyle choices for people with diabetes

Soc Sci Med. 2006 Nov;63(9):2341-53. doi: 10.1016/j.socscimed.2006.06.007. Epub 2006 Jul 27.


Economic rationality is traditionally represented by goal-oriented, maximising behaviour, or 'instrumental rationality'. Such a consequentialist, instrumental model of choice is often implicit in a biomedical approach to health promotion and education. The research reported here assesses the relevance of a broader conceptual framework of rationality, which includes 'procedural' and 'expressive' rationality as complements to an instrumental model of rationality, in a health context. Q methodology was used to derive 'factors' underlying health and lifestyle choices, based on a factor analysis of the results of a card sorting procedure undertaken by 27 adult respondents with type 2 diabetes in Newcastle upon Tyne, UK. These factors were then compared with the rationality framework and the appropriateness of an extended model of economic rationality as a means of better understanding health and lifestyle choices was assessed. Taking a wider rational choice perspective, choices which are rendered irrational within a narrow-biomedical or strictly instrumental model, can be understood in terms of a coherent rationale, grounded in the accounts of respondents. The implications of these findings are discussed in terms of rational choice theory and diabetes management and research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Choice Behavior*
  • Diabetes Mellitus, Type 2*
  • Economics*
  • Female
  • Health Behavior*
  • Humans
  • Interviews as Topic
  • Life Style*
  • Male
  • Rationalization*
  • Self Care
  • United Kingdom