Social Science & Medicine 55 (2002) 451–465
Habit versus choice: the process of decision-making inhealth-related behaviour
Eva Lindbladha, Carl Hampus Lyttkensa,b,c,*aDepartment of Community Medicine, Malm .oo University Hospital, SE - 205 02 Malm .oo, Sweden
bDepartment of Economics, Lund University, P.O. Box 7082, SE - 220 07 Lund, SwedencLund University Centre for Health Economics, P.O. Box 705, SE - 220 07 Lund, Sweden
Abstract
Social differences in the role of habits in health-related behaviour are explored within both sociology and economics,
where we define habits as non-reflective, repetitive behaviour. The corresponding theoretical perspectives are the
habitus theory, the theory of individualization, and habits as rational decision rules. Sixteen thematically structured
interviews are analysed using qualitative methodology.
Three aspects of habits emerged from the narrative: the association between habits and preferences, habits as a source
of utility, and the relationship between habits and norms. We find that people in lower social positions are more inclined
to rely on their habits and are accordingly less likely to change their behaviour. These differences are reinforced as not
only the disposition to maintain habits but also the tendency to conceive of the habitual as something good seems to be
strengthened in lower social positions.
We also note that the intensified individualization that characterizes current society erodes the basis for habit-
governed behaviour, which may also contribute to social differences in well-being. Finally, we find that the scientific
dialogue has enriched both scientific paradigms, and suggest as a tentative hypothesis that the traditional economic
rational-actor model may be relatively less applicable to those with limited resources. r 2002 Elsevier Science Ltd. All
rights reserved.
Keywords: Habits; Behaviour; Health; Social differences
Introduction
This article focuses on the phenomenon of habits in
the context of health-related behaviour. Decisions can,
in practice, be made in terms of constantly new choices
between different options on the basis of their estimated
value, but they can also be made in terms of implicit or
explicit references to prior choices, to the apprehension
of how things are usually done. We are interested in the
extent to which health-related decisions are a reflection
of such repetitive, non-deliberate choice, and in the
possibility that the prevalence of habits in the decision
process varies systematically across the population. In
other words, we concentrate on the process of decision
making in order to improve our understanding of
health-related behaviour in general and of social
differences in such behaviour in particular.
It seems reasonable to presume that the basic
structure of decision making has implications for the
propensity to change behaviour, in relation to, for
example, the adoption of new dietary practices or
patterns of alcohol consumption. Without denying the
importance of many other factors that influence the
individual’s health-related behaviour, such as external
constraints in terms of time and money, we believe that a
focus on the process of decision making offers new
insights into why some people behave more healthily
than others.
*Corresponding author. Department of Economics, Lund
University, P.O. Box 7082, SE - 220 07 Lund, Sweden. Tel.:
+46-46-2228652; fax: +46-46-2224118.
E-mail addresses: carl [email protected] (C.H.
Lyttkens). [email protected] (Eva Lindbladh).
0277-9536/02/$ - see front matter r 2002 Elsevier Science Ltd. All rights reserved.
PII: S 0 2 7 7 - 9 5 3 6 ( 0 1 ) 0 0 1 8 0 - 0
This issue is explored by analysing a set of qualitative
interviews from two different scientific perspectives,
namely sociology and economics.1 Despite the difference
in paradigm we find that we largely agree on the
importance and role of habits as well as the way in which
the relative reliance on habits helps explain social
differences in behaviour.
At the same time, the analysis suggests important
ways to enrich future analyses of behavioural patterns
within both paradigms. This result from the scientific
dialogue is partly due to the fact that our object of
analysisFsocial differences in the individual’s decision-
making processFis a somewhat atypical endeavour
from both scientific perspectives. On the one hand, an
economist rarely focuses on social differences in
behaviour while, on the other hand, a sociologist would
not normally choose individual decisions as the analy-
tical starting point.
Sociology and economics on habits
The purpose of this section is to introduce a socio-
logical and an economic perspective on the role of habits
and the relationship between habit and choice in
individual everyday decision making, which will serve
as the framework for our analyses. We are not concerned
with the distribution of particular lifestyles in the
population, but with social differences in the propensity
to rely on different principles of decision making.
When human behaviour and everyday action is taken
as the analytical focus within the sociological paradigm,
these discourses are naturally associated with the
phenomenological approach.2 Within this theoretical
context, the goal-oriented version of rational behaviour
is distinguished from those routine everyday practices
which are meaningful from an individual standpoint
without involving reflections concerning aims, motives
and means (Sch .uutz & Luckmann, 1974; Berger &
Luckmann, 1966; Connerton, 1989). The definition of
habits as rational decision rules in economics (cf. below),
is coincident with an interpretationFwithin the domain
of phenomenological sociologyFof habitualization, in
terms of a process implying a minimum of decision
making and an economy of effort, liberating the
individual from ‘‘the burden of all decisions’’ (Berger
& Luckmann, 1966, p. 53).
Although the demarcation between reflected and
habitual behaviour is normally fluid in the context of
everyday life, where most social practices contain
elements of both reflection and habit, we have found
the focus on the distinction between habit and choice to
be worthwhile in terms of theoretical insights. Similarly,
it is a relevant empirical question to examine whether
habit or choice turns out to be the superordinate
dimension.
From our sociological position (in contrast to
Rational Action Theory), we will proceed by elaborating
two contextual interpretations of habit versus choice
which are both grounded on the respondents’ first-order
constructions. Following our previous theoretical work
(Lindbladh et al., 1996), we approach observable
variations related to social position by drawing upon
Bourdieu’s habitus theory according to which individual
aspirations and apprehensions are induced and attuned
by a set of deeply rooted principles of action (the
structure of habitus) which in turn represent embodied
conditions of existence.3
At the same time, we seek to incorporate the overall
societal level in our analysis. Since we are concerned
with the meaning of habit as a model of human action,
rather than with the determinants or motives of specific
habits, we take an interest in macro-level processes that
have a bearing on the very structure of everyday
behaviour. The notion of habit emerges as an interesting
sociological category in the light of the continued
unplanned trend towards individualization that appears
to be established at a new level in the present stage of
modernity.4 The intense emphasis on individual choice
and rational calculationFwhich is broadly manifested
in overall societal structures and all the way down to the
level of the individual biographyFimplies by definition
a weakening of the position of habitual behaviour. The
habit-guided individual could consequently be classified
as someone who is ill-adapted to the demands of
contemporary society.5
1We share the belief of Evans, Barer, and Marmor (1994) in
the value of multidisciplinary work in this context.2Even though habits have a major influence on human
behaviour, this is a neglected dimension in sociological theory
(Bourdieu & Wacquant, 1992, p. 123).
3The habitus theory is explicitly developed in a critical
dialogue with the rational action paradigm and one of its merits
lies in its capacity to explain: ‘‘why the finalism of rational
choice theory, although anthropologically false, may appear
empirically sound’’ (Bourdieu & Wacquant, 1992, p. 121). Note
that we draw upon a restricted version of Bourdieu’s theory.
See Williams (1995) for a more comprehensive discussion of
Bourdieu in relation to issues of health and lifestyle.4The notion of individualization goes back in time to
Weber’s, Durkheim’s and Simmel’s analyses of the release of
individuals from feudal and religious structures in the emergent
industrial society. Ulrich Bech is one of those who define the
intense wave of individualization as a key process in the present
society (‘‘Risiko Gesellschaft’’). Collective structures (ties to
social class, region, gender roles, etc.) are now being erased due
to structural transformations related to the labour market, the
educational system, welfare policy, etc. (Beck, 1994a, b).5The issue of correspondence between society and different
versions of action associated with different principles of
rationality goes back to Weber’s theory on idealtypical models
of behaviour.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465452
In economics, the presence and persistence of habitual
behaviour has generated an extensive literature. It
covers subjects such as the relationship between past
and present consumption, asset pricing, labour supply,
and the effects on savings and growth (cf., e.g., Becker,
1992; Becker & Murphy, 1988; Bover, 1991; Deaton,
1992; Hodgson, 1998). There are many conceivable
reasons why an individual may experience that he would
obtain higher utility from choosing the same course of
action as he has done in the past. For example, there
may be physiological reasons why past consumption
directly influences the utility of current consumption.
Our primary focus here is on a special class of
habitual forms of behaviour, namely habits in the sense
of repetitive, non-reflective behaviour. In the paradigm
of mainstream, neo-classical economics, the fundamen-
tal reason for such repetitive behaviour is that it saves on
decision costs (Stigler & Becker, 1977).6 To follow a
habit may therefore be a preferable strategy compared
to searching for an alternative by engaging in explicit
choice. Furthermore, because of the complexity and
uncertainty surrounding decisions in the real word,
habits and rules are very likely to be important elements
in individual behaviour (Heiner, 1983; Hodgson, 1997).
Even though decisions by habit may often be
subconscious, it is implicit in the neo-classical approach
that individuals may make decisions about their habits,
and about changing them. Furthermore, a change of
habit is tantamount to an investment in a superior
decision strategy, and it follows that individuals will not
always find it advantageous to change their habits in the
face of small changes in the decision environment. The
presence of social differences in behaviour is also
implicit in this economic model, because one would
expect that people in similar circumstances find it useful
to develop similar habits. For the purpose of our
economic analysis, we adopt this neo-classical view of
habits as rational decision rules as our starting point.7
We will also touch upon a related concept, namely
norms. Norms appear in the neo-classical paradigm as
normatively sanctioned rules of behaviour and are the
subject of a rapidly growing literature (Elster, 1989;
North, 1990; Kreps, 1997; Lindbeck, 1997; Cole,
Mailath, & Postlewaite, 1998). People comply, for
example, with internalized norms because adherence is
felt to be desirable per se and with social norms since it
leads to better treatment by others.
Data and methodological aspects of qualitative analysis
The present study is based on 16 thematically
structured interviews, which were planned and carried
out with the overall aim of investigating the spectrum of
determinants of health-related patterns of behaviour.8
The interview guide included questions about food,
alcohol, smoking, physical exercise, and other everyday
activities related to health, with special emphasis on the
dimension of change. The interviews were of about 2 h
duration and conducted in the respondents’ home. They
were all taped and transcribed. The interview group
comprised men and women in the age groups 25–30 and
45–50 years, who were living in families with their
husband/wife and children.
The respondents had the following occupations:
chemist, cleaner, engineering graduate, garbage collec-
tor, assistant nurse (2), university student, children’s
nurse, industrial worker (2), computer operator, econ-
omist, civil servant in management position, journalist,
office employee, municipal worker.9 The interview group
was ethnically homogenous (Swedish background).
The verbatim transcripts were analysed manually. The
explanation of everyday practices with reference to
habits emerged in the initial coding process as a
recurrent theme. It was accordingly selected as a key
element for analysis. The further analysis of data
proceeded in terms of the familiar procedure of
6There is also a relationship between habits and risk, which is
worth noting, even though this is not explicitly mentioned in
our interviews. In a certain sense, following a habit makes life
less risky, which is beneficial for risk-averse people. Above all,
the individual is well informed about the particular outcome to
which his habit usually leads. He may also know relatively more
about the probability distribution of different outcomes under
the habit strategy. Note carefully, however, that following a
habit does not in general imply less risky behaviour. For
example, the individual may be in the habit of not wearing a
seat belt in his car. The relationship between habits and notions
of risk is discussed further in a companion paper based on the
same set of interviews (Lindbladh & Lyttkens, 2000).7For a critical assessment of the neo-classical paradigm, with
special reference to the importance of habits, cf. Hodgson
(1997, 1998).
8 It is well known that individuals have a propensity to
present themselves (and their actions) in ways that they perceive
to be in accordance with generally accepted behaviour, cf., e.g.,
West (1990) and Williams (1995) on the distinction between
private and public accounts. Performing a second interview on
the same subject increases to a certain extent the possibility to
identify the different forms of narratives. With this in mind,
some repeat-interviews were conducted within both age groups.
More generally, our confidence in the interpretations is above
all related to the fact that we employ a multi-analytical strategy,
where several analyses are conducted, on the same set of
interviews, where different issues are in focus (Bustos Castro, &
Lindbladh, 1999; Lindbladh & Lyttkens, 2000). Cf. also the
concluding remarks on perspective triangulation and footnote
26.9The attentive reader will note that two of the respondents
are not explicitly referred to in the text, the reason being that
their narratives were less telling in relation to the habit–choice
dichotomy. Needless to say, all 16 interviews are included in the
basis for the analysis.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 453
systematic comparisons between the multiple comments
related to the category of habit (including the contrast-
ing category of choice) in order to uncover patterns and
connections.
Since our interest in the category of habitFinitially
grounded on dataFis primarily concerned with its
theoretical significance, i.e., in its potential for explain-
ing at least some of those social variations in health-
related behaviour that are observable in a variety of
quantitative surveys, we assign our methodological
approach to the notion of grounded theory (Strauss,
1987) in its most extensive but at the same time its most
fundamental aspect.
In the first phase of the following analysis, we present
three different aspects of habit that emerged directly
from the narratives: habits and preferences, habits as a
source of utility, and the relationship between habits and
norms. These three themes of habits as a conscious
phenomenon are illustrated separately with a number of
interview accounts and with a minimum of theoretical
interpretation. In the second phase of the analysis, we
move to a more abstract level and the emphasis is now
on explaining the emerging pattern of social differences
among the respondents in relation to the habit–choice
dichotomy. In this analysis, where we seek to identify
potential linkages between the data and sociological and
economic theory, we return to many of the previously
mentioned accounts, as well as some additional data
from the narratives that are now introduced in the light
of theoretical considerations.
The meaning of habit in the narratives
An initial observation is that references to habitual
structures appear as a typical first-hand explanation of
everyday behaviour. Among the diversity of examples,
Elin (journalist, younger generation) explains why she
seldom eats fruitFeven though she is well aware of its
allegedly positive effects on healthFby the fact that she
is not ‘‘in the habit of having an apple’’. Her alcohol
consumption is restricted to the weekend which she
accordingly perceives as a natural consequence of the
condition that she ‘‘has never got into that habit’’ (i.e.,
drinking on weekdays). Bengt (engineering graduate,
older generation) explains the fact that he does not
exercise (apart from everyday activities like gardening)
by saying: ‘‘I never got into the habit of thinking that it
was natural to exhaust oneself. If I had to put the blame
on anyone, it was just something that I didn’t learn at
home.’’ Correspondingly, smoking is justified with
reference to its status as a deeply rooted habit. For
example, Lotta (children’s nurse, younger generation),
subordinates the importance of craving for a cigarette
and emphasises instead the binding force of habit: ‘‘I
mean, I can smoke although I am not dying for a
cigarette. Just because well, I usually do it.’’ Lotta here
makes a distinction between her physiological addiction
and her dependency on routine behaviour.
Habits and preferences
There is an explicit tendency to equate habits and
preferences. The habitual and the good are two
dimensions that are frequently mentioned side by side.
‘‘I always buy minced pork but it is not just because it is
cheaper. In my opinion, it is actually tastier,’’ says Mona
(assistant nurse, younger generation) and continued, ‘‘I
am not fond of minced beef and things like that. But
that is because I am not used to it.’’ Nils (industrial
worker, older generation), explains his preference for
traditional Swedish dishes in the following way: ‘‘One is
used to eating itFsince my mother used to make
itFand then it has continuedF so I think it has a good
taste.’’
In particular, references to childhood and adolescence
for the grounding of today’s taste preferences are usually
seen as something which goes without saying and
consequently need not be explained further. The young
woman who always buys high-fat milk products makes
clear that it is not that she cannot drink low-fat milk but
rather the fact that: ‘‘You have had it since you were a
small child. So that’s it.’’ Mona emphasises in her
account of her meals that; ‘‘it is always roast on
Sundays’’. She explains that this is something brought
from her childhood (and it is moreover practically the
only element of order in her chaotic everyday life).10
The close link between habits and preferences also has
implications for the propensity to change one’s beha-
viour. Let us turn to the narrative of Kalle (computer
operator, younger generation), which illustrates how
two aspects of decision makingFhabitual preference
versus financial considerationsFare ranked within the
field of consumption. Whenever he buys napkins,
kitchen roll paper, and similar products he claims to
choose on the basis of price-related considerations.
However, he firmly asserts that the question of price is of
no importance to him when he is buying ‘‘sausages,
bread and things like that’’. He answers the follow-up
questionFwhat are in that case the major determi-
nants?Fby saying: ‘‘then it is what I always have
eatenyI have been eating honey on my bread since I
was born and I still consume at least five sandwiches a
day. It has to be ‘Lockarps fina’ [a particular brand of a
common type of bread]. And the honey must be of the
same brand as it always has been’’.
Of course, we could not predict how Kalle’s behaviour
would be affected by a drastic increase in the price of
10Kerr and Charles (1984) noted that the significance of the
Sunday dinner tended to increase in poor families where this
institution attained a special value as a symbol of status and
well-being.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465454
‘‘Lockarps fina’’. However, it seems that financial
aspects influence his choices in areas where there are
no ingrained habits and accordingly no beforehand
given preferences. For certain other goods, the disposi-
tion to reproduce established patterns of behaviourFbuy-
ing what he has always bought, etc.Freduces the
potential influence of financial considerations. In all
likelihood, the higher degree of inertia implied in these
latter cases will also be present in the face of, e.g.,
information on the health effects of these products.
Habit as a source of utility
The issue of why and when individuals are prepared to
try to change their habits leads us to another of the
themes that emerged from the accounts: habits as a
potential source of utility. This theme is illustrated by
the narratives of Robert and H(aakan. It is not an
accident that these two young men were specifically
attentive to the importance of habit and verbalized their
thoughts concerning the intrinsic structure of their
behaviour. Both of them had fathers with heart
problems and they were seriously concerned about their
own health. It is symptomatic that a process of reflection
is initiated when everyday routines that have been taken
for granted are for some reason interrupted.
Robert (municipal worker, younger generation) is well
aware of the health-related threats associated with
several of his habits, and he would truly want to change
in different ways. For instance, he would want to begin
exercising, to stop smoking and to reduce his consump-
tion of alcohol. He takes, however, the changes ‘‘bit by
bit’’, which from his point of view means that he denies
himself the use of a car only when he feels like biking.
His primary aspiration is to avoid feeling restrained: ‘‘I
don’t like to feel pressure. I want to make a habit of it. I
shouldn’t have to feel that I am forced to do it. It should
be a habit so that it makes you feel comfortable,
mentally and in all other ways.’’
Robert’s account provides a clue regarding what
might be the magical power of habit. He sees his habits
as an integral part of his self-identity, something that
exists by itself without any demands whatsoever. He is
aware of the fact that breaking off a habit involves
major investments of energy. The point is thatFfrom
Robert’s point of viewFthis is tantamount to external
restraint, which, in turn, is inconsistent with his personal
notion of comfort. The non-compulsive habit is so
strongly associated with the pleasant that it is not easily
abandoned.
A different view of habits is found in H(aakan’s
narrative (economist, younger generation). He describes
the phenomenon of habit in terms of ‘‘something which
happens automatically, it is not anything that I think
about any more’’Fand adopts as an illustration the act
of putting on a safety belt in the car. From his own
experience, he has realized like Robert that it is ‘‘so
extremely difficult to get out of habits you have got
into’’. He is a health-oriented person in the sense that he,
for example, pays regard to much of the information
about healthy food. Within the field of diet, he attempts
to make changes ‘‘in a long-term view. There is no point
in eating in a healthy manner for one month or so and
then giving it up because it isn’t much fun’’. H(aakan
characterizes himself as a person ‘‘who use to follow
health trends’’ but he adds ‘‘it is not certain that you
include all of them among your habits’’. The last
statement could be seen as an indication of an active
stance towards established habits and the continuous
flow of new information concerning health-related
lifestyle factors.
There is a similarity between the insights of the two
men regarding the intrinsic inertia of habits. Both of
them also argue that a change in behaviour may require
that the new behaviour is turned into a habit. We can,
however, note two major distinctions. Compared to
Robert, H(aakan’s set of habits is much more in line with
the current medical notion of what constitutes healthy
behaviour. More important in the present context,
however, is the fundamental difference in their ways of
tackling the phenomenon of habit as such. First,
Robert’s notion of habits as something pleasurable is
conspicuously absent in H(aakan’s narrative. Secondly, it
becomes increasingly evident that H(aakan represents a
divergent attitude in his account of his fancy for ‘‘snacks
in different shapes’’. He tries to keep himself to popcorn
which he believes to be the least unhealthy of these
products. ButFhe addsF‘‘sometimes you have to
indulge yourself by eating crisps’’. In connection with
this confession he makes the following distinction: ‘‘It is
perhaps not so much a bad habit as a weakness.’’ This
suggests that for H(aakan it is not desirable to present
oneself as a person who is a slave of habitFthat
subordinating oneself to habits is an improper kind of
behaviour. If the behaviour in question is defined as a
‘‘weakness’’, rather than a ‘‘bad habit’’, it appears
instead as a self-chosen phenomenon, something im-
plicitly more acceptable.
The tendency to classify habitual behaviour in negative
terms could be assumed to function as a change-
promoting mechanism. Pleasurable connotations asso-
ciated with habitual structures, on the other hand, will
inevitably render the process of change more difficult.
Habits versus norms
In many situations it seems reasonable to expect that
norms exert an important influence on individual
behaviour. In the first reading of the interview material
we observed, however, that explicit references to norms
in connection with accounts of drinking patterns, dietary
preferences, etc., were fairly few, whereas the spirit of
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 455
habit quite literally permeated the material. On closer
reflection, it appears that norms and moral attitudes are
indeed important dimensions although these factors do
not appear as alternative governing mechanisms in
relation to habits. Instead, it is moral attitudes towards
the ubiquitous notion of habit-governed behaviour as
such that turn out to be important.
In the previous subsection, we saw that the habitual
approach to life could be valued as something princi-
pally beneficial and worth striving for (Robert) but it
could just as well be judged as a manifestation of
passivity and the absence of free will and, accordingly,
as something that one would rather seek to overcome
(H(aakan). Robert’s positive view of habit was rooted in
the dimension of pleasure rather than morals. In
contrast, H(aakan, was inclined to include normative
conceptions in his version of habit and showed a
tendency to consider the habit-governed individual in
disparaging terms. This kind of moral attitude will
inevitably affect the role that habits could be expected to
play in everyday decision making, irrespective of
whether it is verbalized or not.
A similar picture emerges in the few interviews where
explicit normative judgements concerning particular
habits could be noted.11 For example, Birgitta (civil
servant in management position, older generation), who
personally stopped smoking some years ago, now talks
about other persons who she really thinks ‘‘ought to do
something about it for their own sake’’. She sees it as
‘‘humiliating to be addicted’’ and this was her own
primary reason for giving up smoking. In contrast,
Lotta answers the question on the importance to her of
cigarettes by stressing the fact that ‘‘you have to have
them with you all the time’’. Without moral undertones
she concludes: ‘‘So it means a lot. Because you are
addicted. You have to have them.’’ Karl (chemist, older
generation) explains the principal reason behind his
decision to stop smoking as follows: ‘‘Think that your
children could become fatherless because you had
smoked yourself to cancer. It gave me a totally new
perspective. Nothing can be done about the fact that I
am going to die but I don’t have to do it to myself.’’ The
presence of a high valuation of individual independence
and responsibility (and implicitly deliberate choice) is
likely to work as an additional source of pressure, which
may make an energy-demanding change worthwhile.
This motivation may well be stronger than the prospect
of long-term health benefits.12
The phenomenon of habitFan interpretation from the
perspectives of sociology and economics
The connection between behaviour and health could
largely be defined as common-sense knowledge. All our
respondents were accordingly familiar with the health
risks associated with smoking or a large fat consump-
tion, as well as the health-promoting value of vegetables
and physical exercise. In everyday practice, however,
other conditionsFsuch as the underlying model of
decision makingFset the odds for this knowledge to be
translated into action and change.
In the previous section, we saw that individuals are
aware of the presence and importance of habits.
Sociology and economics agree on the fundamental
importance of habits as arrangements for facilitating
decision making, as a basic necessity for making daily
life manageable. Hence we would in general expect all
individuals to more or less consciously perceive their
habits as something which contributes to the economiz-
ing of resources, even though it is very seldom that this is
expressed in terms of reducing decision costs. When
habits are motivated and justifiedFfrom a common-
sense perspectiveFwith reference to their mere existence
and, in particular, when they are explicitly linked to
their perceived tenacity, this could be interpreted as an
everyday standpoint that accords with both sociological
and economic theory. At the same time, it is also
obvious that there are important differences in the way
in which individuals relate themselves to habits. In this
section, we focus specifically on the observed correlation
between social position and orientation towards the
habit–choice dichotomy.
Habits as habitus products (sociology)
We observed a common tendency to account for
everyday behaviour with reference to whether or not one
is accustomed to act in a certain way, or has grown to
see something as natural. Taken together with the close
connection between preferences and the structure of
habitFwhich is present irrespective of which area of
everyday life we focus onFthis position could accu-
rately be described as a common-sense version of the
habitus theory.
The habitus theory is ultimately a theory of practical
sense that accounts for the logic and reason of everyday
practices. The structure of habitus is engendered by
practice and directed towards practical functions, which
simply means that people learn by their actions to
recognize the limits of their potentialities, and that they
consequently adjust their efforts to this experience-based
estimation of chances. Habitus is the mechanism that
converts objective conditions attached to a certain
position in the social structure into subjective aims and
11Here there is a fluid demarcation between efforts to follow
a particular set of normative values and measures taken in
order to meet the desire to present oneself to others in a
particular way.12Furthermore, traditions and habits are closely related
phenomena, and tradition is saturated with moral meaning.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465456
motivations in accordance with the principle ‘‘to make a
virtue of necessity’’ (Bourdieu, 1986, 1990).
To act in accordance with the practice-generating
principles (habitus), which are inscribed in body and
mind, means to act with naturalness and confidence.
Against this background, we can understand the
predilection for affirmative experiences and values that
fit into previously established schemes of perception. We
can also see why a sense of well-being is normally
inherent in the customary way of life, in the same way as
to be at home with something is synonymous with
feeling unconstrained. In other words, within this
theoretical context, the ties to dispositions grounded at
an early stage of life (which tend to reproduce and
reinforce old patterns of behaviour and inherited sets of
preferences) are by definition a universal and inevitable
phenomenon.
To say that everyone acts in accordance with their
habitus, however, is not the same as saying that all
individuals have a similar attitude towards habit per se
or that they are equally disposed to sustain habitual
standards of behaviour. Marked differences in this
respect were also noted among our respondents. The
primacy of habit tended to be associated with indivi-
duals in lower social positions, whereas the notion of
choice emerged as a primary category among individuals
in higher social positions. A number of examples also
demonstrated that references to the category of habit (or
choice) was applied in various fields of everyday life in a
consistent manner, i.e., the same stance seemed to
characterize the respondent’s accounts of the different
themes which were brought up in the interview.
Among the primarily habit-oriented respondents, we
could for example notice Kent (industrial worker,
younger generation) who answered the question regard-
ing why he was living in housing area X by referring to
the fact that he had grown up there rather than to any
qualities in this particular environment. His disinclina-
tion to use the safety belt was attributed to the fact that
‘‘there was no talk of using a safety belt’’ when he grew
up. He also implied that he found the question on which
principles of choice he followed when making purchases
at the supermarket somewhat strange, by repeating in a
surprised tone of voice: ‘‘how do I choose?’’ The follow-
up question (‘‘yes, which factors are you considering’’)
was answered: ‘‘It is generally the same, it is always the
same milk and the same butter.’’ The question whether
he had made any changes in his dietary habits was
answered negatively: ‘‘No it is mainly the same.’’ In all,
Kent’s narrative was consistently organized around the
notion of the same as another way of expressing a
reliance on and preference for the habitual.
The category of habit orientation is further exempli-
fied by the substantially convergent narratives of Nils
(industrial worker, older generation) and Per (garbage
cleaner, older generation). Both talked about their
professional careers, not in terms of choice and
planning, but rather as something which ‘‘just turned
out to be’’. Moreover, both of them were equally
disinclined to give up the food preferences that they had
established at an early age. Similarly, the common short-
term perspective was described by Nils in three steps. He
stated as a fact that he did not use to make plans with
reference to long-term prospects, declared that in his
opinion it was ‘‘dull to live like that’’, and concluded by
saying that non-planning was ‘‘the right way of living’’.
This narrative is a perfect illustration of how cognitive
perceptions of how things are, matters of appreciation
and normative judgements are mutually adjusted and
tied together in coherent structures.
Lisa (university student, younger generation) can be
taken as an illustration of the converse standpoint. In
different parts of the interview, she returned to and
stressed the importance of individual choice: ‘‘That I do
something that I want to do, that I have chosen myself.
Something I really want.’’ Similarly, Birgitta (civil
servant in management position, older generation)
systematically underlined the value per se of the
opportunities to make personal choices. Note, in
particular, the final comment in the quotation be-
lowF‘‘to choose to remain in somethingy’’Findicat-
indicating that the maintenance of a habit was also
enclosed within her definition of choice, which is again a
good illustration of consistence:
These constant changes and all the demands, this
massive information y and the need to choose. It is
hard. And at the same time it is an opportunity. If
you can find a way y It is important for me to feel
that you have the opportunity to influence what you
like to influence, the opportunity to choose and
change to do something else, if that is what you need,
to choose to remain in something that you like.
Even though most of the individuals in our study
referred to certain patterns of behaviour as something
they had ‘‘inherited’’ from their parents, the significance
of this phenomenon could vary. For example, Karl
(chemist, older generation) mentioned that his food and
alcohol preferences were very similar to those of his
wealthy parents. However, this was not referred to as a
dimension of central importance for his identity. Instead
he preferred to characterize himself in the following way:
‘‘I am a person who makes choices and looks forward.’’
By contrast, we can return to Kent who justified his
dietary preferences, his overweight, his whole way of
living, with reference to the fact that he was pleased with
everything as it was: ‘‘I am born like this.’’
The definition of oneself as a person ‘‘who make
choices and looks forward’’ or references to the fact that
‘‘I am born like this,’’ represents two extreme versions of
self-identity, that are rooted in and are expressions of
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 457
different orientations towards the future, and which are
in turn associated with a disposition towards either
change or stability. The recognition of these diverging
principles of action contributes to an understanding of
social variations in the extent to which health-related
behaviours have been modified in accordance with
health information campaigns. Whereas the emphasis
on flexibility and reorientation may be interpreted as a
reflection of a habitus that is the product of conditions
involving a continuous adaptation to everyday situa-
tions involving cost–benefit calculation, the systematic
emphasis on the value of constancy and living in the
present, may, on the other hand, be defined as an
adjustment to the long-term experience of restricted
options (Lindbladh et al., 1996).
From a privileged position, most situations are
automatically seen as cases where choices can be made.
It goes without saying that opportunities to make
explicit choices (in terms of a calculated decision to
introduce change) are not always restrained by current
external hindrances. It is for example obvious that Lotta
is not prevented from stopping smoking and that
nothing stops Kent from making an effort to loose
weight. However, internal subjectively constructed
barriers firmly rooted in prior non-chosen social and
economic conditions can be an equally powerful
restricting mechanism. Bourdieu often returns to the
relationship between the conditions and demands of the
present and the primary conditioning structure (habitus)
produced by experience of the past. Hence, a disinclina-
tion to invest energy in a project of change (with
reference to for example smoking or diet), is conditioned
beforehand by schemes of perception and appreciation
that are moulded by a habitus adjusted to narrow
margins of choice that make it more natural and
comfortable to keep to things as they are.
The rationale for Kent’s non-planning or keeping to
the same strategy was overtly related to his everyday
practices conditioned by a general lack of resources. In
his view, one should not make choices and plans. He
made his position clear by referring to his experience
that if efforts in this direction had occasionally been
made ‘‘it never turned out that way anyway’’. From his
point of view, it is consequently not only meaningless,
but moreover irrational, to consume energy by trying to
calculate the benefits of different choices, since the only
expected result of these efforts is disappointment
(disutility). Compare this persistent principle of ration-
ality with the statement: ‘‘there is still a sort of economic
calculation in the unwillingness to subject existence to
economic calculation’’ (Bourdieu, 1986, p. 180).
The observed relationship between social position and
principles of decision makingFin terms of the disposi-
tion to lean upon previously established habits versus
the disposition to make calculated choicesFcan thus be
elucidated within the habitus theory. In order to further
clarify this theoretical linkage we can turn back to the
notion of habit as a source of utility. In compliance with
a definition within the economic paradigm of habits as
rational decision rules, it seems reasonable that decisions
in terms of choice are in general more energy-intense
than habitual decisions, and that this is valid for all
individuals regardless of their social position. But the
degree of utility, on the other hand, attached to habit
(and conversely, the degree of disutility associated with
choice) is basically influenced by the objective scope of
decision making and is accordingly the dimension which
showsFand is the source ofFsocial variation. When
the amount of resources (material, social, educational,
etc.) have been constantly scarce and, consequently, few
opportunities to choose between different alternatives
have been offered (as in the case of Kent and Lotta) the
dependency upon the energy-saving habit will increase.
In contrast, a continuous exposure to daily situations
where calculated choices are systematically required,
grounds the disposition to choose as a natural and
instinctive act, which inherently means that the costs of
energy related to this kind of decision are substantially
reduced (more on this below).
We have demonstrated how this latent relationship,
becomes manifest, above all, at the level of preferences.13
Kent was expressly pleased with holding on to ‘‘the
same’’. Remember also Robert (municipal worker), who
explained the necessity of turning new behavioural
patterns into habit with reference to the sense of well-
being associated with the non-compulsive status of
habitual structures.14 Those who have learned by
practice to rely on habit (which is another way of
saying: by conditions of necessity) can also make this
underlying disposition visible in other ways (the same
goes for choice). As we have seen; references to self-
image (e.g., I am born like this) could be one clue, while
openly declared normative views15 (the definition of a
habit-directed way of leading once life as good or bad)
could be another.
In conclusion, the primacy of habit over choice (or
vice versa) emerges as a significant habitus disposition
13As expected, since the unconscious structure of habitus ‘‘is
expressed in and through ‘taste’’’ (Williams, 1995).14Note that the analysis is based on a homogenous group of
respondents in the sense that all had family and work. If we had
also included individuals in marginal positions, the ties to
habitual structures would have been even more distinct
(Lindbladh & Bustos Castro, 1999).15Note here the fluid division between social norms and the
notion of normatively regulated action. Whereas social norms
tend to be weakened in a society marked by a dissolution of
collective identities, there is no reason to expect a reduction of
morally regulated action referring to the behaviour of solitary
actors (Habermas, 1984, p. 85). On the contrary, the extended
focus on individual choice and responsibility tends to increase
the burden of individual guilt.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465458
(shaped by experience, reflected in appreciation and
evaluation, and put into action within different fields of
everyday life). Needless to say, the existence of class-
related differences regarding principles of decision
making is hardly a new phenomenon. As noted before,
however, the socially polarized tendency towards
decisions in terms of habit or choice assumes a special
meaning at the present stage of modernity and may serve
as a potential mechanism for the generation of inequal-
ity (see below).
Habits as rational decision rules (economics)
The resource-saving aspect of habits implies that the
relative importance of behaviour governed by habits-
Frather than deliberate choiceFwill vary among social
groups. It seems reasonable to expect that the more
resources that an individual has at his disposal, the more
likely he is to engage in deliberate choice and the less
likely he is to rely on habits. Explicit decisions entail
costs of gathering and processing information, weighing
costs against benefits, etc. For any given anticipated
benefit in terms of a superior outcome, the better-off in
society are more likely to find this worthwhile.16 This
prediction is confirmed by our material, where there is a
social gradient in the propensity to explain one’s
behaviour with reference to habits. For example, we
saw above that for Kent (industrial worker), habits are
the primary explanation for his own behaviour, while
Karl (chemist) defines himself as a person who makes
choices and plan for the future.
Behaviour governed by habit will also be relatively
less likely to change. To change a habit entails an
increase in decision costs and it will only be undertaken
if the external change is of a sufficient magnitude.17
Hence the fact that Kalle is not concerned about price
when he buys certain goods could be seen as a rational
attitude in the face of ‘‘small’’ price changes. This
reasoning also implies that low-income earners will be
less likely to change their behaviour, since they are more
apt to rely on habits.
Furthermore, we can expect high-income earners to be
more prone to change their habits because they can
better afford to invest in a superior decision rule. For
example, H(aakan takes an active stance when he argues
that he follows health trends but does not necessarily
include all of them among his habits. Additionally, as
noted above, it seems likely that someone who is well off
in terms of resources will face lower costs for making
calculated decisionsFincluding the decision to change a
habitFbecause they are more familiar with that
decision-making process.
The social differences in the decision process will tend
to be self-reinforcing: if high-income earners incur low
costs for explicit decisions, this will strengthen the
tendency to make them relatively less reliant on habits.
In fact, as already hinted, the logic may be taken one
step further. Calculated decision making could in a sense
be argued to have turned into a habit for those with
ample opportunities for deliberate choice. For them, the
cost of making calculated decisions may in certain
situations seem lower than the costs of relegating the
decision to the domain where things get done ‘‘by
habit’’. It could be difficult for such an individual to
decide what ‘‘the non-calculated decision’’ would be,
and he would find the idea of abstaining from calculated
decisions uncomfortable. Hence, in a general and
subjective sense, the cost of doing things by habit could
be quite high.
Hence we may conclude at this point that the less well-
off in society are less likely to change their behaviour in
response to, for example, a health information cam-
paign. This is partly due to their greater reliance on
habits and partly because they are less likely to change
these habits. Remember, for example, how Robert
expressed great difficulties in trying to amend his
behaviour. This may be contrasted with Lisa (student,
younger generation) who notes that ‘‘if new information
turns up, it will influence me’’.
Even if individuals are aware that their habits are
resource-saving, it does not necessarily mean, however,
that they take a rational-decision view on the formation
of habits. Among our respondents, H(aakan comes closest
to an explicit stance regarding a change of habits that is
in accordance with a straightforward economic logic at a
conscious level. When he suggests that it is ‘‘not worth
it’’ to eat healthily for a while and then give it up, the
most natural interpretation is that he is well aware of the
waste of energy involved in recurrent changes in
behaviour. He is also aware that the least costly way
of maintaining a healthy life style is to turn it into a
habit. We could furthermore interpret H(aakan’s position
as a recognition that the establishment of a healthy habit
may be a rational way to overcome weakness of the will
(Elster, 1985).
16 Income is useful, e.g., in relation to markets for informa-
tion. Education expands the individual’s resources and/or
reduces the cost of deliberate choice by providing training in
rational decision making. The prediction that someone with
more resources will be more prone to invest in a more costly
decision process, ceteris paribus, appears relatively straightfor-
ward: with more resources (lower marginal utility of income,
etc.), it is less of a sacrifice to devote resources to the decision
process. In contrast, it seems doubtful whether any similarly
uncontentious a priori notion can be formed with respect to
systematic differences in the expected benefit from making
choices rather than following a habit. Note also that the
marginal utility of time could be higher for high-income
individuals.17Conversely, no increase in cost is implied for a change of
behaviour if that behaviour is governed by calculated choice
anyway.
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In contrast to H(aakan, as we have seen, Kent was
surprised at being asked how he went about making
choices at the supermarket. It is hardly conceivable that
he would see a change of habits as a search for the best
solution among different options. One explanation for
this is the relationship between habits and preferences,
to which we will return. Another interpretation is
suggested by the statement of Birgit (cleaner, older
generation): ‘‘We get by. You don’t have to be
immensely rich. I am satisfied if I have enough to get
by.’’ This suggests a concern with finding acceptable-
Frather than the bestFsolutions to everyday pro-
blems, i.e., ‘‘satisficing behaviour’’. Habits would be a
natural part of an instrumental strategy of bounded
rationality, where individual action is purposeful but not
optimizing (Simon, 1987a, b; Hodgson, 1997). While
Hodgson (1997) has suggested that optimization is
applicable only to a special class of situations, our
material suggests that the optimizing framework of neo-
classical economics may be relatively more relevant for
some individuals than for others. A tentative hypothesis
would be that satisficing behaviour is more prevalent
among those with limited resources who ipso facto have
fewer opportunities for choice.
While almost no individual in our material is explicit
about habits as a means of reducing decision cost, there
are some examples of explicit value judgements concern-
ing habits. The analytical status of these normative
attitudes is a question of considerable theoretical
interest, and it seems likely to affect the relative strength
that we should accord this factor. In the sociological
perspective, the individual’s valuation of habits as such
reflects his conditioned relative reliance on habits. For
an economist, in contrast, the normative views could
represent an independent explanatory factor. For
example, one could argue in relation to Robert, that a
habit is not just a matter of low decision costsFthese
low decision costs also figure as an independent factor in
his utility function. However, the fact that such
additional factors may be so easily incorporated in the
neo-classical paradigm is a temptation to which one
should not necessarily always yield. An alternative
interpretation is that the normative statements are a
manifestation of the fact that people are intuitively
aware of the energy-saving aspect of habits (a latent
structure). The case for the latter interpretation is
strengthened by the fact that it seems to provide the
best explanation for the observed tendency towards a
social gradient in the appreciation of habits, with a more
negative attitude being found among the higher social
classes.18 Obviously the more you rely on energy-saving
habits, the more this will be manifested in a positive
attitude towards habit-governed behaviour.
Finally, the most prevalent of the explicitly mentioned
aspects of habits in our interviews is the conspicuous
and close association between habits and preferences.
This means that for our purpose, the structure and
formation of preferences is an important object of
analysis, in contrast to the approach in most mainstream
economics. It is obvious from our material that one has
to acknowledge that habits qua experiences help shape
our current preferences, confirming the suggestion by
Becker that ‘‘y the evolution of preferences out of past
experiences seems far more intuitive [y] than the opposite
assumption so dominant in economics that preferences are
independent of the past’’ (Becker, 1992, p. 340).
The association between habits and preferences has
obvious implications for the propensity to change
behaviour. It is likely to add to the already inferred
reluctance of an individual to change those behavioural
traits that are associated with habits. Remember Kalle’s
standpointFfor him, one particular brand of a common
type of bread is a good that is significantly different from
other brands of the same type of bread.
One possible representation of the association be-
tween what we are in the habit of consuming and what
we find pleasurable is the economic rational addiction
model where the stock of previous consumption may
increase the marginal utility of current consumption.
The higher the individual’s discount rate, the more likely
it is that past consumption will have a positive effect on
present consumption (potential addiction) (Becker &
Murphy, 1988; Becker, 1992). Since people with more
education are likely to have lower rates of discount
(though the direction of causality is unclear) they are
also less likely to develop such an association between
past and present consumption.
It is obvious in our interviews that the link between
preferences and habits is something of which people are
generally aware. Some respondents (notably H(aakan and
Robert) also express an awareness that habits may be
changed but that these changes are costly. The logical
implicationFfrom an economic perspectiveFis that it
should also be realized that it is possible to make an
investment with the intention of changing both habits
and one’s preferences.19
Social differences in the propensity to change habits
may be strengthened by considerations of the transi-
tional period before a new habit has fully replaced an
18A comparison may, however, be made with the fact that
individuals tend to hold ethical views that are in accordance
with their self-interest (Elster, 1996), and try to rationalize their
behaviour (Kreps, 1997).
19The notion that the individual may decide to influence, e.g.,
his future utility from consumption is embraced by much of the
economic literature on habitual behaviour. One can also go one
step further and assume that meta preferences are stable and
that rational actors take full account of the relationship
between past choices and current preferences. Cf., e.g., Becker
(1996, Chapter 1), for such a general framework.
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old one. If the association between habits and prefer-
ences is sufficiently strong, it could be argued that there
is no difference in experienced utility between the two
habit-governed steady states. This will be realized by the
rational individual. At the same time, the individual may
also expect to experience a transitional period of reduced
utility when one set of preferences is being exchanged for
another, before he has become accustomed to the new
ones. A well-off person has greater opportunities to
compensate himself during such a transitional period by
increasing consumption expenditure in different areas.20 He
can also afford more high-quality products and activities.
Hence he can reasonably expect the temporary loss in utility
to be less than that expected by a poor person.
It seems fair to say that the association between habits
and preferences does not necessarily invalidate the
economic rational-actor perspective. It may yield
testable predictions regarding social differences in
behaviour, which are consistent with our empirical
findings. However, for some individuals, preferences
and habits seem so intimately connected that a change of
paradigm is suggested. The rational-choice point of view
is close at hand for a person like Elin (journalist), who
explained that. ‘‘It is not that we think that we have to
eat wholemeal bread to avoid cancer but you still have
the thought in the back of your mind about how you
lead your life.’’ On the other hand, Kalle clearly does
not see before him a situation where he would
voluntarily prefer to change to another kind of bread.
The fact that some people are unwilling to perceive a
change in habits in the ‘‘rational’’ perspective could be
accommodated within the economic paradigm. They
may be assumed to be, for example, myopic or
uninformed. However, rational considerations in the
tradition of neo-classical economics are not the sole
basis for decision making. For example, proponents of
the ‘‘old’’ institutional economics viewed habits as the
fundamental source of preferences and of rational
choice, all ‘‘y ideas, including beliefs, preferences, and
rational modes of calculation, were regarded as evolu-
tionary adaptations to circumstances, established
through the acquisition of habitual propensities’’
(Hodgson, 1998, p. 178). This almost brings us back of
course to the sociological view of habits. Once again, it
seems reasonable to suggest as a tentative hypothesis
that the neo-classical paradigm is relatively less likely to
be applicable to those with limited resources, who rely
more on habits and therefore seem likely to exhibit a
closer association between habits and preferences.
Habit versus choiceFan interpretation in a macro-
structural context
The extended and intensified process of individualiza-
tion inherently implies that the proportion of life
situations ‘‘which are fundamentally closed to decision
making is decreasing’’ (Beck, 1994a, p. 135). Hence, it
follows that whereas the category of choice is perfectly
consistent with the individualized society, the category
of habit represents instead a typical case of Ungleichzei-
tigkeit.21 This development also entails the definition of
calculated choice as the legitimate form of behaviour,
and those who do not act in accordance with this
principle tend to be viewed as indifferent and undeser-
ving people.22
The trend towards individualization also emerged as a
central dimension of the respondents’ perceptions of
social change. ‘‘These constant changes and all the
demands, this massive information y and the need to
choose. It is hard. And at the same time it is an
opportunity’’ (Birgitta, older generation). ‘‘There are
other demands on people today. Formerly one could drift
with the stream’’ (Lisa, younger generation). Kalle
(younger generation) who underlined that the course
of events was entirely his ‘‘own choice’’, missed the past
when ‘‘one got proper food’’ (home cooking) and when
‘‘conditions were simple and one was pleased with this’’.
The major principle of the present period was in his
experience, the ‘‘demands on oneself’’ (in the sphere of
work and family) which he perceived as an important
source of stress. If we listen to Birgit (cleaner, older
generation), we can moreover understand how the
continuously increased sphere of individual choice and
responsibility, could be primarily perceived as a burden.
Birgit’s attitude could be classified as a consistent short-
term perspective. She pointed out that no energy was left
in her daily life to make plans for the future and said
that she had ‘‘her hands full just thinking about the
present, and seeing that everything works as it should’’.
Birgit meant that society had ‘‘become harder’’23 and
elucidated this statement in the following way: ‘‘you have
to think more nowadays, you can’t trust people today as
20 It is reasonable to assume that individuals strive to arrange
their consumption pattern so that they can avoid temporary
reductions in the overall utility from consumption. It has been
experimentally observed that individuals prefer an improving
sequence of events and to spread events evenly (Loewenstein &
Prelec, 1993).
21The notion of Ungleichzeitigkeit (Uncontemporaneity) was
introduced by the German philosopher Ernst Bloch (1977).22Cf. the dominant designation of smoking (at a point in time
when the majority of smokers belong to the working class) as
irresponsible and vulgar behaviour, which is related to the fact
that individuals in dominant positions possess the symbolic
capital needed to set the standards for the legitimate and
desirable way of living (Poland, 2000).23 ‘‘The hard society’’ was a recurrent formulation in the
interviews, often related to increasing inequalities and/or
growing physical violence. These examples indicate a society
marked by a decreasing degree of social cohesion, where the
sense of trust is undermined, and once again bring individual
responsibility to the fore.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 461
you could at that time y You can almost expect
anything to happen. So it is a bit more insecure today
than it was before’’.
At the same time, an important function of habits is
that they provide ‘‘a structuring medium for the
continuity of life across different contexts of action’’
(Giddens, 1994, p. 101). This means that habitual
structures (in terms of daily routines) have a major
psychological significance and that the tendency to
experience the presence of habits as a security-promot-
ing structure (Berger & Luckmann, 1966) reasonably is a
universal phenomenon (just as habits generally function
as an energy-saving mechanism). It seems moreover
likely that rapid technological and institutional changes
in society, in combination with the reduction in binding
traditions and pre-determined models of behaviour,
increase the value of habits as security enhancing
factors. The more the dimension of familiarity and
consistency is sapped, the higher the valuation that we
could expect in relation to its residual fragments. The
primary issue here is whether the disinclination to
change one’s habits (as well as the overt positive view
of the habitual features of everyday life) should also be
interpreted in relation to these overall societal changes.
Could for example Kent’s systematic expression of his
preferences in terms of taking a fancy to ‘‘the same’’,
Kalle’s strong dependence on the Lockarp bread of his
childhood, or Mona’s ambition to serve the joint of
roasted meat every Sunday, also be understood as a
manifestation of a fundamental yearning for security in
a society marked by the continuous dissolution of
collective structures?
This interpretation implies that there is inevitably a
fundamental value in retaining habits but as was noted
above, this value seemed to be particularly evident
among individuals in lower social positions. In contrast,
Lisa (university student, younger generation) who
certainly recognized the association between her daily
habits and her sense of security, added: ‘‘it [habits] must
be combined with other things so that it doesn’t feel too
protectedFtoo small a world’’. Once again we meet the
tendency to judge the habitual as something relatively
less desirable which is typically associated with higher
social positions.
Here we encounter two intersecting dimensions. On
the one hand, contemporary society’s organizing prin-
ciples and dominant mentality inevitably affects us all.
Within this context, it seems likely that greater weight in
the near future will be attached to well-established
habits as a reaction to structural processes which make it
increasingly difficult to retain stability and continuity.
On the other hand, habits are just one way to try to
create some security for yourself in a changing world.
For the affluent, there will always be alternative ways of
dealing with the negatively perceived implications of
individualization, whereas for individuals in disadvan-
taged social positions, sticking to old habits may be
almost the only means available to create some sense of
security. Taking this line of argumentation one step
further, one could moreover envisage how the very
process of grounding and maintaining everyday routines
becomes a matter of long-term planning and investment
in calculated decisions (to sustain a comforting habit),
which again implies a relative disadvantage for indivi-
duals in less privileged positions.
There are two fundamental changes in the decision
environment. The changing society deprives the indivi-
dual of many energy-saving habits,24 and, at the same
time, there is a systematic increase in the number of
situations where he is explicitly expected to make
choices. In an economic perspective, both these devel-
opments suggest that the individual will feel compelled
to make certain calculated decisionsFthe alternative
prospect is often to suffer a reduction in utility. The
decision costs will be more of a burden on those with
fewer resources. Furthermore, the well off will be better
equipped to deal with this situationFbecause they rely
more on choice in daily life, they have lower decision
costs.
All things considered, it is therefore likely that in the
extensively individualized society, the odds for well-
being will be higher for those relatively well-off
individuals who are better adjusted to the strategy of
calculated choice, while the disadvantaged in society
experience that they are made worse off in utility terms.
The need to make decisions could also be seen as
stressful, giving rise to negative consequences for
health.25 Hence, there are several reasons why the
contemporary emphasis on individual choice could be
an important mechanism underlying the persistence of
social inequalities in health.
Concluding remarks
In this article, the nature of the decision process in
health-related behaviour was explored by using the
categories of habit and choice as a focus for the analysis.
It evolved around the finding of a social pattern in
relation to the habit–choice dichotomy in its various
24For example the increase in female labour market
participation has made the preparation of certain kinds of
food in the household impractical so that people are induced to
give up many of their habits-as-preferences.25One could also say that the emergence of a society where
individuals are systematically compelled to make decisions in
terms of choice implies a greater drain on emotional energy in
those groups for whom choice is not an embodied strategy. Cf.
Williams (1998) on the notion of emotional energy (capital) and
its theoretical importance as a potential link between social
structure and health.
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465462
dimensions. Approaching the same set of data from
different scientific view points and combining theoretical
perspectives within sociology and economics could be
seen as a particular version of the classical principle of
triangulation in qualitative research (Denzin, 1978).
Hence the confidence in the validity of our conclusions is
strengthened by the confluence of the implications of the
two approaches.26 We would also argue that many of
the results are due to the dialogue between two scientific
paradigms.
The essence of the common conclusions is the finding
that people in lower social positions are more inclined to
rely on habits and are accordingly less likely to change
their behaviour. These social differences are reinforced
as not only the disposition to maintain habits but also
the tendency to apprehend the habitual as something
good seem to be strengthened as we move down the
social hierarchy. These attitudes should, however, not
necessarily be seen as a truly independent factor. It
could rather be a manifestation of the partly subcon-
scious reliance on energy-saving habits or more speci-
fically of the individual’s habitus.
Finally, the most obvious aspect was the way in which
the habitual and the preferred were intertwined. There
was a clear tendency to account for one’s pattern of
behaviour by moving in circles from preferences to
habits and back to preferences again. This provides yet
another reason to expect social differences in behaviour.
The notion of a transitional period of disutility being
more of a burden for the less privileged is something
upon which both sociology and economics can agree.
There is also common ground regarding the perception
of new inequality-producing mechanisms engendered by
the process of individualization.
For policy purposes, the habit–choice dichotomy
helps explain why it is that health promotionFin
particular through information campaignsFtends to
increase rather than reduce social differences in health-
related behaviour. It can also help us understand the
consternation of health professionalsFbiased by the
middle-class outlookFregarding the relative disinclina-
tion of those in lower social positions to change
behavioural patterns.
We have focused on habits in the sense of repetitive,
non-reflective behaviour. Habitual behaviour is also
often associated with addiction. Our interviews covered
a broad spectrum of health-related behaviour, and
consequently provide little empirical basis for an
analysis of the specific relationship between habits and
addiction. However, our analysis suggests an interesting
hypothesis regarding social differences in addictive
behaviour. We noted that those in higher social
positions tended to take a disparaging view of sub-
ordinating one’s behaviour to habit. It seems likely that
this tendency functions as a restraint on the consump-
tion of potentially addictive goods, since the individual
would reasonably expect such consumption to be
relatively likely to turn into a habit. (Obviously,
however, there are many other factors underlying
observed differences in addictive behaviour, including
the previously mentioned importance of time prefer-
ences.) At the same time, from the macro viewpoint, it is
rather the institutionalized compulsion to choose that
bears an intriguing relationship to addiction. The
dominant notion that individuals have chosen their
lifestyles and consequently are responsible for their risky
behaviour naturally implies a declining tendency to see
people as victims of social conditions. It is a logical
consequence of this structurally conditioned process of
individualization that even drug addiction now tends to
be conceived as an expression of the individual’s rational
choice (Lindbladh, Lyttkens, Hanson, & .OOstergren,
1998).
A few concluding comments on the scientific dialogue
and the consequences for the two paradigms are
appropriate. As noted before, the sociologist’s focus
on decision making was initially inspired by economic
theory. The recognition of the socially polarized
categories of decision could in consequence indirectly
be assigned to this influence. It seems also obvious that
reflecting on economic theories of human behaviour
within the context of sociology has left concrete marks
on the sociological interpretation. The definition of
habits as rational decision rules with reference to their
lower decision costs (as compared to choice) could be
seen as one way to make the habitus mechanism
concrete. Accordingly this low-energy consumption
could be one way of explaining why people normally
feel at ease as long as there is an agreement between their
habitus and the everyday situations and demands with
which they are confronted.
With respect to economic research, our results suggest
that habits are very important at the micro-level as a
way to save on resources. It would seem that in many
contexts the economic model of individual behaviour
should be extended to take account of this fact
(Hodgson, 1997, 1998). Furthermore, it was noted that
the issue of social distinctions is not the normal focus for
an economist. This focus on social differences in
behaviour and attitudes towards habits has led to the
tentative hypothesis that the usual economic rational-
26A multi-theoretical approach does not necessarily eliminate
theoretical bias. It leads, however, to a more comprehensive
picture and entails an element of internal comparisons between
different explanatory perspectives that would reasonably
promote a critical assessment of interpretations and conclusions
(Flick, 1992). It is also worth noting that our model seems to
explain many other observations, such as the fact that
individuals in low social positions are much less prone to take
advantage of the possibility to change to more favourable bank
loans (SIFO, 2000).
E. Lindbladh, C.H. Lyttkens / Social Science & Medicine 55 (2002) 451–465 463
actor model is more likely to be applicable to high-
income people, whereas other models of behaviour
might be more useful with respect to the less well off.
Here the economics of satisficing behaviour, the old
institutional economics, or sociology, may provide a
useful source of inspiration.27 Future empirical work in
this direction might consequently lend support to
Bourdieu: ‘‘Economic theory which acknowledges only
the rational ‘responses’ of an indeterminate, inter-
changeable agent to ‘potential opportunities’ [y]
conceals the fact that the ‘rational’ habitus which is the
precondition for appropriate economic behaviour is the
product of a particular economic condition, the one
defined by possession of the economic and cultural
capital required in order to seize the ‘potential oppor-
tunities’ theoretically available to all.’’28
Acknowledgements
Financial support from the Swedish Council for
Planning and Co-ordination of Research, the Swedish
Council for Social Research, the Swedish Medical
Research Council (grant no. 27P-10737), and Axel and
Margaret Ax:son Johnsons foundation is gratefully
acknowledged. The authors have benefited from helpful
comments from John Cairns and the other participants
at the 19th Arne Ryde Symposium on Individual
Decisions for Health, Lund, Sweden, August 1999, and
from two anonymous referees.
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