Conceptualising the experience of health risk: the case of everyday management of elevated cholesterol

Abstract

Public health and individual health care are increasingly oriented towards managing risks. This ‘surveillance medicine’ does not target present illnesses but aims to prevent possible future conditions, greatly expanding the number of people implicated in medical interventions. In this paper, I interrogate the everyday experience of being at risk of illness. First, I suggest that we lack a comprehensive account of this experience, because current ways to characterise this phenomenon tend to equate risk with (chronic) illness and patient status. I then report a case study designed to avoid this starting point. I conducted interviews with laypersons with varying levels of elevated cholesterol, a common risk factor for cardiovascular diseases, who were recruited from a consumer panel in Finland in 2015. I found three elements that structure the health risk experience: the intangible nature of risk, the probabilistic character of risk estimates, and the ambivalent status of risk in terms of health and illness. While these findings overlap with previous literature in many ways, detaching health risk from illness foregrounds health management instead of patient behaviour. These findings call for caution in approaching health risk uncritically through illness categories or patient status, and I invite researchers to critically examine such elements in other cases and contexts.