The Lifestyle & Health Jurisdiction: A Danish Case about Reducing the Development of Lifestyle Related Chronic Diseases

The objective of this paper is to contribute new insights on the intra- and inter-professional responses to, and dynamics within, an emerging jurisdiction of health problems related to lifestyles. It is examined how health professionals and hospitalised patients are mobilised to reduce the risk of developing the most common and deadly lifestyle related chronic diseases. How are socially contested issues such as dieting, smoking, alcohol intake and physical activity (in Danish the so-called KRAM factors) defined and managed in terms of medical problems? A Danish case to illustrate the issues of disease prevention as they emerge in clinical practice in Danish publicly owned hospitals is: “KRAM screening & intervention”, that is registration and detection of patients’ so-called risk factors to strengthening the efforts on disease prevention. This intervention program followed up by disease prevention counseling is a free service provided by publicly owned hospitals, at present in the Northern part of Denmark, eventually all over the country. One key jurisdictional dynamic to be analysed in this paper is: Jurisdictional disputes and professional settlements (Abbott 1998, 2005): What is the division of labour between medical doctors and other professional groups within the interventions programs, and how is this division of labour maintained in professional practice and organization? Empirical materials include documents (standard procedures, registration forms a.o.), qualitative interviews with patients and counselors about goals and practices, and observations of counseling situations. It is discussed how medico ideas feed into the policy process and how governance networks are linked to explain why lifestyle problems are turned into the medical area, nationally as well as in international spheres, i.e. WHO.