Children's Conceptualizations of Health, Healthy Bodies, and Health Practices

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Public health officials have been giving increasing attention to, and making behavioral recommendations for, reducing obesity. Many authors attribute these behavioral recommendations to the ‘dominant obesity discourse,’ which rests on the assumption that weight and disease are related in a linear fashion and emphasizes personal responsibility for “healthy lifestyle choices” and the maintenance of “healthy weights.” However, not all researchers and practitioners agree on this discourse’s effectiveness or safety. Because childhood is a critically important development period that sets the stage for health behaviors later in life, it is imperative to encourage children to have broader understandings of health that are not centered on weight. In order to achieve this aim, there is a need to explore children’s conceptualizations of health, healthy bodies, and health practices as well as the factors that shape these conceptualizations.

To address this knowledge gap, a poststructuralist approach was applied to conduct in-depth qualitative interviews with eight to 11 year old children (n=29). In Study 1, children’s conceptualizations of health, healthy bodies, and health practices as well as how these conceptualizations compared with the dominant obesity discourse were explored. Findings revealed that children placed importance on specific diet and physical activity choices and a particular type of body in order to be healthy. Less frequently, children’s concepts of health extended beyond diet, activity, and body size. In many cases, aspects of children’s conceptualizations were informed by arguments embedded within the dominant obesity and in fewer instances, children’s conceptualizations reflected alternative discourses as well. In Study 2, children’s functional, communicative, and critical health literacy were compared against their conceptualizations of health, healthy bodies, and health practices. Findings suggested that children’s conceptualizations were associated with certain aspects of functional (e.g., interpretation rather than identification of written health information), communicative (e.g., extraction of health information and application of this information to their own lives), and critical health literacy (e.g., belief in health information and level of participation in own health decisions).

Findings from this project can inform the development of recommendations, policies, and health promotion programs which offer a broader perspective on health and well-being and do not focus on weight.