“That’s the Price You Pay”: Muscovites’ Understandings of Ecological Health Risks (in the Context of the Oncological Threat)

Abstract

Oncological diseases are in a special focus of social policy programmes. They are multifactorial, attributable to individuals’ lifestyle, genetic predispositions, and the external environmental factors. In the Russian healthcare system, the attempts to build a model of individual rational responsibility of individuals for themselves and for their health were being made, while sufficient institutional conditions that would allow citizens to implement the patterns of self-preservation behavior of developed countries are not fully provided. The environment, being one of the systemic factors of health, depends on infrastructural, economic, political prerequisites. At the same time, it requires a proactive subject that uses structural opportunities to manifest one’s agency. Thus, using the example of oncological diseases and their link with the environmental conditions, we aim to identify individuals’ attitudes to health and agency in selfcare. Based on the theoretical premises of interconnection between structure and agency, this study addresses the justifications that individuals apply to their health-preservation practices and oncological risks in connection with the quality of the environment or lack thereof. We take Muscovites as an example since they are the residents of a metropolis who, on the one hand, are prone to greater environmental health risks, especially in the long term, but, on the other hand, have greater access to healthcare and diagnostics.Based on the materials of 39 in-depth interviews, we conclude that environmental conditions are perceived by Muscovites as a significant factor in health, however, currently, environmental risks are insufficiently perceived as individual responsibility and an encouragement for personal proactivity. We suggest that a refusal to take a proactive position about cancer risks due to environmental factors turns is a locally rational strategy of Muscovites. Thus, Muscovites are characterized by an industrial type of self-care, in which health has a utilitarian value and is considered a ‘price’ for the benefits of an urban lifestyle, for industrialization and self-realization. Yet, Muscovites, in our opinion, would be ready to respond to environmental institutional changes.