“Optimizing” Health in the Time of COVID-19: How Neoliberal Health Orientations Dictate Families’ Responses

Abstract

Neoliberal health orientations that emphasize specific health behaviors provide frameworks for how class-advantaged Americans understand themselves and their health. The family is a consequential pathway for such privilege to be enacted. Using dyadic interviews with U.S. parents and teenagers, the authors explore how families in two middle- to upper-middle-class, health-conscious cities reoriented their beliefs and practices around health in response to coronavirus disease 2019. Neoliberal health orientations were still the logic many families used to approach health, even as public health messaging focused on protecting vulnerable groups. The authors find that before and during the pandemic, teenagers experienced intense pressure to maintain a classed, thin body via diet, participation in sports, and exercise. Families that adhered closely to neoliberal ideals and encouraged these practices felt that their health behaviors boosted immune defenses against coronavirus disease 2019. However, parents and teenagers worried about the worsening of their fitness and diet. The authors discuss implications for public health and inequalities.