The ideological construction of risk: an analysis of corporate health promotion programs in the 1980s.

The nature of theoretical knowledge about health promotion and disease prevention programs at the worksite is examined in the context of knowledge as ideological construction. The emergence of the discourse about health promotion is linked to corporate attempts to reduce their share of medical expenditures and solve problems of productivity and absenteeism which plague the American workforce. Although not always evident, corporate managers choose selectively from a body of knowledge about medical costs and illness and disease in contemporary America. That knowledge reinforces the notion of risk: individual propensity to the risk of disease or the attempts of the firm to minimize risk. Three examples of ideological construction: (1) the corporate construction of the cost problem in terms of employee demand and overutilization; (2) the construction of disease etiology as individual risk; and (3) entrepreneurial activity in health promotion, all provide evidence for the dominance of the risk discourse.