For several decades, scholars have discussed the function of science education. At the heart of this discussion is the emphasis either on science for science’s sake or on science for citizenship and democracy. Douglas Roberts (2007) outlines two different views: Vision I and II. The goal in Vision I is science literacy, that is, knowledge within the scientific disciplines. In Vision II, the goal is scientific literacy, that is, the creation of the ability to use scientific knowledge to handle complex societal issues or, in other words, to be an informed citizen. Vision II is a democratic and inclusive form of science education. It has taken many different shapes in science education research and policy documents over the last three decades. The science-technology-society (STS) movement was followed by, e.g., “science-technology-citizenship” (Kolstø, 2001), “socioscientific issues” (SSI) (Ratcliffe & Grace, 2003; Zeidler, Sadler, Simmons, & Howes, 2005), the “public understanding of science” (Solomon, 1992), “humanistic science education” (Aikenhead, 2006) and, recently, by “Science|Environment|Health” (S|E|H) (Zeyer & Dillon, 2014, 2019). These directions all involve a drive towards scientific literacy and call for interdisciplinary science education, not only among science subjects but also between science, the humanities and social science. Sadler (2004) proposed SSI as a way to open up science education as a practice where students’ identities can be expressed as part of their everyday life. For this reason, working with SSI is characterized by making school science important and usable outside the classroom and outside the scientific discourse.
If we as educators want to leverage SSI to promote practices and understandings that support development of students as informed and capable citizens, then we ought not strip away the contextual realities of these issues that confer meaning and generate student interest. (Sadler & Zeidler, 2009, pp. 912–913).
More recently, Zeidler, Herman, and Sadler (2019) have brought together new trends in SSI research involving socioscientific reasoning, socioscientific perspective taking and informal and place-based contexts. The ever more complex societal problems facing us require interdisciplinary science education with such capacities.
Furthermore, topics within the S|E|H and SSI approaches are controversial, rife with moral tensions (Zeidler et al., 2019), and characterized by both descriptive facts and normative values, thus making them both scientific and political. This article will elaborate on the political and democratic dimensions of S|E|H and SSI. To that end, we use our ongoing research on responsibility for obesity. Therefore, this study contributes to the discussion of new directions in science education research (Liu & Wang, 2019; Zeidler et al., 2019; Zeyer & Dillon, 2019). It explores whether responsibility for obesity is individualized and depoliticized in Swedish schools and discusses what kinds of citizenship and democracy are thus constructed. The empirical material consists of teaching materials that are used by teachers in Swedish schools in the subjects of biology, health pedagogy, physical education and health, and science.
This article is structured in three parts. The initial part is theoretical. First, we discuss health as an individual and/or societal problem; second, we elaborate on the concepts of politics, democracy and citizenship. The next part is empirical and consists of a presentation of our research and our empirical results on how obesity is treated in Swedish teaching materials. We focus on whether the causes of and solutions to obesity are described as individual and/or societal since these dimensions are the foundation of responsibility. The last part discusses the empirical results in relation to the theoretical framework consisting of politics, democracy and citizenship. We discuss what forms of citizenship and democracy are constructed in the Swedish teaching materials for science and health and the implications for future health education.
Individualization, global health problems and schools
In recent decades, Western societies have undergone major changes in regard to the location of responsibility. Within a wide range of societal areas, a shift from democratic politics to individual responsibility has occurred (Brown, 2015; Miller & Rose, 2008; Mouffe, 2005; Nordgren, 2003, 2010). The focus on individual responsibility rather than democratic politics is described using labels such as “individualization”, “depoliticization” and “responsibilization” (Soneryd & Uggla, 2015), which are often connected to the notion of a neoliberal rationality and what Wendy Brown (2015) calls ‘Undoing of the Demos’.
The transition from democratic politics to individual responsibility is also prominent within health. Robert Crawford (1980) labeled this phenomenon “healthism”. Central to healthism is that the fact that it solicits the individual and locates the determinants of health and the solutions to health problems at the level of the individual. Health becomes individualized and depoliticized, detached from social and political factors. This is the case even though health problems are to a large extent caused by social factors and, therefore, are often better served by political solutions (e.g., Marmot, 2015; Wilkinson & Pickett, 2011, 2018).
The Lancet Commission report The Global Syndemic of Obesity, Undernutrition, and Climate Change (Swinburn et al., 2019) singles out obesity as one of three global challenges. The report questions the predominant idea that individuals are personally responsible for health-related behavior and states that health and health behavior are strongly influenced by the social environment. This statement is in line with what Michael Marmot writes: “The social distribution of obesity and overweight within and between countries should give pause to those who think of health only in terms of personal responsibility” (p. 66).
Although health has generally improved over the last several decades, the health inequalities both between and within countries are increasing (e.g., Berkman, 2009). It is evident that health outcomes fall along a social gradient, showing that at every step on the socioeconomic ladder, poorer people have poorer health (Marmot, 2015; Wilkinson & Pickett, 2011). Furthermore, obesity is generally increasing globally (Swinburn et al., 2019).
There are many different societal institutions that are important for engaging citizens in health, society and politics. The educational system is probably the most important. In short, how young people perceive themselves and society – as solitary individuals or as democratic citizens – depends to a large extent on what issues are put on the agenda and how they are framed in schools. Schools are one of the most important institutions in the making of citizens, i.e., people who are involved in society, are interested in and participate in democratic politics (Amnå, Ekström, & Stattin, 2016). This point is clearly manifested in political decisions about our educational system. One main task of schools, at least insofar as this task is expressed in the Swedish Educational Act (SFS, 2010:800) and other documents that regulate the Swedish educational system, is to develop pupils into active, competent and responsible individuals and democratic citizens.
Despite the explicit formulations in the Swedish Educational Act, the extent to which schools actually contribute to making democratic citizens is unclear. The question is if and how health education entails societal and political perspectives. This question is discussed by Katie Fitzpatrick (2016). Discussing the purpose of health education, she says that two different and competing approaches appear – education about health, on the one hand, and about making students healthy, on the other hand. The tension is unresolvable since the educational norm is to deal with actual health problems and health promotion with the aim of making pupils healthy. In Katie Fitzpatrick’s words, health education is caught in an “ethical bind” (2016) that opens up a moralistic paradigm (Jensen, 1997) characterized by the cultivation of a pedagogy aiming at behavioral change. This type of strategy easily creates a focus on individual responsibility for health issues rather than a focus on democratic politics.
This focus on individual responsibility stands in contrast to a statement issued by the WHO asserting that the social determinants of health (SDOH) need to be part of health literacy, i.e., health education needs to include skills related to, for example, accessing, understanding and communicating information on the SDOH (Commission of Social Determinants of Health, 2008). According to Nutbeam (see Smith, Nutbeam, & McCaffery, 2013), health literacy is divided into three levels: functional health literacy, interactive health literacy and critical health literacy. The third level is described as follows:
Critical health literacy reflects the literacy and numeracy skills that support critical reflection on information or advice received, including recognition of the influence of wider social determinants of health. These include the ability to obtain, understand and critically appraise different sources of information, and the ability to engage in shared decision-making. (Smith et al., 2013, p. 1013).
This emphasis on the SDOH has led to the founding of organizations, e.g., Just Health Action in the Pacific Northwest of the USA. The health pedagogy of such organizations (Mogford, Gould, & DeVoght, 2010) is not only “critical” but also interactive and inspired by Paulo Freire’s pedagogy of the oppressed. They conceptualize critical health pedagogy as knowledge related to teaching the SDOH, activities that help students find their own traits based on the SDOH and actions for development and implementation to increase health equity. This approach is a promising example of how the content of health education can be widened.
Politics, democracy and citizenship
Our theoretical perspective is based on the distinction between individual and political responsibility (Malmberg & Urbas, 2019; Urbas & Malmberg, 2019). We use this distinction when analyzing how responsibility for health (obesity) is portrayed in teaching materials and what kinds of citizenship and democracy are thus created.
As mentioned above, one of the main functions of Swedish schools is to develop pupils into active and participating citizens in a democratic society. This function concerns all school subjects. Specifically, those that treat health issues with their challenges, complexity and convergence of value and knowledge. To discuss the democratic function, a few points regarding politics and democracy need to be clarified.
First, we recognize the relation between politics and democracy, meaning that (the existence or presence of) politics is a prerequisite for democracy. We can have politics without democracy (nondemocratic politics), but we cannot have democracy without politics.
Second, we adopt David Easton’s classic definition of politics:” … what distinguishes political interactions from all other kinds of social interactions is that they are predominantly oriented toward the authoritative allocation of values for a society” (Easton, 1965, p. 50).
Accordingly, for us, politics is about the making of binding decisions (rules, laws and norms) that regulate the lives of members of an association, for example, a state (Dahl, 1989, 2000). Put differently, “… politics is about decisions, collective decisions which are in some way regarded as binding upon a group of people” (Heywood, 2004, p. 52).
Our definition of politics as the governing of an association through decisions that are binding for its members (e.g., Lewin, 2015) differentiates politics from individual decisions, especially those that focus on and concern only the individual. In this sense, politics is a social activity (Hay, 2007; Heywood, 2004). Furthermore, our definition builds on the idea that politics incorporates dimensions such as situations of choice and human capacity for change. If one or both of these dimensions are lacking, either, for example, as a law of nature (e.g., gravitation or thermodynamics) or due to religious/ideological propaganda that makes people believe that “it must be in a certain way” or “there are no alternatives”, then there are no politics (Hay, 2007).
Third, we use a classic and simple view of democracy. According to us, democracy is about collective self-governance; put differently, about citizens governing the association of which they are members (Dahl, 1989) This aspect is important since there are alternatives – rule by a single person or a group of persons. Wendy Brown describes it as follows: “The idea of the people ruling themselves together in a polity is important for many reasons, but not least because the alternative is to be ruled by others” (Brown, 2015, 2019).
The fourth point relates to the important distinction between individual decisions that affect only the individual him- or herself and democratic politics that affects an association. The decisions that an individual makes only on his or her behalf and that are not focused on the authoritative allocation of values for society are not political. The focus on the authoritative allocation of values is important since it differentiates between politics and nonpolitics. This distinction can be illustrated by a related but not identical view that separates manifest political participation from civil participation (which should be understood as latent political participation). Separate from other forms of action, political participation, according to Ekman and Amnå, is “… quite simply all actions directed towards influencing governmental decisions and political outcomes” (Ekman & Amnå, 2012, p. 289).
Furthermore, manifest political participation, according to Ekman and Amnå (2012), can be differentiated into formal political participation and (legal and illegal) activism. Both formal political participation and activism (extraparliamentary participation) can take individual and collective forms. Examples of formal political participation that are individual include a) voting in elections, b) contacting political representatives and, c) running for or holding public office. Examples of formal political participation that are collective include a) being a member of a political party and b) being active within an organization or a trade union. Examples of activism that are individual include a) signing petitions and b) handing out political brochures. Examples of collective forms of activism include a) involvement in new social movements and b) participation in strikes and demonstrations. These are all legal forms of activism. Both individual and collective activism can also be illegal. Examples include civil disobedience, politically motivated attacks on property and sabotage (Ekman & Amnå, 2012). Thus, politics and political participation are oriented towards the authoritative allocation of values for society; put differently, they are oriented towards rules, laws and norms that that are binding and that regulate life within an association (Dahl, 1989).
The fifth point positions citizens at the heart of democracy. If democracy is rule by the people, then democracy needs citizens, i.e., people who at least to some degree are involved in society and are interested in and participate in politics. Citizen participation in politics is often seen as a core element in democracy (van Deth, 2014) since it means – or at least should mean – that the rules, laws and norms that regulate life within an association are decided by citizens (Dahl, 1989, 2000; Dalton, 2008).
The question, then, is how people – particularly young people – become citizens, i.e., persons who are involved in society, are interested in and participate in politics. In this regard, one crucial societal institution is the educational system, as mentioned above, since it affects the norms and knowledge of young people. One can claim that schools are the most important institution in the making (or unmaking) of citizens (Amnå et al., 2016). How urgent and challenging issues such as obesity are framed in schools affects how young people view these issues (as personal or political), themselves (as individuals or as citizens), action (as individual or political) and society (as given or as changeable). Therefore, it is important to analyze how the causes of and solutions to and, thereby, the responsibility for health issues (in our case, obesity) are portrayed in schools.