Data from the 1984 Illinois Comparative Health Survey are used to examine whether
the poor have adopted a consumer orientation toward professional health services
in view of the reduction of financial barriers and clear signs of increased physician
utilization. It was found, however, that lower-status persons stand as more or less
passive recipients of such services, with a significantly greater tendency to invest
responsibility for their own physical health in the health-care delivery system itself.
Yet there was a general lack of difference with respect to health lifestyles involving
food habits, emphasis on appearance, sports and exercise, smoking, and alcohol use.
A culture-of-medicine thesis was found to provide a stronger explanation of this
situation than a culture-of-poverty perspective. Medicine and the mass media have
promoted the practice of a healthy lifestyle, but have not encouraged consumerism
in the physician-patient relationship. Consequently, it appears that where social
institutions provide positive sanctions, self-management and consumerism seems to
grow for the poor; but where negative sanctions exist, consumerism does not seem