Abstract：
Health promotion has long recognized the ecological determinants of health, underscoring the interconnections between planetary health, economic systems and human health. Despite calls for synergy across them, these domains are governed by fundamentally divergent paradigms leading to unaddressed conceptual and institutional gaps. Sustainability, meanwhile, is reduced to personal responsibility and behaviour change. This qualitative research explores ecological determinants through a focus on sustainable consumption in the under-researched context of the global south where rapid modernization has profoundly impacted the natural environment. The article uses the theoretical framework of \'practice\'-namely, the social routines, values, conventions and norms that drive consumption-to critically examine everyday household sustainable consumption in India\'s southern state of Kerala. The findings show that in most households, sustainability is a health promotion practice. People practice sustainability fundamentally for its beneficial health outcomes. However, the institutional structures set up in favour of economic development continue to dominate society and is the paradigm that contextualizes everyday social life for consumers. The findings suggest that the practice of sustainable consumption is complex and caught in the space that is neither \'upstream\' or \'downstream\'; instead, the focus on the \'mid-stream\' reveals complex calculations that go into everyday negotiation of healthy living.
Consumerism is rapidly spreading through the global south. While the conveniences associated with easily available goods are appreciated, population health has been adversely impacted by attendant decline in ecosystems through the increase in plastics, waste and toxicity in the food chain. Health promoters, for decades, have sought to draw attention to the misalignment between the values that govern environment, economy, and health policies. This article investigates policy misalignment through the experiences of everyday consumers. Set in the context Kerala, in south India, which has recently seen rapid consumerism, the study shows that everyday consumption, even unsustainable ones, are part of meaningful social practices actively negotiated around health. Thus, people buy goods wrapped in plastic, despite its environmental impacts, because it is perceived as safer. Individuals act ‘unsustainably’ largely because they have little control over systemic factors—like urbanization, changes in social life, lack of government regulation and infrastructure—that shape their consumption practices. The study shows that initiatives that focus on knowledge and behaviour modification are not sufficient to ensure sustainable consumption. Instead, what is needed are institutional convergences across environment, economy and health priorities so that individuals can create new consumption practices that are both sustainable and healthy.
Consumerism is rapidly spreading through the global south. While the conveniences associated with easily available goods are appreciated, population health has been adversely impacted by attendant decline in ecosystems through the increase in plastics, waste and toxicity in the food chain. Health promoters, for decades, have sought to draw attention to the misalignment between the values that govern environment, economy, and health policies. This article investigates policy misalignment through the experiences of everyday consumers. Set in the context Kerala, in south India, which has recently seen rapid consumerism, the study shows that everyday consumption, even unsustainable ones, are part of meaningful social practices actively negotiated around health. Thus, people buy goods wrapped in plastic, despite its environmental impacts, because it is perceived as safer. Individuals act ‘unsustainably’ largely because they have little control over systemic factors—like urbanization, changes in social life, lack of government regulation and infrastructure—that shape their consumption practices. The study shows that initiatives that focus on knowledge and behaviour modification are not sufficient to ensure sustainable consumption. Instead, what is needed are institutional convergences across environment, economy and health priorities so that individuals can create new consumption practices that are both sustainable and healthy.
摘要：
健康促进早已认识到健康的生态决定因素,强调行星健康之间的相互联系，经济体系和人类健康。尽管呼吁在他们之间发挥协同作用，这些领域受到根本分歧的范式的支配，导致未解决的概念和制度差距。可持续性,同时,减少到个人责任和行为改变。这项定性研究通过在全球南部研究不足的背景下对可持续消费的关注来探索生态决定因素，该地区的快速现代化对自然环境产生了深远的影响。本文使用了“实践”的理论框架-即，社会惯例，值,推动消费的公约和规范-严格审查印度南部喀拉拉邦的日常家庭可持续消费。调查结果表明，在大多数家庭中，可持续发展是一种健康促进实践。人们从根本上实践可持续性是为了其有益的健康结果。然而,为促进经济发展而建立的体制结构继续主导着社会，并且是为消费者提供日常社会生活背景的范式。研究结果表明，可持续消费的实践是复杂的，并且陷入了既不是“上游”也不是“下游”的空间；相反，对“中流”的关注揭示了进入健康生活日常谈判的复杂计算。
消费主义正在全球南方迅速蔓延。虽然人们赞赏与容易获得的商品相关的便利，随着塑料的增加，生态系统的衰退对人口健康产生了不利影响，食物链中的废物和毒性。健康促进者,几十年来,试图提请注意管理环境的价值观之间的错位，经济,和卫生政策。本文通过日常消费者的经验来调查政策失调。在喀拉拉邦的背景下，在印度南部,最近出现了快速的消费主义，研究表明，日常消费，即使是不可持续的，是围绕健康积极谈判的有意义的社会实践的一部分。因此，人们购买用塑料包装的商品，尽管对环境有影响,因为它被认为更安全。个人行为“不可持续”，主要是因为他们对城市化等系统性因素几乎没有控制权，社会生活的变化，缺乏政府监管和基础设施-这塑造了他们的消费实践。研究表明，注重知识和行为改变的举措不足以确保可持续消费。相反，需要的是跨环境的制度融合，经济和健康优先事项，以便个人可以创造可持续和健康的新消费实践。
消费主义正在全球南方迅速蔓延。虽然人们赞赏与容易获得的商品相关的便利，随着塑料的增加，生态系统的衰退对人口健康产生了不利影响，食物链中的废物和毒性。健康促进者,几十年来,试图提请注意管理环境的价值观之间的错位，经济,和卫生政策。本文通过日常消费者的经验来调查政策失调。在喀拉拉邦的背景下，在印度南部,最近出现了快速的消费主义，研究表明，日常消费，即使是不可持续的，是围绕健康积极谈判的有意义的社会实践的一部分。因此，人们购买用塑料包装的商品，尽管对环境有影响,因为它被认为更安全。个人行为“不可持续”，主要是因为他们对城市化等系统性因素几乎没有控制权，社会生活的变化，缺乏政府监管和基础设施-这塑造了他们的消费实践。研究表明，注重知识和行为改变的举措不足以确保可持续消费。相反，需要的是跨环境的制度融合，经济和健康优先事项，以便个人可以创造可持续和健康的新消费实践。
