Health Craftsmen: Shaping a Healthy Image of Old Age

Abstract

The article examines the concept of 'craftsmen of health' — a special category of individuals who promote a positive perception of aging. The research is based on the results of four focus groups conducted in July 2024 at the Russian Gerontological Scientific and Clinical Center with elderly individuals undergoing medical examinations. Participants were selected based on their pensioner status, some of whom had experience caring for aging parents (children of centenarians over 90 years old). The authors identify several key practices that are characteristic of health craftsmen. First, they consider regular preventive check-ups to be essential, even in the absence of symptoms. Second, conscious dietary habits have become a way of life, not just a preventive measure. Third, consistent physical activity adapted to individual needs plays a crucial role. Fourth, maintaining intellectual stimulation through work or specialized cognitive exercises significantly contributes to well-being. Special attention is given to the social dimension of healthcare. Respondents emphasize the importance of feeling needed within family circles. Health craftsmen view their proactive behavior as a contribution to scientific knowledge and healthcare development, as well as personal gain. They are critical of official medicine and often experiment with alternative treatments, willingly sharing their experiences. The study reveals contradictions between the dominant 'logic of choice' in modern medicine, which prioritizes individualization and standardization, and the 'logic of care,' which emphasizes open, long-term relationships among participants. Drawing on the theoretical works by Richard Sennett and Annemarie Mol, the authors advocate for moving away from mechanistic views of health and adopting a more flexible approach that considers the uniqueness of each case. Key challenges to developing health craftsmanship include the age barrier to learning new things and the lack of mechanisms for transferring experience across generations. The authors propose viewing health craftsmen as socially oriented experts whose activities aim to promote both longevity and quality of life. Healthy aging is presented as achieving a balance between longevity and happiness, with the primary objective being to maintain a ‘good life’ rather than absolute health. Over the past few decades, old age has acquired normative traits that go beyond biological and social descriptions, and has become a subject of norm creation. Although numerous state programs and institutions divide responsibilities, they often absorb and redefine public initiatives. In Russia, a healthy lifestyle remains a state responsibility approached through multifunctional, multipronged strategies outlined in roadmaps and distributed among the relevant agencies. However, such regulation risks losing the human element in healthcare. Pursuing objectivity, order, and discipline can lead to an expansion of normative frameworks, which undermines the agency of individuals. Here, the pursuit of health is reimagined as striking a balance between freedom and coercion, with an emphasis on care rather than mechanistic treatment.