Introduction

Health is essential to individual, social and economic wellbeing. For this reason, it is central to political wellbeing or, put another way, political viability. Political success is increasingly being judged against public health parameters; the intensely divided reaction to the Obama administration's passing of the Health Bill or the emotive debate over ringfencing the NHS budget in the UK's 2010 general election are clear cases in point. As such, any examination of health goes straight to the heart of the rationalities, modes, tools and techniques of liberal governance that have been so ably explored by governmentality theorists in sociology, law, anthropology, accountancy and, most recently, geography, across a range of empirical contexts (see in particular Osborne 1997; Crampton and Elden 2007). This chapter therefore starts from the assertion that health is vital for what it tells us about the governance of individuals and society and, as a consequence, what the enterprises of governance reveal about those individuals and societies. In exploring how and why we are governed by and through health, we also uncover the ways in which space and place have become instrumental to these endeavours – a critical conceptual undertaking in the health geography perspective that underpins this book (Kearns 1993). Space and place are increasingly part of the weaponry called on to achieve the kind of sensible citizenry needed to undertake the inherently intricate task of ensuring the optimal functioning of the neoliberal project, while also managing the well-documented negative externalities. In order to explore these assertions, this chapter and that one that follows present and examine the book's core conceptual thesis and its central objectives. In so doing, they make a case for why an exploration of the overlooked realm of sensible behaviour offers a novel perspective from which to analyse health, its governance, the settings within which this takes place and the subjects who are made by these interlocked discourses and practices.

To this end, this book is grounded in three contentions:

• 1. Personal responsibility and informed choice are the discursive bedrocks of neoliberal health policy, but the relative influence of people's circumstances or ‘luck’ has received far too little attention. Given that, in order to be sensible, people need to be able to overcome the effects of their (bad) luck, the ascription of responsibility is both a ‘moral enterprise’ and a practical problem.