What does the biomedical model of health and illness suggest about the cause of disease and what is meant by “health”?
It locates the cause of disease in the individual
It sees each health problem as being in isolation
It sees health is a biological process
What does the social model of health and illness suggest about the cause of disease and what is meant by “health”?
It locates the cause of disease in the relationship between individual and society
It sees health as a social construct - it cannot be understood by focusing on biological processes alone
What is the difference in the way the biomedical and social models of health and illness focus on risk factors?
Biomedical focuses on genetics and clinical risk factors
It focuses on the risk factors on an individual level
Social focuses on social structures and risk factors
It focuses on risk factors to ill health being related to the individual and society
What is the difference in what is highlighted by the biomedical and social models of health and illness?
Biomedical highlights risk behaviours and individual behavioural change
Social highlights social change
What is the key focus of the social model of illness and health?
It locates health and illness as a social construct that cannot be understood by only focusing on biological processes
How does the fact that there have been changes in adolescent mental-health behaviours over the last 10 years relate to the social model?
There is no change in genetics or biology that accounts for the change in behaviour
The environment has changed, and certain behaviours have changed due to social factors
How does wealth relate to life expectancy?
Wealth does not necessarily equate to life expectancy
Why is a high life expectancy not always a positive?
Life expectancy describes how long you will live, but not how well you will live
It does not take into account quality of life
What are the UN indicators of poverty and deprivation?
- dirty water
- lack of sanitation
- lack of shelter
- poor nutrition and insufficient calories
- lack of essential medical and maternity care
- no access to education
- information deprivation
What do poverty and deprivation lead to?
- high infant mortality
- high morbidity
- premature death
What is meant by absolute poverty?
A condition where household income is insufficient to afford basic necessities of life
e.g. food, shelter, clothing
When is someone defined as living in absolute poverty?
If a person is living in conditions that meet at least 2 of the UN indicators
What is meant by relative poverty?
A condition where household income is a certain percentage below median income for that country
How is relative poverty defined within the EU?
Having a household income that is < 60% of the national median
What is the Index of Multiple Deprivation (IMD) used to measure?
It measures how well certain areas are doing compared to others
It is about the earnings of the area in which you live, not individual earnings
What are the 7 domains of deprivation included in the Index of Multiple Deprivation (IMD)?
- barriers to housing and services
- living environment
It is mainly driven by income and employment
What is health inequality that is present from birth in the UK?
The area in which the child is born
e.g. a boy born to a family in the most deprived area of Blackpool can expect to live for 67 years
a boy born to a family in the least deprived area of Hart can expect to live for 89 years
How can the area in which you are born affect health outcomes?
In more deprived areas, there is a reduction in life expectancy
People also live a shorter length of time being disability-free
What is meant by human agency?
This is the capacity of an individual to act independently
They have the ability to make choices and impose those choices
What constrains human agency?
Social structures constrain the ability to exercise choices that are made by an individual
What is meant by social structures?
Society is composed of:
- an organised set of institutions
- patterns of relationships
How can society affect decisions made relating to health?
Social structure, such as media, wealth, law, economy, social networks, family, religion can affect the way in which choices are made and imposed
How is women’s agency constrained to an extent?
Through the social context of family
They have increasing agency over the choices they make with their bodies e.g. contraceptives
What did Pierre Bourdieu - Habitus state about social classes?
It is not the type of work you do that determines your place in society, it is your interactions with society
e.g. it easier for people with relatives in the medical profession to get a place in medical school
What was the focus of Habitus on the maintenance of social status?
Social order and status are maintained across generations
Access to cultural, symbolic and social capital produces and reproduces inequality
How is socioeconomic status related to health?
Mortality rate decreases as socioeconomic status increases
e.g. much lower mortality rate amongst professionals than manual labour
What are social structures and what do they determine?
They are a product of our social interactions
They determine distribution of power and capital (economic, cultural and social)
How can social structures lead to inequality?
They constrain our agency through the distribution of power and creation of norms of behaviour
Inequality of opportunity if social structures favour some groups over others
What is meant by intersectionality?
It identifies that interlocking systems of power have a compounded impact
What is meant by inequality?
A systematic difference in the distribution of power, resources and opportunity in a social system
What is an example of reproducing inequality?
Educational outcomes are the highest amongst those with the highest socioeconomic status
What is the Rainbow model when describing determinants of health?
Individuals are placed at the centre and surrounding them are various layers of influences on their health:
- age, sex and constitutional factors of the individual (in the centre)
- individual lifestyle factors
- social and community networks
- living and working conditions
- general socioeconomic, cultural and environmental conditions
According to the rainbow model, what are the living and working conditions that influence health?
- agriculture and food production
- work environment
- water and sanitation
- health care services
What constitutes the social determinant of health?
Why is this significant?
Structural determinants and conditions of daily life constitute the social determinants of health
They are crucial to explaining health inequalities
What did Marmot estimate the NHS costs associated with inequalities was?
£5.5 billion a year
What is meant by health inequity?
There is an unjust distribution of health and healthcare due to inequality
How can a health inequality be defined?
Variation in health status, life expectancy, mortality and morbidity between different groups
Inequalities are systematic differences in health that are judged to be avoidable by reasonable action
How are health inequalities linked to lifestyle choices?
Social position is linked to health status through lifestyle
How can the relationship between health status and social position/lifestyle be changed?
Through health education and access to healthier diets and physical activity
How much does health problems associated with poor housing cost the NHS?
At least £600 million a year
What is meant by the life-course explanation?
Health develops over a lifetime and across generations
What are the 3 aspects that influence health status development over time?
Health trajectories are particularly affected during sensitive periods
today’s exposures influence tomorrow’s health
physical and social environment affects the capacity to be healthy