ln this assignment
ln this assignment, I am going to discuss how social factors and social categories can influence health by comparing the social model of health to the biomedical model.
There are many models of health throughout the world but the models that play the largest roles in the UK, USA, France and a greater part of Western Europe are the biomedical and social-medical models.
Healthcare in the west this society today is dominated by professionals employing the Biomedical Model Baxter (2010) This model defines health as individuals being free of illness or disease; each of which has a cause and effect. When this cause and its associated effect are removed the individual is deemed to be healthy.
Due to its rigorous scientific basis, this model is an efficient diagnostic tool. In addition, it promotes restorative health by employing widely differing techniques, e.g., pharmaceutical and surgery. Therefore, any illness displaying symptoms can be diagnosed and treated (Jones,1994)
However, this model fails to consider social factors that can and do influence illness. Therefore, the biomedical model fails to consider an individual’s social circumstances, e.g., effects of poverty (ref). This model treats the mind and body differently, i.e., the cure is key, not prevention; this disempowers the individual as it fails to embrace a holistic approach to health (Yuill et al. (2011)
To this end, the biomedical model only treats the visible symptoms. This can be harmful to the individual as it places significant power in the hands of health professionals – power that can and has been abused.
An example of this abuse within our society is when professionals have such power over their patients and no one questions that power because as professionals in our society we do not expect abuse and mistrust to exist. However, an example is the case of Dr. Harold Shipman who abused the trust of his patients by injecting them with lethal doses of morphine and killing patients he deemed not fit to live. In addition, Ian Patterson carried out operations for breast cancer in which he failed to remove the correct amount of diseased tissue from the breast so in those cases patients died. Despite cases like this, innocent people seem to always place a lot of trust in their doctors and consultants.
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figure 1 The determinants of health (Dahlgren and Whitehead, 1993; in Dahlgren and Whitehead, 2007)
By examining Dahlgren and Whitehead’s model we can see that within our society a more social model explains health and well-being through a social context rather than starting with a person physical state of health or disease. They suggest it is how we focus on living conditions and social factors and why they affect health and well-being within everyday life that is important. Having both a healthy mind and body can be achieved by the individual or group if these factors can be incorporated into people’s everyday lives – making the smallest of changes can have a greater impact on themselves their family and society on a whole.
Therefore, a suitable alternative to the biomedical model is the social model of health (Yuill and Duncan, 2010) as it recognizes the role of the individual in determining their own wellbeing. This model considers the effects of poverty, diet, pollution, etc. These forms of inequality are all tackled by this model as they are not found within the biomedical counterpart (Dahlgren and Whitehead, 1993).
The main aim of this model is to empower the individual (ref) so they can reduce the effects of poverty. For example, by uniting with others to demand a change in social circumstance the whole group can embrace a healthier lifestyle; thus, making the process of change holistic rather than deterministic. Overall, this model aims to improve core factors that cause illness, so they will not occur again – prevention for the group rather than a cure for the individual (Henderson,2014).
Admirable as this may be, this model fails to embrace the biological basis of illness as well as recognizing that social change never occurs quickly. Hence, social prevention only offers improvement when applied over time and is acceptable to the individual or group (Henderson, 2014).
It is my conclusion that the biomedical model of health only works if an individual suffers visible physical illness or injury. The social model of health within our society only concentrates on how we live our everyday life; health and well-being being a side product of how we live – that is if we are living in poverty, poor housing and how we manage our diets.
According to philosopher and social therapist Michel Foucault (1973), the doctors and patient relationship and our health and social care services are dominated by the power those professionals hold over their patients. Indeed, the hold medical professionals have over western society today lead Martin Marshal to suggest:
“The medical model is so dominant, so seductive in the health service, that unless we challenge it in a very concerted and focused way, we’re not going to be able to develop an alternative.”
Martin Marshall (Vice Chair of the Royal College of General Practitioners) in Iacobucci (2018, p. K1034)
Within our society, people are social by nature as connections between them are required to maintain both a healthy well-being. A lack of connections with others can lead to a feeling of isolation, so exhibiting a negative impact on our personal state of mind and behavior. Within our society interpersonal power is the way individuals form and maintain social relationships that can stop them feeling isolated and to being judged (service user quoted in Leach, 2015, p65)
However, we must remember that the social model is not devoid of power over the individual; there are legal obligations and policies in place within the social model that can be as restrictive and powerful as those displayed within the biomedical model. For example, people who are in hospitals or care homes or live at home but have support workers coming to do things for them to deserve to be treated fairly and with respect and to have power over their own lives for what they want to do but sometimes this is not always the case; they are not always included in the decisions made about their care.
Managers and other professionals have significant responsibilities placed upon them because people who need care go to them for help and advice sometimes it is very difficult for them to make decisions. For example, it could be a professional a social worker that has to decide a care package for an individual suffering dementia and could be a danger to themselves and others. Should they go into a care home with 24 – hour care, stay at home with support or go into hospital for medical attention so they can have their treatment they need. These examples would put a lot of strain on themselves, their manager and other professionals as they can only do what in their legally obliged to do and within their professional policies and codes of practice operating within their organization.
However, people who use all these services have, according to the social model, the power to complain or make other demands; they could also get a second opinion or find other information about other services that available to them. But why does the system still go wrong, why is the offered empowerment not so readily available?
David was a 59-year-old diabetic who died in poverty. Due to DWP sanctions, David was unable to prevent his electricity being cut off; or buy food. At post-mortem, it was discovered that David’s stomach was empty and, due to the lack of refrigeration, his insulin had spoiled.
Due to his lack of power David was alone and it could be argued that both models had exerted power over his situation but in different ways. The biomedical model had dealt with his symptoms and provided insulin to maintain his life; the medical professional’s job was done. The social model failed as it did not recognize the need for an advocate for David (Action for advocacy, 2007); a response to his need by, for example, a social worker, that likely would have saved his life. As David was a quiet and reserved individual who was intimidated by all forms of authority, it appears the social model exerted a level of power over him.
Evidence now exists that both models have exserted power but in very different ways. That power served to ensure the death of David, a death that need not have occurred if either model was able to recognize David’s failing health. Therefore, this serves to demonstrate that no single model of health can adequately promote an overarching prototypical scenario of healthcare.
Word Count: 1450Reference List
Action for advocacy (2007) a4a Online. Available at https://www.actionforadvocacy.org.uk/ (Accessed 20 November) Atkinson, D. (1999) Advocacy: A Review, London, Pavilion/Joseph Rowntree Foundation.
Baxter, M. (2010) Health, Cambridge, Polity
Foucault, M, 1973. In Open University K219, Online. Accessed 19, Novermber 2018.
Henderson, R. (2014) Holistic Medicine Online. Available at https://patient.info/ doctor/ holistic-medicine (Accessed 9 July 2018).
Jones, R. K. (2004) ‘Schism and heresy in the development of orthodox medicine: The threat to medical hegemony’, Social Science & Medicine vol. 58, no. 4, pp. 703–712.
Leach. 2015. In Open University K219, Online. Accessed 19, Novermber 2018.
Martin Marshall (Vice Chair of the Royal College of General Practitioners) in Iacobucci (2018, p. K1034)
Yuill, C., Crimson, I. and Duncan, E. (2010) ‘The social model of health’, in SAGE Key Concepts Series: Key Concepts in Health Studies Online, London, Sage UK. Available at https://search-credoreference-com.libezproxy.open.ac.uk/ content/ entry/ sageukkcheal/ the_social_model_of_health/ 0 (Accessed 20 November 2018)
