Development of New Public Health and the Social Model of Health (VCE SSCE Health and Human Development): Revision Notes
Development of New Public Health and the Social Model of Health
The emergence of new public health
By the 1970s, Australia's health landscape had changed dramatically. Medical advances and improved knowledge about disease had successfully controlled many infectious diseases that once caused widespread death. However, a new challenge emerged: lifestyle diseases, particularly cardiovascular disease and cancer, had become the leading causes of death and disability.
The biomedical approach, which focuses on treating illness and disease, could improve health outcomes to some extent. However, many of these new diseases were linked to lifestyle factors such as smoking, poor diet and lack of physical activity. Health authorities believed that if people were educated about the health consequences of their behaviours, they would make healthier choices. This led to health promotion strategies being introduced alongside biomedical treatments.
Despite widespread health education campaigns, awareness alone proved insufficient to change behaviour. Even when people knew that smoking, poor diet and lack of exercise harmed their health, many did not change their behaviours. This gap between knowledge and action revealed a fundamental limitation of the traditional approach.
Additionally, health inequalities were widening - wealthier individuals consistently experienced better health outcomes than those from lower socioeconomic backgrounds.
This realisation highlighted an important truth: numerous factors influencing health and wellbeing lie beyond individual control. Health behaviours and outcomes are shaped by the physical, sociocultural and political environments in which people live. This understanding led to the development of new public health, also known as the social model of health.
Understanding the social model of health
The social model of health recognises that achieving better health requires more than just individual behaviour change. This approach acknowledges the significant influence of sociocultural factors - including socioeconomic status, access to healthcare and social connections - on health status and wellbeing.
Key Definitions:
New public health is an approach to health that expands the traditional focus on individual behaviour change to one that considers the ways in which physical, sociocultural and political environments impact on health.
Social model of health is an approach that recognises improvements in health and wellbeing can only be achieved by directing effort towards addressing the physical, sociocultural and political environments of health that have an impact on individuals and population groups.
The key insight of this model is that by addressing underlying sociocultural and environmental factors, many diseases and illnesses can be prevented altogether. Rather than focusing solely on individuals (as the biomedical approach does), the social model takes a community-development approach. It uses policies, education and health promotion activities to create healthier environments and more equitable conditions for all people.
Principles of the social model of health
The social model of health operates according to five interconnected principles that guide health promotion efforts across Australia.
Addresses the broader determinants of health
While behavioural factors - such as reducing tobacco smoking or eating a nutritious diet - are important for health, these behaviours don't occur in isolation. They are influenced by broader determinants including gender, culture, race or ethnicity, socioeconomic status, geographical location and the physical environment.
These broader determinants have strong relationships with health status and wellbeing. For example, someone's ability to eat healthily may be limited by their income, the availability of fresh food in their area, or their working hours. The social model recognises these connections and increasingly focuses health promotion strategies on addressing these underlying factors rather than just targeting individual behaviours.
Involves intersectoral collaboration
Many organisations beyond the health system influence the sociocultural and environmental factors that affect health. Government departments responsible for employment, education, finance, housing and transport all play important roles. Private sector organisations, including service providers and manufacturers, also have significant influence.
While the health system contributes greatly to health outcomes, it cannot address sociocultural and physical environments alone. Intersectoral collaboration means having groups from many sectors - such as government, health and the private sector - working together to achieve a common goal.
By encouraging collaboration between all interested groups both inside and outside the health sector, the social model enables more effective action on the sociocultural and physical factors that shape health outcomes.
Acts to reduce social inequities
Many individuals and population groups experience poorer health due to sociocultural and environmental factors including gender, culture, race, socioeconomic status, access to healthcare, social exclusion and the physical environment. These factors contribute to unfair differences in health status between groups.
To reduce social inequities, efforts to improve health must take these factors into account. This means designing health promotion programs that specifically address the needs of disadvantaged groups and tackle the underlying causes of health inequalities rather than just their symptoms.
Acts to enable access to healthcare
Healthcare significantly influences health and wellbeing for most people. However, various sociocultural and environmental factors can create barriers to accessing healthcare services. These include cultural and language differences, economic constraints, geographical isolation and varying levels of education.
Enabling access to healthcare means ensuring services are readily available to everyone, simple to understand and designed with consideration for aspects such as culture, gender and ethnicity. This might involve providing interpreter services, establishing healthcare facilities in remote areas, or offering culturally appropriate health programs.
Empowers individuals and communities
Empowerment means enabling people to participate in decision-making about their health and wellbeing. When individuals feel they have power and control over their circumstances, they are more likely to engage in healthy behaviours.
By building health knowledge and skills within communities, the social model helps individuals make positive changes to their health and wellbeing. This might include community health education programs, peer support networks or initiatives that give communities a voice in planning local health services.
Advantages of the social model of health
The social model of health has become a key component of Australia's health system, working alongside the biomedical approach. This model offers several important benefits:
| Advantage | Explanation |
|---|---|
| Promotes good health and assists in preventing diseases | By focusing on the broader determinants of health and wellbeing, this approach can prevent conditions from developing in the first place, thereby improving health status across populations. |
| Takes a holistic approach to health and wellbeing | Rather than only addressing diseases that are already present, this model has the potential to promote overall health and wellbeing by considering all dimensions of health. |
| Less expensive than the biomedical approach | While health promotion programs may cost millions of dollars to implement, this investment is often significantly cheaper than treating conditions after symptoms develop. Prevention saves healthcare costs in the long term. |
| Focuses on vulnerable population groups | Because it emphasises promoting equity, many disadvantaged groups become targets of health promotion programs, including Aboriginal and Torres Strait Islander peoples, those from low socioeconomic backgrounds and people living outside major cities. |
| Education can be passed between generations | The social model often uses education to enhance health and wellbeing. This knowledge can be shared with future generations, creating sustainable improvements in health status over time. |
| Shares responsibility for health and wellbeing | This approach makes health and wellbeing the responsibility of more than just the health sector, meaning the underlying causes of poor health are more likely to be addressed effectively. |
The cost-effectiveness of the social model is particularly significant when considering long-term healthcare expenditure. Investing in prevention through health promotion programs can reduce the burden of chronic disease management and treatment costs over decades.
Disadvantages of the social model of health
Despite its many strengths, the social model of health has some limitations that must be acknowledged:
| Disadvantage | Explanation |
|---|---|
| Not every illness or condition can be prevented | The causes of some conditions, particularly many genetic conditions, can be very difficult or impossible to prevent through environmental or social changes. |
| Does not promote the development of technology and medical knowledge | Because this model focuses on the broader determinants of health and wellbeing, it does not directly encourage medical advancements or technological innovations in healthcare. |
| Does not address the health concerns of individuals | People who are already sick are not a specific focus of the social model of health. This can negatively impact their health and wellbeing, and consequently affect the health status of the overall population. |
| Health promotion messages may be ignored | The social model relies on public cooperation and engagement. If people choose to ignore the health messages provided, health and wellbeing outcomes may not improve despite significant investment in programs. |
While the social model excels at prevention and population-level health improvement, it must work in conjunction with the biomedical approach to ensure comprehensive healthcare. Individuals who are currently experiencing illness still require medical treatment and support.
Remember!
Key Points to Remember:
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New public health emerged in the 1970s as lifestyle diseases replaced infectious diseases as the leading causes of death, highlighting the need to address broader determinants of health beyond individual behaviour.
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The social model of health recognises that improvements in health and wellbeing require addressing the physical, sociocultural and political environments that impact individuals and communities, not just treating disease.
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Five key principles guide the social model: addressing broader determinants of health, involving intersectoral collaboration, reducing social inequities, enabling access to healthcare, and empowering individuals and communities.
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Major advantages include disease prevention, a holistic approach to wellbeing, cost-effectiveness compared to treatment, focus on vulnerable groups, intergenerational benefits and shared responsibility across sectors.
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Key limitations include the inability to prevent all conditions (especially genetic ones), lack of focus on medical technology development, insufficient attention to individual health concerns, and dependence on public cooperation.