Improving Health Status Using the Social and Biomedical Approaches to Health (VCE SSCE Health and Human Development): Revision Notes

Improving Health Status Using the Social and Biomedical Approaches to Health

Introduction

Over the past century, Australia has experienced remarkable improvements in health status, with significant changes in patterns of death and disease. As these disease patterns evolve, the strategies needed to address them must also adapt. Understanding how disease and illness have changed over time, and examining the interventions that have been implemented, helps us tackle contemporary health challenges more effectively.

Both the biomedical and social models of health offer different perspectives on health, wellbeing and illness. Whilst each approach has its own strengths and limitations, there is now clear recognition that both are essential for bringing about meaningful improvements in health status and overall wellbeing.

We can see the value of combining these two approaches by examining how lung cancer mortality has changed over time, and identifying which interventions have proven most effective.

Lung cancer case study

Historical context and trends

During the early twentieth century, lung cancer was considered uncommon, and specific mortality data for lung cancer was not collected until 1945. The graph below shows how death rates from lung cancer have changed since recording began.

For males, there was a sharp rise in lung cancer deaths that reached its highest point around 1980. Tobacco smoking was responsible for the vast majority of these lung cancer deaths in both males and females.

Health promotion and the social model of health

Early anti-smoking campaigns

Anti-smoking health promotion campaigns first appeared in Australia during the early 1970s. This timing coincided with growing scientific understanding about the connection between smoking and various forms of cancer, particularly lung cancer. The catalyst for government action was the 1964 United States Surgeon General's report on smoking, which definitively linked smoking to disease and death, and called for urgent government intervention.

Population-based approaches

Recognising that sociocultural and environmental factors significantly influence health and wellbeing, both state and Commonwealth governments implemented a wide range of population-based approaches. These initiatives were designed to promote health and wellbeing, minimise the harmful effects of passive smoking on non-smokers, and encourage people to either quit smoking or avoid taking it up altogether.

These approaches clearly reflect the social model of health principles and included:

• Comprehensive anti-smoking media campaigns that educated the public about smoking dangers
• Policies that made tobacco products significantly more expensive through taxation
• Strict regulations on tobacco products, including advertising bans
• Requirements for plain packaging on all tobacco products
• Mandating that tobacco products be kept out of sight in retail outlets

These population-wide strategies have been instrumental in reducing smoking uptake rates and encouraging existing smokers to quit.

Timeline of key anti-smoking interventions

The following timeline shows major milestones in Australia's comprehensive anti-smoking efforts over nearly five decades:

1973 — Health warnings first appeared on cigarette packets in Australia

1976 — Tobacco advertising banned on radio and television

1985 — Quit organisation established; anti-smoking television commercials launched

1987 — Commonwealth Government banned smoking on domestic flights

1990 — Commonwealth Government banned tobacco advertising in newspapers and magazines

1995 — Most tobacco sponsorship phased out

1996 — Billboards, outdoor and illuminated cigarette advertising signs banned

2006 — Graphic anti-smoking advertisements broadcast

2010 — Multiple significant changes implemented:

• Smoking banned in pubs and clubs
• Tobacco taxes increased by 25 per cent
• All states and territories (except Northern Territory) banned smoking in cars carrying children
• Point-of-sale displays in retail outlets selling tobacco prohibited
• Plain packaging became mandatory for all tobacco products
• Publishing tobacco advertising on internet or other electronic media became an offence

2013 — First 12.5 per cent tobacco excise increase on 1 December

2017 — Four additional annual 12.5 per cent tobacco excise (tax) increases implemented each 1 September from 2017 to 2020

Decline in smoking rates

The social model of health has proven highly effective in reducing smoking prevalence and minimising harm from passive smoking. According to the National Drug Strategy Household Survey, only 11.6 per cent of Australian adults smoked daily in 2019. This represents a significant decline from 12.8 per cent in 2016, and the rate has fallen by half since 1991, when it stood at 25 per cent.

Biomedical approach to lung cancer

Importance of medical intervention

Despite declining death rates from lung cancer, cancer remains a major cause of both death and disability in Australia, even after decades of health promotion initiatives. Therefore, it is crucial that people who develop lung cancer can access medical care for early diagnosis and receive appropriate treatment when needed. The biomedical approach to health is essential for improving both individual health and wellbeing outcomes and overall population health status.

Improvements in survival rates

Advances in our understanding of lung cancer and developments in medical technology have significantly improved survival chances. The five-year survival rate was only 8 per cent during 1983–87. By 2018, this rate had more than doubled to 18 per cent.

Diagnosis methods

Early and accurate diagnosis is crucial for effective treatment. Lung cancer is diagnosed using various tests and procedures, including:

• Chest X-rays — create images of the lungs to identify abnormalities
• Sputum cytology — involves examining phlegm samples under a microscope
• Bronchoscopy — insertion of a flexible tube through the mouth or nose into the lungs to examine airways
• Fine needle aspiration — removes a small tissue sample from the lungs through the chest wall for analysis
• CT scans — computed tomography scans use specialised x-rays taken from multiple angles to build a three-dimensional picture of the body
• PET scans — involve injecting a small amount of radioactive material, enabling a scanner to build up a detailed picture of the body
• Bone scans — detect whether cancer has spread to the bones

Treatment options

Once diagnosed, various treatments may be implemented, including:

• Surgery — to remove affected parts of the lung
• Radiotherapy — uses high-energy radiation to destroy cancer cells
• Chemotherapy — uses drugs to kill cancer cells or stop them from growing

Until recently, there was limited evidence suggesting that people with terminal lung cancer could be cured. However, new technologies are currently being trialled that may offer those with advanced cancer a genuine chance of cure. Furthermore, improvements in technology have enabled people suffering from terminal lung cancer to receive more effective palliative care.

The value of combining both approaches

It is clear that both the biomedical and social models of health have made vital contributions to reducing lung cancer death rates and improving health status. The social model has focused on bringing about behaviour change through education, policy and environmental modifications, whilst the biomedical model has improved diagnosis and treatment services. Together, these complementary approaches have achieved far more than either could accomplish alone.