Models of Health (AQA A-Level Sociology): Revision Notes
Models of Health
Understanding different approaches to health requires examining three contrasting frameworks that explain how health impacts the body and society. These models offer different perspectives on the causes of illness, treatment approaches, and the role of healthcare professionals.
These three models of health provide complementary perspectives rather than mutually exclusive approaches. Modern healthcare increasingly recognises the value of integrating insights from all three frameworks to provide comprehensive patient care.
Biomedical model
The biomedical model represents the dominant scientific medical approach in contemporary healthcare. This framework treats the human body as a biological machine where illnesses can be identified, classified, and measured through objective scientific methods.
Key characteristics of this approach include:
- Mechanical view of the body: Healthcare professionals view bodily systems as interconnected parts that can malfunction and require repair
- Focus on pathology: Primary emphasis on diagnosing and treating specific diseases rather than promoting overall wellbeing
- Scientific methodology: Relies heavily on empirical evidence, laboratory tests, and clinical observations
- Technological solutions: Employs sophisticated medical technology, prescription drugs, and surgical interventions
- Specialist approach: Different medical professionals focus on specific body systems or organs
The model's effectiveness becomes evident in areas like transplant surgery, where damaged organs (kidneys, hearts, corneas) can be replaced with functioning alternatives, demonstrating the "spare-part" approach to medical treatment.
Criticisms of the biomedical model
The biomedical approach faces substantial criticism from various perspectives. Thomas McKeown (1976) argued that public health improvements stem primarily from enhanced living standards, clean water provision, effective sewerage systems, and improved nutrition rather than medical interventions alone.
Ivan Illich (1975) introduced the concept of iatrogenesis, meaning "doctor-generated illness," which represents one of the most significant critiques of modern medicine. Understanding these three types of iatrogenesis is crucial for evaluating the limitations of biomedical approaches.
Ivan Illich (1975) introduced the concept of iatrogenesis, meaning doctor-generated illness, which encompasses three distinct forms:
- Clinical iatrogenesis: Occurs when medical treatments cause unwanted side effects or when medical malpractice harms patients rather than helping them
- Social iatrogenesis: Describes how populations become overly dependent on medical professionals, developing hypochondriac behaviours
- Cultural iatrogenesis: Refers to society's adoption of a "pill for every ill" mentality, where medical solutions are sought for all problems
Additional criticisms include:
- Gender bias: Feminist scholars argue that conventional medicine marginalises women's health concerns, leading to overprescription of tranquillisers and antidepressants while ignoring female experiences
- Medical superiority complex: Critics suggest the biomedical approach dismisses complementary and alternative medicine without proper evaluation
- Patient exclusion: The model often ignores patient opinions, experiences, and preferences in treatment decisions
Social model of health
Despite the biomedical model's global dominance, researchers observe that illness and premature death are not randomly distributed across populations. The social model of health addresses these health inequalities by examining how social factors influence wellbeing.
This approach focuses on several key areas:
Structural determinants
The model highlights how social deprivation creates health disparities. Areas like Calton in Glasgow demonstrate extreme health inequalities, where poverty and environmental factors contribute to higher disease rates and earlier mortality.
Social determinants include:
- Housing quality and overcrowding
- Environmental pollution and safety
- Access to healthcare services
- Educational opportunities
- Employment security and income levels
Lifestyle and cultural factors
The social model examines how individual choices are shaped by social circumstances. Action on Smoking and Health (2014) data reveals stark differences in smoking rates across social classes:
- Professional/managerial occupations: 14% smoking rate in 2012
- Routine/manual occupations: 33% smoking rate in 2012
- Very deprived areas: Up to 75% smoking rates
These statistics demonstrate the correlation between socioeconomic stress and harmful health behaviours, suggesting that lifestyle choices are not made in isolation from social conditions.
The dramatic difference in smoking rates between social classes (14% vs 75%) illustrates how health behaviours are strongly influenced by social circumstances rather than individual choice alone. This challenges the biomedical model's focus on individual pathology.
Contemporary developments
Recent healthcare policy has begun acknowledging social factors through initiatives like the Expert Patient Programme, which recognises patients' expertise in managing their own conditions, and think tanks such as the King's Fund, which research the social dimensions of health.
Complementary model
The complementary model offers the strongest critique of biomedical medicine by adopting a holistic perspective that integrates mind and body. This approach argues that the biomedical model focuses too narrowly on illness rather than promoting health.
Key principles include:
Holistic integration
CAM (Complementary and Alternative Medicine) therapists emphasise treating the whole person rather than isolated symptoms or body parts. This approach recognises the interconnection between physical, mental, emotional, and spiritual wellbeing.
Balance and equilibrium
Rather than suppressing symptoms through medication, the complementary model seeks to restore natural balance within the body's systems. Practitioners believe the human body possesses inherent self-healing capabilities that can be supported through appropriate interventions.
Treatment philosophy
The complementary approach differs from biomedical medicine by:
- Working with the body's natural healing processes
- Addressing root causes rather than just symptoms
- Considering environmental and emotional factors in treatment
- Emphasising prevention alongside treatment
Healthcare availability
While the NHS historically operated five homoeopathic hospitals in the UK, these have largely closed or significantly reduced their services. Current NHS policy prioritises traditional medicine, though some CAM therapies remain available through local and private providers.
Comparing the models
| Aspect | Biomedical model | Social model | Complementary model |
|---|---|---|---|
| Mind-body relationship | Separates mind from body | Examines social impact on mind and body | Holistic integration of mind and body |
| Primary focus | Illness diagnosis and cure | Social factors affecting health | Restoring balance and equilibrium |
| Treatment approach | Targets specific illness or body part | Addresses social factor impacts | Treats the whole person |
| Professional role | Doctors as experts using invasive procedures | Doctors increasingly recognise social factors | CAM therapists facilitate healing alongside natural capacity |
| Relationship with nature | Overcoming/controlling natural processes | Offsetting social disadvantage effects | Harnessing natural healing forces |
Research evidence
Worked Example: Green, Griffiths and Thompson (2006) - "Are my bones normal doctor?"
This study examined how effectively the biomedical model operates in practice, particularly regarding risk management in contemporary scientific medicine.
Participants: Middle-aged women undergoing osteoporosis screening
Aim: To investigate how healthcare professionals manage patients presenting with specific health concerns, focusing on bone density screening and risk assessment
Procedure: The researchers conducted a literature review examining the medicalisation of women's bodies through health interventions such as screening programmes. They analysed the role of medical technologies in defining risk levels and explored how screening processes generate their own risk categories.
Key Findings:
- Bone density screening has become widely accepted by both women and healthcare practitioners as essential for preventing osteoporosis
- Osteoporosis is perceived as a "women's disease," with projections suggesting one in three women will experience fractures during their lifetime
- Women identified as high-risk are recommended hormone replacement therapy (HRT), though research highlights concerning side effects
- Both patients and practitioners tend to over-interpret screening results, confirming many women as "at risk" when results allow for flexible interpretation
Evaluation Strengths:
- Addresses contemporary healthcare practices and their real-world implications
- Examines gender-specific health issues often overlooked in medical research
- Provides insight into how medical technology shapes risk perception
Evaluation Weaknesses:
- Limited to literature review rather than direct empirical research
- Focuses specifically on women's health, limiting generalisability to broader population
- May not account for beneficial aspects of screening programmes
Significance: The study supports Illich's iatrogenesis argument by demonstrating how medical interventions create new categories of illness and risk, potentially causing anxiety and unnecessary treatment in healthy individuals.
Key Points to Remember:
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The biomedical model treats the body as a machine, focusing on diagnosing and curing specific illnesses through scientific methods and medical technology
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The social model recognises that health inequalities result from social factors including poverty, education, housing, and lifestyle choices shaped by social circumstances
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The complementary model takes a holistic approach, treating the whole person and working with the body's natural healing processes rather than just suppressing symptoms
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Iatrogenesis (Illich, 1975) describes how medical practice can generate illness through clinical side effects, social dependence, and cultural over-medicalisation
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Research evidence shows that social factors interact with biological factors to produce health outcomes linked to class, gender, ethnicity, age, and regional differences