This essay willbe outlining and evaluating the biomedical model of health. Thisessay will also outline opposing theories and models which havehighlighted weaknesses in the biomedical model of health. Thesetheories and models will then be evaluated. In conclusion to thisessay, there will be an evaluation of the biomedical model of health.
The WorldHealth Organisation define health in the following way:”Healthis a state of complete physical, mental and social well-being and notmerely the absence of disease or infirmity”.(WHO, 2017).The worldhealth organisation offers a holistic approach to health including;intellectual, psychological, mental, emotional, social and physicalhealth. Intellectual health focuses on an individual’s learning,thinking and capacity to make judgements. Psychological healthfactors into an individual’s emotional and intellectual health.
Mental health consists of the ability to think clearly and coherentlywhile coping with everyday life. Emotional health is described as anindividual’s ability to recognise their own feelings and express themappropriately. Social health involves an individual’s relationshipwith other people in society and is related to socioeconomic factorssuch as education, employment and housing. To be physically healthy,you must be mentally and emotionally healthy as the mind and the bodyare linked (WHO, 2017).
The biomedicalmodel of health is a scientific approach to health and illness,describing disease as a result of biological factors alone. Thebiomedical model is the most dominant in the western world, andexplains each illness has one cause, and once that cause is treatedor removed, the individual is healthy again. Within this model,doctors hold the power to treat or cure illnesses or diseases whichare seen as a breakdown in the human body. The biomedical model ofhealth also contains the medical model of disability which focuses ondisability in terms of the impairment that it gives an individual.The biomedical model of health has been used and is still being usedto save lives every day and is conducted by highly trained andcompetent individuals. This model also provides a structural model ofhealth. However, the social model of health offers opposing views tothe biomedical model of health which suggests that health can bedefined objectively, ignores wider social conditions that causeillness such as poverty and poor quality of food. It also suggeststhat resources are best used to improve medical science, new drugsand medical technology rather than health education and preventivemedicine (Walsh, 2004).
Socialconstruction is a major research topic in medical sociology. Socialconstruction offers significant knowledge and understanding of thesocial dimensions affecting health and illness. The socialconstructionist approach to illness not only focuses on disease,which is seen as the biological condition, but also to illness whichis seen as the social element of the condition. Gussow and Tracy(1968) were the first to explain stigmatised illnesses, as theyresearched leprosy, giving an insight to the affects that werecreated by the stigma of an illness or disease. Researchers went onto examine other illnesses which had a stigma with it such as; AIDS,mental illnesses and sexually transmitted diseases. The sigmaattached to AIDS was seen to limit the access to treatment and affectrelationships and an individual’s identity (Epstein, 1996). Incontrast to the biomedical model of health, which assumes thatdisease is purely a result of biological factors, and irrelevant tosocial factors, social constructionists emphasise how the presence ofdisease and illness is shaped by cultural and social systems (Berger& Luckman, 1966).
Social constructionists explain how illnessesand diseases change from time to time and place to place. Forexample, homosexuality was seen as a mental illness and a crime inthe UK and it was treated by therapists using extreme methods such asvomiting induced drugs and electric shocks. These methods wereentirely ineffective. Although the legalisation of homosexuality camein the UK in 1967, the World Health Organisation did not update it intheir classification of mental illness until 1992.
This example showsthat illnesses and diseases can change over time and may not beconsidered illnesses at all in different places, therefore health cannot be objectively defined as the biomedical model of health suggests(Burton, 2015).The socialmodel of health offers opposing views to the biomedical model ofhealth. The social model of health looks at how society andenvironmental factors affect our health and well-being, such as;social class, occupation, education, income, poverty and poor diet.The aim of the social model of health is to resolve the factorsabove. The description of health in the social model of health,explains that the health of an individual is based on social factors,not medical criteria.
The priority of the social model of health isto solve the problems, and laws have been put in place to reduce therisk social factors have on individuals lives. For example, in 1906local councils were told to provide free school meals for poorchildren, and in 1907 school medical examinations were also given toall children. After that in 1908, the old age pension was introducedalso. The social model of health sees illness following a patternlinked to the factors stated above, which opposes the views of thebiomedical model of health which sees illness and disease as strikingat random (Conrad & Baker 2010). The biomedical model of healthstates that only doctors and other health care professionals can usethe model, whereas the social model of health is flexible to a widerange of people can relate to it.
The biomedical model also focuseson diagnosis, cure and treatment whereas the social model of healthgives preference to the prevention of illnesses and diseases (Anon,2017).Anothercontribution to the social model of health incudes improvements inpublic health. A Marxist doctor named Thomas McKeown (1979) explainedhis historical study on mortality rates in England and Wales, and howdisease rates declined before the discovery of vaccines. McKeown alsoput forth the view throughout the 1950’s to the 1980’s that thegrowth of population in the industrialised world was not due to lifesaving treatments in the medicine field but instead to theimprovement of lives and living standards since the 1700’s.
In theearly 19th century, growing towns in Britain resulted inovercrowding, poor housing in bad weather conditions causing illnessand disease. In 1884, the first public health act was put in place,followed by the vaccination of smallpox which was compulsory in 1853,with improvements in hospital hygiene becoming regulated a yearlater. The public health act was updated in 1875. The studies ofMcKeown identified that diseases were not declining by vaccines orother biological resources, but instead were as a result of betterliving conditions and environmental factors, arguing that diseaseswere fundamentally caused by environmental factors (Ogden, 2002).Marxists agreewith the social model of health, emphasising that poverty caused byliving in an unequal society is what causes illnesses and disease.Marxists believe that poor people are exploited by rich people andthe cause of illness is poverty.
For example, if an individual isliving in poverty, its stated that they do not have essentials tolive healthily, as they will not have the money for food or shelter.Marxists argue that doctors and other health care professionals arenot there to make individuals as healthy as they can be but insteadmake individuals healthy to a minimum requirement to work, so thoseindividuals can work again and make money for the ruling class.Marxists express that dealing with social factors such as warmhousing free from damp, is more important than the priorities of thebiomedical model of health (Kirby et al, 2000).Ivan Illich isanother critic of the biomedical model of health, in 1975 proposed atheory that modern medicine has caused more damage to an individual’shealth opposed to curing or improving the illness or disease. Illichsuggested there are three types of iatrogenesis; clinical, social andcultural.
Clinical iatrogenesis arises from the medical treatment anindividual receiving making the problem worse, not better or if newconditions are created from the treatment. Ilich argued that the sideeffects of treatment caused more ill health. An example of clinicaliatrogenesis would be when lymphedema occurs as a result of breastcancer surgery. Social iatrogenesis occurs as medical treatmentsgrow, an artificial need is created, meaning more individuals rely onthe medical field. An example of this is an individual going intohospital at the end of their life, instead of staying at home. Thisfollows on to cultural iatrogenesis, where individuals feel unable tocope without dependence on the medical profession. An example of thiswould be seeking medical attention and feeling a lack of ability tomanage minor illness such as a stomach bug. As the biomedical modelof health says doctors are experts and their scientific knowledge isthe only way to be cured, Illich questions the authority of this bystating medicines cause more illnesses and in turn create adependence on the medical professionals (Giddens & Griffiths,2006).
The biomedicalmodel of health has its critics such as the social model of healthand Ivan Illich (1975) who suggested medicines make individuals moreunhealthy apposed to curing or treating illnesses. However,functionalist Talcott Parsons (1951) supports the biomedical model ofhealth’s view that doctors are the experts. Parsons created a conceptof ‘The Sick Role’.
The sick role was created to prevent individualsfaking symptoms of illnesses that can not been seen such as mentalhealth illnesses, which becomes problematic for society. Parsonsagreed that individuals have the right to be sick however they needto actively try to get better, this is when Parsons created thedoctors sick note. The sick role firstly needs to the distinguish whois well and unwell. Doctors are the main group responsible fordeciding this which is why there is a patient-practionier dynamic insociety, giving doctors a role in social control and maintaining thefunctioning of society. Secondly, the individual who is sick hasrights and obligations to adhere to, for example, the individuals areexcused from their roles in society and not blamed however, they mustsee being sick as undesirable and seek and cooperate with treatmentsgiven by doctors to get better.
This role assumes that individualswill voluntary accept the sick role. Individuals may not want tocomply with the sick role, a reason for this could be due to thestigma attached to some illnesses, for example mental health isstigmatised in society and individuals may feel shame admitting theyare affected by this. Although in more current times this is beingchallenged as people in society who have social power, such ascelebrities are normalising mental health issues.
Also, individualsmay not give up social obligations, for example a single parent maynot be able to be relieved from duties from work as they have theresponsibility of providing for their child financially (Heidarnia &Heidarnia, 2016). Although the social model of health is inopposition to the biomedical model of health, they do have somesimilarities. Both models of health have the aim of making anindividual healthy and improving their quality of life. Thebiomedical model of health uses medical knowledge to treat and cureindividuals who are sick, whereas the social model of health usesholistic health remedies such as reflexology. However, as thebiomedical model suggests, an individual should trust a doctor andagree to their treatment plan.
The social model of health gives theindividual the independence to chose their own way of becominghealthier, which is more empowering. In conclusionto this essay, it is evident that the biomedical model of health isthe most dominant model of health and the main opposition for thismodel is the social model of health. The biomedical model of healthdoes not take in account factors which do affect health such associal conditions leading to illness and disabilities that do nothave a physical impairment and mental health illnesses. It wouldappear that healthcare systems are adapting in way that provides amore holistic approach, as health remedies such as reflexology andreiki are now available on the national health service. However, thebiomedical model of health has been used to save many lives and isconducted by a team of highly trained and competent individuals.
Thebiomedical model of health has increased the knowledge of causes andtreatment regarding ill health and helps to prevent illnesses becauseof this knowledge.
