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Measuring Health & Illness
Two indicators are used: Morbidity and Mortality.
It is impossible to measure morbidity with any validity or reliability because definitions of health and illness are so subjective.
Therefore, mortality rates are the most commonly used to measure health/illness.
Discuss (Pairs)
What do you think has happened in the UK to explain this continuous decline in mortality?
In pairs, identify and explain a minimum of five explanations.
Ext: - Which explanations would be favoured by the biomedical model?
The Social Model of Health
The Social Model of Health is an umbrella term for a range of ideas and strategies about health and healthcare.
It emerged as a result of criticisms against the biomedical model.
RECAP: What were the key criticisms of thebiomedical model? Write down at least two!
The Social Model of Health
The biomedical model looks for the causes of illness within the individual.
The social model looks for the causes of illness within society.
McKeown (1976)
The work of McKeown (and othermedical historians) is one of thebiggest criticisms of biomedicine – and demonstrates the importance of the social model.
The McKeown Thesis states that medical intervention has been largely ineffective in curing illness and disease.
Tuberculosis
What is tuberculosis?
http://www.nhs.uk/Conditions/Tuberculosis/Pages/Introduction.aspx
McKeown used tuberculosis as a case study (though the same has been applied to other diseases)
Social Factors
1. Nutrition
Improvement in people’s diet – due to advances in agriculture (e.g. new crops, increased availability) – from end of C17th onwards.
Better nutritional levels increase resistance to infectious disease (and reduce death by starvation).
Social Factors
2. Public Hygiene
E.g. Cleaner, piped water and better sewage disposal.
This reduces exposure to disease (esp. water-borne diseases like cholera).
Improved food hygiene from 1900 also helped (e.g. Introduction of sterilisation and bottling).
Social Factors
3. Birth Limitation
Fall in birth-rate and family size in the middle-classes from 1870s.
Limits on population crucial for health of a society.
Drop in birth-rate also nearly eliminates infanticide by reducing unwanted pregnancy.
Criticisms of McKeown
Not all diseases respond to an improvement in the social environment.
Medicine was the decisive factor in curing/treating diseases like diphtheria and polio.
Relative To… The society you live in Your gender Your Social Class Your ethnicity Your age
In pairs: Identify at least two ways in which EACH ONE of the above could influence how healthy/ill you feel (5 mins)
Relative to… The society you live in (e.g. obesity)
Your gender (e.g. men less likely to define themselves as “ill”)
Your social class (e.g. working class accept higher levels of illness)
Your ethnicity (Punjabis in Bradford suffer from a ‘sinking heart’)
Your age (e.g. joint pains being accepted as normal)
The Social Model
Nettleton (2006) Health and disease are socially
patterned. Illness is not randomly
distributed: There are clear patterns in terms of class, gender andethnicity.
This suggests it is social andenvironmental factors that makesome groups more vulnerable todisease than others.
The Social Model
Promotes the view that the definitions and judgements of lay people are just as valid as professional assessments.
Much illness is diagnosed and treated within the family.
Illness is a personal experience, not a medical one.
The Social Model
McKeown developed his work into a critique of modern healthcare.
He argues that we spend too much money on treating disease and not enough on prevention and health education.
Criticisms of the Social Model
Most of the time, illness exists. It’s not relative or subjective: If you’re ill, you’re ill.
The social model doesn’t ‘replace’ the biomedical model: It puts it into perspective.
Activity (Small groups)
Create a presentation promoting your own healthcare company that only uses the social model to treat illness/disease.
How would such an approach work?
20 mins then present.