Health concept Awareness in the society

 

Health is a key component in the survival and optimal functioning of every human being. It is considered a continuum according to Neumann (2009) which factors in the human being and environment with close interrelation to illness and disease concepts. Following the acknowledgment of this fact, various models developed by various scholars have sought to explain this phenomenon. These models include the sociological model of health developed by sociologists who have always viewed health and illness around behavioral orientation and the biomedical model that utilizes scientific terms in the explanation of the health and illness phenomenon (Jeana, 2010).

  1. Controversy in the definition of health.

Despite their deep insight into the explanation of health and the factors surrounding it, they do pose key differences both in definitions as well as the approaches they utilize to describe health. The definitions of health by both models raise a controversy. On its side, the biomedical model approach defines health as the absence of pain, disease or deformity and doesn’t factor in other sociological factors that define health (WHO, 2014).

Its counterpart, the sociological model of health and illness defines as a state of complete well being, socially, physically and mentally, not merely the absence of disease or infirmity (WHO/UNICEF 2014). The two statements on the definition appear contracting with the latter antagonizing the former and can greatly influence the management of diseases especially when one relies exclusively on one definition.

 

  1. The biomedical model of health

The biomedical model approaches health through a scientific approach, which involves interrelated fields all with an aim to achieving the well being of an individual as a whole. It involves a physician diagnosing a particular condition followed by its management to correct the condition. As opposed to the sociological model of health and illness, it focuses on the physical, physiological, biochemical and pathological aspects of the disease in human illness which are objective without taking into account the social aspect which is objective in nature (Dutta, 2008). Its main concentration lies in the biological factors concerning health.

According to it, health is defined as the absence of disease, pain or deformity (WHO, 2014). It holds that an illness is an abnormal functioning that results from organisms within or without the body. It can also result from internal factors such as autoimmunity dysfunctions of the body systems (Robert & Thomas, 2014). The diseases developing from these organisms can be passed from one person to another externally or through the biological systems to other generations other individuals in close contact with the individual.

Kenneth J. (2012) clarifies that disease occurs as an interaction between the individual and the disease-causing-organism in the environment and has stages for it to cause a significant clinical effect.  For some diseases, prevention is possible while, for others, it is not. The development of the disease cannot be influenced by the individual sociology, only the biological components such as genetic makeup. After the disease has developed, it is when it causes the signs and symptoms which are clear in the individual and evident through an examination of biological parameters within the body.

As opposed to the sociological model of diseases with difficulties to verify since it assumes illness to be a role, the biomedical model can verify the presence of a disease in the system

.  It is done through measurement of the current parameters in the individuals, including weight, presence of physical injury, biological alterations compared to the known normal values. Corrections of the detected abnormalities occur through tangible and evidence-based interventions such as administration of substances determined to be disturbed, which range from simple to in-depth procedures.

Biomedical model approaches rely on knowledge and skills on various biological subjects. These enable one to make comparisons between the known, the experienced and the present on the management of various conditions presenting in an individual. Some require further specialization to enable the acquisition of some finer details and know-how about the disease for easy handling and management of the complicated cases. The sociological approach may not require specializations since management of the conditions perceived by the individual or community as illness depends on the norms, beliefs, and behaviors acceptable within that society.

The worsening or improvement in the patient’s illness using the biomedical model can be easily done through reassessment compared against the baseline data, whereby the variation can be quantified clinically and be used to make a decision whether the condition has improved. As opposed to the sociological approach in which the behavioral changes, determine improvement or deterioration.

The biomedical model is uniform across all ages of the people in society. The approaches utilized in handling young children are similar for adults giving it a scientific universality with little variations in the amount of the interventions. It is also universal across all people irrespective of their cultures and backgrounds making it easily acceptable. It differs from the sociological model in that the interpretation of aspects of the sick role in a person may not be applicable in the very young and sick children who may not have undergone the process of socialization to comprehend what happens within their cultures. Its applicability may differ from one community to another since cultures and their components are not similar.

The dualism action of the body and mind as a principle is factored in the biomedical model approach. The dualism principle assumes that some aspects of the mind are not physical and assessment is through non-physical methods that include measurements and other specific assessments to achieve the right diagnosis and guidance to the achievement of the desired outcome of patient care.

In the management of patients using the biomedical model of health and illness, the principle of reductionism is well applied. It divides the body into various components, each with an important function and the role of each component, and its subcomponents being explained. It is by dysfunction of each part; that constitutes the base principle under which diseases are diagnosed, classified and managed effectively. The sociology model approach does not segregate the body’s functions, and all the behavior, even if originating from a single part of the body is considered as a whole which makes it difficult in narrowing down to a particular condition with specificity.

With the evolution of the world, technology remains a relevant component in the management of patients from their diagnosis to the treatment of the disease. The biomedical model has been in the front bar in the utilization of this in making it more effective. These range from simple diagnostic equipment for common conditions to advanced diagnostic equipment that can pick even small defects that are trouble to the patient. Curative Surgeries too have undergone significant positive change whereby surgeries that were previously considered complicated are performed with much ease and success. The use of new technology has also increased the efficiency and accuracy of investigations and their management, thus promoting a better outcome of care.  The sociological model does not take into account the changes in technology and advances since the techniques in the cure of the disease are simple and do not require advanced technology.

The doctrine of specific etiology of the disease remains well explained in the biomedical approach. For effective treatment, the causative agent of the disease must be sought and found. Its characteristics such as the drugs that can treat the survival adaptation and host characteristics that make him or her vulnerable to the condition are important for an easy target during the process of disease eradication. It is through research along with the doctrine of specific etiology that some of the diseases that their causes were previously unknown have been currently identified as well as their possible treatment and cure. Known examples are cancers and other diseases with a genetic predisposition. The sociological model does not factor in specific etiology, but views disease in a generalized manner, hence some diseases remain to have unknown causes or their causes remain differently thought of in different communities.

The biomedical model takes into account a component of generic diseases. These are the diseases that result from the alterations of the parental genetic composition giving rise to offspring with an altered genetic composition thus resulting in some conditions that are generational and run along familial lines. Their treatment can be difficult owing to the fact, genetic changes are permanent and lifelong. With advanced technology and diagnostic techniques, it is possible to detect the pathology early and to prevent it. The sociological aspect does not factor this and such diseases remain unaccounted for.

The bio-medical approach has criticisms from different scholars for various things. Friedson (1970) argued that the model is monolithic and doesn’t consider the relationships between the doctor and the patient that could affect the outcome of the care.  Engel (1981) sees the model as incomplete. He argues that the model views disease as a single entity without considering the other factors that model the health of an individual. It also tries to reduce diseases to a very small component which is not the case since the disease is a component of many factors and not very simple. The biomedical model is considered expensive in implementation and the money spent on it not having a direct influence on the outcome of health (Engel, 1981). This idea was emphasized by Powles (1984) who argued that the expenditure of money on health had no direct impact on the reduction of the illnesses in individuals.

According to Illich (1990), the biomedical model was responsible for causing more harm than benefits. He argued that physicians caused illnesses to patients instead of cure. The example he gave was the adverse reactions resulting from drugs given to the patient for the cure of a diagnosed disease. He also laid the blame on the pharmaceutical companies and manufacturers for coming up with products that were iatrogenic to society. In a similar work in the year 1990, Illich considers the biomedical model as having robbed the society a few aspects such as tolerance to pain and other social conditions and urged people, not to over depend on medicine.

The scholars accuse the bio-medical model of taking away a few roles from the society, including activities of childbirth whereby most women give birth in hospitals instead of the community as before (Oakley, 1990). A similar criticism had been raised by Donnison (1977) in support of the things that biomedicine has taken away from women in different cultures. Another criticism of biomedicine regarded pregnancy, which originally was considered a normal process, taken by biomedicine as sickness and women had to attend hospitals for it (Martin, 1989).

On the prevention of the illnesses, the model is considered a failure by focusing only on the healing process ignoring the aspects involved in disease prevention and the promotion of health among the members of the society (Taylor and Field, 2003). Nettleton (1995) criticized the model, arguing that the biomedical model does not consider social, economic inequalities that affect the health of the population. He stressed the need for factoring the lay peoples feeling about health for effective treatment.

The model has also received feminist critics who argue that it disadvantages women as compared to men by creating a gender imbalance. According to Patricia and Chiloe (1999), they argue that there is an emphasis on studying mortality from female related conditions as opposed to men. The arguments revolve around the creation of a need to involve all genders in the handling of diseases to avoid bias. Despite these criticisms, the biomedical model remains a commonly used component in the healthcare systems.

  1. The sociological model of health.

The sociological model view of health from its development to the tackling of the effects of the disease is varied and focuses on different perspectives. It views illness as natural occurrences and its cure or solution as a product of interactions within the society’s components which include cultural values, beliefs, and norms as wells societal sanctions (Armstrong, 1983).

The social definition of health is broad and lacks specificity on the various components of human life. In her handbook of the sociology of health and illness, Bernice defines health as a state of the optimal capacity of an individual allowing an effective performance of his or her social duties and tasks. This term optimum capacity does not give adequate specificity in what areas are one healthy. On the contrary, the medical model of illness has a clear definition of health. Based on WHO, the definition of health is clearly stated as a state of wellbeing, physically, mentally and socially, not merely the absence of disease or infirmity. The defining factors in all the aspects of health and in case of a deviation, it can easily be determined (WHO, 2014)

According to sociologists’ views, the society functions determine the health of its individuals, as well as the prevention of illness, (Talcott Parsons, 2006) and further explained that the happenings in the society make us perceive our natural bodies as unnatural. As per, Talcott Parsons, being sick is a role with rights and responsibilities attached to the person, the society and close relatives such as family members. Each activity pertaining to this role must be done to enable the full health of the individual. The sick person has a right not to be involved in any duties, right not to be held accountable for his or her sickness. The society expects her not to like her condition and has the responsibility of seeking help in order to get out of the condition. The society is allowed to participate in helping the individual by showing sympathy. It is allowed to lose sympathy for those who seem to enjoy the role (Talcott Parsons, 2007)

Another approach employed Marxist theory in sociology of health, the wellness of an individual, economic forces of production are the determinants. Samuel B. (2011) argues that the origin of diseases as per the Marxist conceptualization has included injuries, job-related stress, pollution and all is a product of operations to sustain the economic system. His view quantifies that diseases occur as a result of the consumption of the products.  He cites products like chemical additives in foods, cars and other products of production as the ones resulting in illness.

In sociological explanations, education appears to have an influence on health. The more one is exposed to education, the more is likely to have better health. The education influences one’s health by exposing him or her to more knowledge on sociological behaviors affecting health as well as social interactions. The role of how one feeds, recreational facilities are also given weight on the influence on the effects on health in determining how we perceive our bodies. (Ann  & Chris, 2011).

  1. Awareness of constructivism.

Constructionists view health factors through our experience in our bodies internally. Peter Morral (2001) explains that illness cannot occur without human beings perceiving it as internally present. This is also stressed by Armstrong in her argument that the feeling of being ill or healthy is determined by the individual’s assumption of the sick role.

With its adoption and involvement in the care of patients, the sociological model has contributed to various aspects of health promotion and management. It has contributed to the deeper analysis and comparison of diseases and factors contributing to them. This has been used in the control and management of various diseases such as HIV / AIDS and other diseases that are socially based. Through the analysis of the various cultures and how they affect the disease process, the sociological model has brought a breakthrough in various orientations including medical education across cultures (Rose W. 2012).

Diseases that have been viewed by the community from different aspects. These include mental diseases and other stigmatized diseases in which the use of the sociological model has analyzed the causative and contributing factors leading to their mitigation, contributing to the overall health of the individual as well as the community.

Major organizations dealing with human health and its related aspects have utilized the somitogenesis model in coming up with solutions to health issues. It has also been important in the development of community health systems acting as a linkage between the biomedical and comprehensive care of patients.

The sociological model has criticisms too based on the way it operates. It is known not to factor in the differences in some characteristics of each person. This includes the age of a person in the interpretation of socio-cultural contributors to their health and that is because age is a key factor in the process of socialization and the young may not socialize enough to assume the sick role. According to Thomas et al. (2004), people with disability may be oppressed by this sociological way of illness and health interpretation due to the effect of their disability. These individuals may fail to be included in society, affecting their health. The model also requires more time in the analysis of all factors that affect the health hence making it more difficult to implement for every person.

Lay ideas on health refer to the people’s diluted knowledge on medical issues developed and nurtured within communities as a result of social and cultural orientations as well as geographical location. They differ from community to community and across cultures.

Some of these lay ideas believe in biological causes of diseases while others value the sociological models. Some communities go deeper to develop the epidemiology of this disease, as well as explanations of them depending on their lay understanding.

It is important to understand these lay ideas of people on health for various benefits that include the understanding of the patient-health care provider relationships. It also provides the basis for planning, implementations and the success of health education programs for the implementation of these may require the community to unlearn the beliefs learned in the culture.

Though they appear true to the believers in the lay ideas, they differ with biomedical ideas as well as the sociological model of illness and health in that they cannot undergo verification scientifically as well as through formal explanations. Understanding the lay ideas help in knowing the community health beliefs hence understand the models they likely to choose either the sociological or the biomedical model (Dutta 2008).

REFERENCES.

Ann M. & Chris Y. 2011. Understanding the sociology of health. An introduction. New York; NY: Sage

Ann O. 1993. Essays on women, medicine and health. Edinburgh; UK: Edinburgh university press.

Dutta M. 2008.Communicating Health: A Culture-centered Approach. Boston: Polity.

Illich I. 1995. Limits to Medicine: Medical Nemesis – The Expropriation of Health. London; UK: Marion Boyars.

Jeana L. 2010.Therapist’s Guide to Positive Psychological Interventions. America: Academic     Press.

Kenneth J. 2012. Epidemiology, an introduction. Oxford; UK: Oxford University Press.

Nettleton S. 1995. The sociology of health and illness. Boston; USA: Polity.

Peter M. 2001. Sociology of nursing. Hove; UK: Psychology Press.

Robert H. & Thomas A. 2014. Epidemiology for Public Health Practice. Sudbury; MA: Jones & Bartlett Learning.

Rose W. (2012). Sociology of Health and Illness and health care. Hampshire: Cengage learning.

Share S. & David R. 2001. Handbook of cultural health psychology. Salt Lake City; USA: Academic Press.


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