The outcome of this essay is to focus on a discussion between the biomedical and social models of health and illness and the social determinants of health. The biomedical and social model of health and illness has been around for the past century (national centre for biotechnical information, 2004). Analysing and debating the social and biomedical models of health and illness, sociological perspectives of the models as there are many sociologists agree that there is only one explanation of illness (Durkheim, 1895).
Health has different definitions within the modern world, Earle (1995) as can defining the word health can be quite hard to describe. The meaning of the world health has a meaning of absence of disease (Kelman, 1975). The biomedical model of health will look at the individual aspects of each individuals physical functioning, this giving a description of illness and bad health. As a result of physical causes such as injury and infections the biomedical model does not look at the social and psychological factors, it influences the persons perceptions to what a person experiences feel like to be ill. Many individuals feel anomalous sensations depending on the change of the disease that has been cured (National library of medicine, 2004).The social model looks at the health within the society and the environment affecting those everyday factors such as class, gender and ethnicity. Therefore the dominant biomedical model is not sustainable on its own and therefore needs to have the social model incorporated to improve the quality of healthcare (Adibi, 2014). The Bio medical model of health and illness has been influenced by the decisions of individual patients and the delivery of health care as it is today (Wade,2004).
The biomedical model of health has been described as with its focus on the bodies and the disease entities rather than the people on the whole. Biomedical model of health and illness, which has dominated health care for the past century, cannot fully explain a numerous of illnesses (Wade and Halligan, 2004). This failure partly comes from the three assumptions that all illnesses comes with a single underlying cause, disease (pathology). The assumptions of the biomedical model are the germ theory of diseases, the separation of the mind and body (dualism), and rendering the patient as the sick machine. The treatment of illnesses lies within the hands of every trained specialist that those are capable of seeing the patient through the medical gaze and not with the untrained eye (Sutton, 2013). Foucault (2010) has been influential on viewing the ways that modern medicine is part of the process of regulating and disciplining both of the individual bodies and of the social body. The whole idea of the biomedical model was to take shape of the health of the public by eradicating pathologies from the social body. The biomedical model is classed as the dominant within disease as it has been within the healthcare for the past century (Wade and Halligan, 2004). Having progressed thoughts into and beyond the enlightenment Descartes (1596-1650) focused on the whole person and not just the body. Cartesian dualism comes from Descartes (1596-1650) because of the whole perspective of the focus on the whole body. Within the bio medical model it is classed that health is in the absence of a biological abnormality, that diseases have specific causes and that the human body is to be like a machine so that it can be restored to health through treatments with help to reverse the disease (Taylor and field, 2004). Sociologists have discussed the terms of health and illness and to outline the biological and sociological perceptions towards health and illness (lard bucket, ND). Bio medical and social model of health and illness are the health conditions that people are born and grow with, live, work and the age including the health system. These conditions can be influenced by things such as age, gender and social classes. (World health organisation, 2016). The social model of health and illness is mostly responsible for the health inequalities. By scientists concentrating on smaller fragments of the body, modern medicine often loses sight (Rhodes, 1995) of the patient as being a human, and to reduce health to be like mechanical functioning; (Bennett, 1994). It is no longer able to deal with the phenomenon of healing. Baggott (2004) has stated that the biomedical model rest mainly on biomedical changes. In effect this is directed towards the dysfunction of the organs and tissues of the body rather than the overall condition of the patient. Having evaluated the different perspectives of health and illness within the society, it describes different patterns of the health inequalities according to the national centre for biotechnical information (NCBI, 2006b). Sociologists study the incidences of health and illness within the population linking the variables such as gender, race, age, social class and geography (health knowledge, 1995). Evidence exists that the three assumptions of the biomedical model are wrong. It describes the problems with the current models and describes a new model, which has derived from the World Health Organization's international (WHO, 2014) classification of functioning framework, which provides a more comprehensive, less biologically dependent account of any illness. According to Talcott Parsons (1991) he believed that an illness is partly biologically and socially defined. Talcott Parsons (1991) also argued that an illness was a form of deviance and disruptive towards the normal functioning towards society. Talcott parsons (2016) sees the structure of an organisation of the society more important than an individual (Truman, 2015). Problems with the Biomedical Model is that the analogy between the causes of physical and psychological disorders. The problems are a product of continuous adverse influences covering over long-term periods (Szasz, 1960).
Blaxter (1990) argues that the medical model of health does not focus on the biomedical science and that more holistic concepts of health are also part of medical practice. Many sociologists argued that the biomedical model is outdated and quite unhelpful, thinking that is possibly used as a strait jacket when it comes to thinking about health matters (Allot and Robb, 1998). Simply because this has come to light by Engebretson, (2003) it has shown that other models of health have emerged that show the role of the social factors and the production and distribution of disease. The biomedical model related to the belief that medicine is neutral and scientific. But the social model emphasises in the way that healthcare is influenced by a range of social factors this includes age, gender and social class (Jeffery, 1979). Talcott Parsons (1991) believed that an illness is partly biological and socially defined. Talcott Parsons (1991) argued that ill health was a form of deviance and disruptive to the normal functioning of the society. And that those who are really ill are able to adopt the sick role. Freidson (1970) argues that the sick role has been modified into three ways that depend on the legitimacy of the illness, special privileges that are normally accorded due to the illness being withheld from those who have stigmatised illnesses. Those who claimed to be ill but where not ill where perceived as skivers and malingerers. Erving Goffman (1963) argued that stigma is a discrediting label that can change, and spoil the way that each person is viewed. Goffman (1963) argued that there were two types of condition this was discrediting where the disease that is visible quite clearly to others and discreditable was diseases that cannot be seen by an individual. Although some forms of diseases are immediately stigmatised due to having features that are visible and to also have no visible diseases. Downs syndrome has said that it is discrediting due to facial features being distinct, so that person has been portrayed with the stigmatisation of the theories that Goffman (1963) pursued. The media have stigmatised the parents of children who have downs syndrome as the parents have been seeking cosmetic surgery (Down’s syndrome Scotland, 1999). The social detriments of health have a large impact on health and the widening gap in health inequalities (WHO, 2008). World health organisation (2008) stated that unequal distribution of health damaging illnesses is not in any sense a natural phenomenon, that the determents and conditions of illness are part of the daily life that constitute towards the social determinants of health. The social determinates do have a direct impact on health and the behaviours (Lee, 2005). The social gradient of health inequalities between all countries is caused by unequal distribution of health care, schools, education, communities and the chances of living a full and normal life. The social determents of health have a big impact on the social gradient and a vast majority of diseases (wainwright, 2008). The differences in people’s health across the National Health Service are a widening gap between the richest and the poorest. Men in the least deprived areas can tend to live 13-14 years longer than those men that are living in the deprived areas of the country. The main gaps for women in the deprived areas are between 8-9 years longer (Equalities in health, 2014). Health inequalities within the models have shown that such variables compromise the indicators of people’s social circumstances and social class. These health inequalities include housing, education, transport, income and social support (Nettleton, 2008). The Register Generals Social Class Scheme (RGSC) and the Socio-economic Group (SEG) first appeared in 1911. In 1951 the classification of the occupations where sorted with surveys and censuses these where used to give the form of social class (Clarke, 2010). The surveys where used to outline the differences of mortality and health between the sub grouping of the social class within the population. Social classes where determined by manual and non-manual work that reflected on the differences and skill levels of each individual. (Registrar Genera’s Social Class, 2001) and (Socio-Economic Group, 2001) attempted to introduce a third classification. The third classification introduced the occupation, working employment status and the size of the establishment where the person worked (National statistics Socio-economic Classification, 2001). Independent Inquiry into Inequalities in Health, Acheson Report (1998) state that inequalities health is measured in terms of mortality, life expectancy or the health status of the individual. This is categorised by socioeconomic measures or ethnic group. The Black Report explains health inequalities by dividing them into four broad categories artefactual explanations, theories of natural and social selection, cultural and behaviour explanations (Townsend et al, 1992). Income is one of the main detriments of living standards that is enjoyed by individuals and families. Evidence has shown that that income inequality within the society is associated with the differences in health (Lynch et al, 2000). Wilkinson (1986) showed that the occupational activities that experienced faster rise in income showed the fastest fall in mortality. Chadwick’s report (1842) showed that poor housing was established within sanitary conditions, damp housing and poor ventilation showed that was found in working class areas can help spread infectious diseases and increased mortality rates (Preston, 1978).