Concepts of Health and Illness

Health is perceived in different ways giving rise to various concepts of health. Health has evolved
over the centuries as a concept from an individual concern to a worldwide social goal. Traditionally
health has been considered as an absence of the diseases and if someone was free from disease, then
that person was considered healthy. This concept is known as biomedical concept, and it has a
basis on the “germ theory of the disease.”

Biomedical Concept:
• Health means “absence of disease.”
• The basic premise is that human body is a machine made up of a number of divisible and
abstractable parts. As such, any malfunction (such as disease) is an ‘engineering’ problem which
is capable of being tackled by technical means and one of the doctor’s tasks was to repair the
machine.
• Those who subscribe to the biomedical model place particular emphasis on the biological causes
and manifestations of disease and ill-health.
• This, in turn, gave rise to the doctrine of specific aetiology: for every disease there is a single and
observable cause that can be isolated. The principal strength of the biomedical model is that there
is a considerable amount of evidence to support its basic assumptions, in that specific causes for
particular diseases have been found.

Positive feature:
This approach examines cause and effect and this has led to significant research and advances in
many areas, such as cancer. Many illnesses can be treated via medical intervention.

Negative feature:
• This approach focuses on cause and effect. Therefore the approach is used to treat illness instead
of educating individuals about health before the onset of an illness.
• This approach is very narrow in its focus- it does not consider other factors that cause illness; it
only considers abnormal bodily functions.
• It is repair- not prevention-oriented
• It is technology-centred
• It is expensive

Developments in medical and social sciences led to the conclusion that the biomedical concept of
health was inadequate.

Social Model:
This model has become more dominant in society, where the focus has become prevention rather than
cure. The social model emphasises the importance of addressing the origins of ill health i.e. social
conditions. The focus of this approach is on the cause of illness linked to societal factors not
abnormal bodily functions.

In the social model the health of individuals and communities is seen as the result of complex and
interacting social, economic, environmental and personal factors.
Thus, for those who adhere to the social model, the determinants of health are far more varied and
broader in scope than those found in the biomedical model. Because of the range of its determinants,
the potential for allocating responsibility for ill-health is much greater.

Basic assumptions:

(1) a human being must not be taken as a mechanistic combination of biophysical functions but as an
organistic whole, in which the sum counts for more than its parts.

(2) social factors do not affect a human’s health from ”outside” but partly constitute her/him and
her/his health.
(3) LIFE STYLE – the way of people live is influenced by
o social values
o Attitudes
o activities

Positive feature:
• This model focuses on all aspects of an individual’s lifestyle in order to understand ill health.
• This model focuses on explaining and addressing the root causes of ill health and therefore trying
to address these rather than waiting for a person to become ill and treating the illness/ symptoms.

Negative feature:
• It is difficult to identify single causes of illness due to the focus being on many causes and
explanations.
• It is difficult to generate a complete definition of health when so many factors and variables need
to be considered.

Ecological Concept:
• Ecologists viewed health as a dynamic equilibrium between man and his environment, and
disease – a maladjustment of the human organism to environment.

Psycho-social Concept:
• Advances in social sciences showed that health is not only a biomedical phenomenon, but one
which is influenced by social, psychological, cultural, economic and political factors of the
people concerned. Thus health is both a biological and social phenomenon.

Holistic Concept:
• Holistic concept recognizes the strength of social, economic, political and environmental
influences on health.
• It has been variously described as multidimensional process involving the wellbeing of the person
as a whole
• The emphasis is on the promotion and protection of health.