Models of Health

Psychology
Medical Model or Biomedical Model of Health

 It views health as the absence of disease and illness and suggests that the
human body can be understood as a machine, with health being the normal
state of functioning and illness representing a deviation from this norm.
Characteristics of Medical Model
 Cause of Disease: This model considers health as equivalent to a state of absence of disease

and symptoms.

 The root cause of disease according to this model is always some external pathogenic agents

like viruses, bacteria, or some other physiological problem or cellular abnormalities.

(Guttmacher,1979).

 Further, it denies any role of emotional and psychological factors in disease.

 Responsibility for disease: This model considers that the cause of illness is not dependent

on the individual. Due to this reason, individuals are not seen as responsible for their illness.
Patients are considered as only victims of some external factor or internal abnormalities
 Treatment: Since the focus of the medical model is always on the biological or physical
aspects. Therefore, treatment also focuses only on the human body’s physical aspect. It
involves the removal of pathogenic agents either through drugs or through
interventional strategies like surgery. The objective of treatment is the removal of
symptoms and relief from any type of pain.
 Techno-oriented Model: This is the only model of health that relies heavily on
machines and technologies. From making a generic drug to performing surgery,
everything here requires technology.
 Practitioner-Physician relationship: This model considers that physicians possess
all the required knowledge, expertise, and skills to treat patients. The medical model
further considers patients as only passive recipients of their physician’s expertise and
expects patients to only corporate with their treatment regime. Thus, the model
considers practitioners superior to patients.
Example: Diagnosis and treatment of a common medical condition,
such as diabetes

 Identification of Pathophysiology: In the medical model, diabetes is primarily viewed as a metabolic

disorder characterized by elevated blood sugar levels. The focus is on identifying the specific
pathophysiological mechanisms that lead to insulin deficiency (Type 1 diabetes) or insulin resistance
(Type 2 diabetes). This understanding is based on research into the biological and genetic factors
contributing to the condition.

 Diagnosis: A patient who presents with symptoms such as frequent urination, excessive thirst, and

unexplained weight loss undergoes diagnostic tests, including blood glucose measurement, HbA1c tests,
and possibly oral glucose tolerance tests. These tests provide objective, measurable data to confirm the
diagnosis of diabetes.

 Treatment: Once diagnosed, the medical model prescribes treatment options. Type 1 diabetes, typically

involves insulin therapy, which is administered through injections or an insulin pump. For Type 2
diabetes, treatment may include oral medications to increase insulin sensitivity, lifestyle modifications
(diet and exercise), and potentially insulin therapy if necessary.
 Monitoring and Management: Patients with diabetes are regularly monitored for
blood sugar levels and complications. Medications and insulin dosages are adjusted
based on objective data and medical guidelines. The goal is to maintain blood sugar
within a target range to prevent acute complications like hyperglycemia and
hypoglycemia and reduce the risk of long-term complications such as cardiovascular
disease, neuropathy, and kidney disease.

 Disease-Centered Focus: The medical model tends to focus on managing the disease
itself—diabetes. It aims to control blood sugar levels and mitigate the associated risks.
Lifestyle factors like diet, exercise, and stress management are addressed primarily as
they relate to managing the condition.
 Symptom Management: While efforts may be made to educate patients
about healthy living, the primary emphasis is on managing symptoms and
addressing the underlying biochemical abnormalities through medical
interventions.
 Objective Measures: The effectiveness of treatment is assessed primarily
through objective measures such as blood glucose levels, HbA1c, and other
clinical markers. Subjective experiences of the patient, such as their quality
of life or emotional well-being, may be considered but are often secondary.
 It's important to note that the medical model, while effective in diagnosing and
treating medical conditions, does have limitations, as it may not address the
broader psychosocial, cultural, or lifestyle factors that can influence a patient's
overall health.
 As a result, many healthcare providers are increasingly adopting a more holistic
approach, taking into account not only the medical aspects of a condition but
also the patient's individual circumstances and well-being.
 Holistic Model of Health
 The term Holistic medicine was first used by F. H. Hoffman in 1960.

 It refers to conceptualizing health as a ‘whole’.

 Guttmacher (1979) has suggested that the holistic model considers health as
equivalent to “a sense of well-being” and disease is not considered as the presence
or absence of a pathogenic agent only.
 Instead, according to the holistic model, a disharmony between social, psychological,
and spiritual dimensions of one’s life causes disease.
Characteristics of Holistic Model of
Health
 Biopsychosocial Perspective: This model considers the biological, psychological, and
social dimensions of health and wellness. It recognizes that physical health, mental
health, and social well-being are interconnected and influence each other.
 Mind-Body Connection: The holistic model emphasizes the interconnectedness of the
mind and body. It recognizes that mental and emotional factors can have a
significant impact on physical health and vice versa. For example, stress and
emotional distress can contribute to physical health problems.
 Prevention and Wellness Promotion: Rather than solely focusing on treating illness
and symptoms, the holistic model emphasizes preventive measures and wellness
promotion. It encourages individuals to adopt healthy lifestyles, manage stress, and
engage in behaviors that promote long-term well-being.
 Individualized Care: Holistic healthcare takes into account the unique needs and
preferences of each individual. It recognizes that there is no one-size-fits-all approach
to health and wellness and that treatment and interventions should be tailored to the
individual.

 Holistic Interventions: Holistic healthcare incorporates a wide range of interventions

beyond medical treatments. These may include psychotherapy, nutrition
counseling, physical activity, mindfulness and relaxation techniques, and social
support.

 Holistic Assessment: When assessing an individual's health, practitioners using the

holistic model consider not only physical symptoms but also psychological and social
factors. They take into account the individual's lifestyle, relationships, stressors, and
overall quality of life.

 Holistic Goals: The primary goal of the holistic model is to enhance overall well-being
and quality of life, rather than just addressing specific symptoms or diseases. It
promotes a sense of balance, vitality, and fulfillment in all aspects of life.
Stress Management and Well-Being Program:

 Imagine a stress management and well-being program designed for

employees in a corporate setting. In a holistic approach, this program would
address multiple dimensions of health.
 Physical Health: The program might include exercise sessions, nutrition
workshops, and regular health check-ups to promote physical well-being.
Physical activity can release endorphins, which are natural mood lifters, and
improve overall health.
 Mental Health: Participants could attend stress reduction and mindfulness
meditation classes to enhance their mental well-being. These practices can help
individuals manage their thoughts and emotions, reducing stress and anxiety.
 Emotional Health: Workshops on emotional intelligence and self-awareness
might be offered. These sessions could help employees understand and manage
their emotions better, fostering healthier relationships with colleagues and
reducing workplace conflicts.
 Social Health: Encouraging team-building activities, communication training,
and fostering a supportive work environment can improve social health. Strong
social connections are associated with increased happiness and reduced stress.
 Spiritual Health: While not necessarily religious, this aspect focuses on finding
a sense of purpose and meaning in life. The program could provide sessions on
values, personal growth, and finding meaning in one's work.
 Work-Life Balance: Promoting work-life balance through flexible schedules,
family-friendly policies, and stress-reduction techniques can significantly
contribute to overall well-being.
 Environmental Health: Creating a healthy and sustainable work
environment, with good air quality, ergonomic workstations, and green
spaces, can positively impact health.
 Community Engagement: Encouraging employees to engage in community
service or volunteer work can enhance their sense of belonging and purpose,
contributing to their overall well-being.
 In this holistic model, the program recognizes that an individual's health is
not solely dependent on physical factors but is a result of the complex
interaction between various aspects of their life.
 By addressing all these dimensions simultaneously, the program aims to
promote overall health and well-being, reduce stress, and increase employee
satisfaction and productivity.
 This approach recognizes that improving one aspect of health can have
positive ripple effects on other dimensions, leading to a more balanced and
fulfilled life.
Bio-psychosocial Model of Health
 The Biopsychosocial model was first conceptualized by George Engel in
1977, suggesting that to understand a person's medical condition it is not
simply the biological factors to consider, but also the psychological and social
factors
 Bio (physiological pathology)
 Psycho (thoughts emotions and behaviors such as psychological distress,
fear/avoidance beliefs, current coping methods, and attribution)
 Social (socio-economical, socio-environmental, and cultural factors such as
work issues, family circumstances, and benefits/economics)
 A biopsychosocial approach to healthcare understands that these systems
overlap and interact to impact each individual’s well-being and risk for
illness, and understanding these systems can lead to more effective
treatment.
 It also recognizes the importance of patient self-awareness, relationships
with providers in the healthcare system, and individual life context.
Understanding Chronic Pain Through
the Biopsychosocial Model
 Chronic pain is a complex and pervasive health issue that affects millions of
individuals worldwide. Unlike acute pain, which typically results from a
specific injury or illness and resolves with treatment, chronic pain persists
for extended periods, often without a clear underlying cause.
 This case study explores chronic pain through the lens of the biopsychosocial
model of health psychology, illustrating how this holistic approach can
enhance our understanding and management of this challenging condition.
 Sarah, a 45-year-old woman, has been experiencing chronic lower back pain
for the past five years. Despite numerous medical consultations, imaging
studies, and treatments, her pain remains persistent, significantly impacting
her daily life, including her ability to work, engage in physical activities, and
maintain social relationships.
 Biological Factors
 Sarah's chronic pain can be attributed to various biological factors. Imaging
studies reveal degenerative changes in her lumbar spine, including herniated
discs and osteoarthritis. These structural abnormalities contribute to her
ongoing pain. Additionally, her genetic predisposition to musculoskeletal
issues may have played a role in the development of her condition.

 Psychological Factors
 Sarah's psychological state is intricately linked to her chronic pain. She
experiences anxiety and depression due to her persistent discomfort,
diminished quality of life, and the frustration of not finding a definitive
solution. Her emotional distress further exacerbates her pain perception,
leading to a cycle of pain and negative emotions.
 Social Factors:
 Social factors also contribute significantly to Sarah's chronic pain. She is a
single mother of two young children and the primary breadwinner for her
family. The financial stressors and responsibilities associated with her role
intensify her pain perception. Additionally, her pain has led to social
isolation, as she can no longer engage in activities she once enjoyed or attend
social gatherings.
Interactions Between Components:
 The biopsychosocial model emphasizes the interactions between these
components. Sarah's biological factors influence her psychological state, as
the physical source of her pain contributes to her emotional distress. Her
psychological factors, particularly her anxiety and depression, heighten her
pain perception, making it more challenging to manage. Socially, her pain
has led to job loss and strained relationships, perpetuating the cycle of
distress.
Social Model of Health
 Case Study: Reducing Health Inequities through a Community-Based
Approach: A Social Model of Health Case Study

This case study illustrates the application of the social model of health in addressing health
inequities within a diverse urban community. The project focuses on the "Healthy
Neighbors Initiative," which aims to improve health outcomes and reduce disparities
among residents.
 Community Profile:
 The community in question is a densely populated urban neighborhood
characterized by high levels of poverty, limited access to healthcare, and a
culturally diverse population. Health disparities are prevalent, with residents
facing higher rates of chronic diseases, mental health issues, and limited
healthcare utilization.
Key Social Determinants Identified:

 Socioeconomic Status: The majority of residents have low-income levels,

limited job opportunities, and unstable housing situations.
 Access to Healthcare: Many community members lack health insurance
and have limited access to primary care services.
 Education: Educational attainment is lower than the national average,
limiting health literacy and awareness.
 Social Support Networks: Social isolation is common due to linguistic and
cultural barriers, further exacerbating mental health challenges.
 Neighborhood Environment: High crime rates and limited access to green
spaces contribute to stress and safety concerns.
Social Model of Health Intervention:

 Community Engagement: The project begins with extensive community

engagement efforts, including surveys, focus groups, and town hall meetings.
Residents' voices and concerns are central to shaping intervention strategies.

 Cultural Competency Training: Healthcare providers and community

workers receive training on cultural competency to improve interactions and
communication with residents from diverse backgrounds.

 Access to Care: A mobile health clinic is established to provide primary care

services directly within the community, increasing healthcare accessibility.
 Health Education: Community-based health education programs are
implemented, focusing on chronic disease management, nutrition, mental
health, and preventive care.

 Mental Health Support: Culturally sensitive mental health services are

introduced, including support groups and counseling services tailored to
the community's specific needs.

 Youth Engagement: Programs for youth are initiated to promote

education, mentorship, and positive recreational activities, aiming to break
the cycle of poverty and improve overall well-being.

 Green Spaces: Community gardens and green spaces are developed,

providing safe and accessible areas for physical activity and relaxation.
Conclusion:
 This case study highlights how the social model of health can be applied
effectively to address health inequities within a disadvantaged urban
community. By identifying and targeting key social determinants of health,
engaging the community, and implementing a range of interventions, the
"Healthy Neighbors Initiative" serves as a model for achieving better health
outcomes and reducing disparities through a holistic and community-
centered approach.