Assess the Biomedical and Socio-Medical
This essay will assess how useful the biomedical and socio-medical models of health are and what contributions they have made to health and social care. The biomedical model of health is an approach which eliminates psychological and social factors (environment) but only comprises biological issues in trying to recognise or understand an individual’s medial illness/disorder. In the Western world, the biomedical model has dominated all other models of health since the 19th century.
This model is the model of health most used by health care professionals and is the foundation of most medical science. As a result, it is the cure that doctors focus on. Their approach is based on what is perceived as normal or abnormal in terms of bodily functions. The biomedical model is most effective with short-term or acute illnesses, where a cause is identified and the relevant treatment is administered. It is least effective when dealing with chronic illnesses; those which persist over long periods of time and are managed rather than cured.
The biomedical model of health fits in well with the functionalist perspective to sociology as it sees ill-health as being dysfunctional to society. For functionalists, if people adopt the sick role they are exempt from their usual roles and responsibilities. The biomedical model also takes a curative approach, meaning that it focusses on the cure of an illness. Focussing on physical aspects of illnesses means they can be scientifically tested, which therefore allows development of treatments. A disadvantage of the biomedical model of health is that it is not a long-term strategy.
By not looking at a patient’s medical history, asking them how they feel and also not asking fully detailed questions about an illness, means that the same illness could re-occur in the future. Marxists criticise the biomedical model of health because this model ignores an individual’s living conditions and Marxists also argue that doctors only benefit the rich by getting poor people back to good health in order to enable them to go back to work. Further criticisms of this theory are focussed principally on the suggestion that it has over-simplified the biological processes now known to be very intricate.
For many diseases, there are multiple and interacting causes. Moreover, such a theory looks only to the agent of disease, and ignores the host and the possibilities of biological adaptation. As stated, this theory is much more easily applicable to acute conditions then to chronic ill-health and is difficult to apply to mental disorders. The biomedical model also cannot explain why some illnesses are more common in some social or ethnic groups, for example, schizophrenia in Afro-Caribbean people.
Diseases are differently defined in different cultures and medical definitions of disease have clearly changed over time. Generally, it can be seen that what is viewed as illness in any particular society and at any historical time depends on cultural norms and social values (Naidoo & Wills, 2004). McKeown (1979) argues that the biomedical model is “less effective” than other models because health started to improve before the NHS came into place. The socio-medical model argues that health is a complex mix of behavioural, structural, material and cultural factors. All together these impact on health.
The social model emphasises the need to address the origins of ill-health, for example, instead of treating a child with asthma; treating the damp conditions that the child is living in. The social model came about in the mid-twentieth century when there was an increasing dissatisfaction with the dominant model of health offered by biomedicine. The emphasis on health as being simply the absence of disease encouraged thinking about only two categories; the health and the disease. The social model of health imbibes social constructs and relativity in its approach to health.
It tends to define and redefine health in a continuous manner, and views health differently between individuals, groups, times and cultures. Some supporters of the social model have written extensively about sickness having a role to play in various societies (Parsons, 1951) as this helps to determine the structure of and functionality of the society. The social model is organic and holistic rather than a reductionist, mechanical method. A mechanical system acts according to its programming, its instructions or natural laws.
The social model allows for mental as well as physical health. This model also allows for more subtle discrimination of individuals who succeed in leading productive lives in spite of a physical impairment. Another disadvantage of this model is that the conception runs the risk of excessive breadth and of incorporating all of life. Thus, it does not distinguish clearly between the state of being healthy and the consequences of being healthy nor does it distinguish between health and the determinants of health (Ewles and Simnett, 2010).
The development of this social model has been accompanied among the public, by a growing enthusiasm for alternative therapies, which tend to rest on holistic theories. Gradually, these too have been integrated to some extent into the mainstream model. In order to have a comprehensive understanding of health, it is vital to look at various premises of health definition, as just one aspect may not provide a complete answer to the enquiry about our health at a particular given time.
It is therefore important to consider the various aspects of health when making a judgement and decision about the health status of an individual. The socio-medical model fits in with the Marxist perspective to sociology, as it focusses on social and environmental factors. Poorer people are more likely to have poorer living conditions. Marxists argue that there are higher levels of illness in more impoverished areas. This model also fits in with current health policies, for example, Change for Life, which encourages individuals to take more responsibility over their own health.
The functionalist perspective also supports this model by stating that if people are taking more responsibility over their health, they will be able to contribute more to society. Finally, feminists such as Lesley Doyal (1995) support the socio-medical model by arguing that women are more likely to become ill because they have more roles in society than men. Doyal argues that women are likely to have a full time job and then still do the majority of the house work/childcare when they get home. A more stressful environment is likely to lead to a higher chance of illness.
In conclusion, the biomedical model of health is obviously most easily defined by the absence of disease, though the model is also compatible with more positive definitions in terms of equilibrium of normal functioning. In the socio-medical model health is a positive state of wholeness and well-being associated with, but not entirely explained, by the absence of disease, illness or physical and mental impairment. The concepts of health and ill-health are unbalances. The absence of disease may be part of health but health is more than just the absence of disease.