In this essay it will look at how health and illness are defined and look at them from a professional organisation and a lay perspective. Both the biomedical model and social model will be looked at and argued which of the models can best explain how health and illness are to be treated and how medicine is used as social control and how societys treatment towards health and illness has changed over the years.
Sociologists including Mildred Blaxter have said that negative and positive definitions of health need to be argued. Medical professionals say that illness is defined as subjective, a feeling that underestimates a person’s feeling of well-being. A health and lifestyle survey conducted by Blaxter (1990) looked at how people defined their own health, following this she came up with lay definitions of health, these were a positive definition, negative definition, and a functional definition. In the study what she found was that people were negatively defining illness, and that health was defined as the absence of disease.
A disease is the objective way mental health or physical health can be defined. According to the World Health Organisation (WHO) Health is ‘a state of complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity” (WHO,1974). It could be argued that this definition is too broad, one reason for this could be that no one ever feels ‘completely’ normal and that health and illness vary across time and culture. Also, whether there is such a thing as a ‘normal’ body as over time these also change (Haralambos, 2004). The WHO issued a second definition in 1984 that was deemed to be a stronger more holistic definition that looked to argue some of the criticisms of the first definition ‘ Health is the extent to which an individual or group is able, on one hand, to realise aspirations and satisfy needs; and on the other hand, to change or cope with the environment. Health is therefore, seen as a resource for everyday life, not the objective for living; it is a positive concept emphasising social and personal resources, as well as physical capacities.’ (Bown, 2015). Therefore, this shows that health is now being associated with an individual’s personal growth and development and that health is not merely the absence of disease. Although there are many criticisms of the WHO’s first definition it remains the most popular definition of health used to date.
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When measuring health, death and morality rates are what are most often used. Although these are the most common way of measuring health the validity of data collected remains questionable. Morality refers to the amount of illness that happens within society, so for example takes its statistics from doctors’ surgeries and hospital admissions or it can be by the amount of people claiming disability and sickness benefit. The question as to how many of these claims are genuine remains debatable as people often make fraudulent claims for benefits, official figures released by the government shows that in the year 2014-2015 around £1.9bn was falsely claimed in sickness benefit (BBC, 2019). Another way could be a national survey but again the validity of these is questionable as women are more likely to complete these surveys compared to men so thus throws doubt as to whether these statistics give a true representation of the health of people in our society.
There are two main models of health the biomedical model and social model of health. The biomedical model of health is the most dominant in western medicine. It has 4 core components, these are mind-body dualism, specific aetiology, mechanical metaphor and objective science. As it focuses more on illness and cure and the biological factors but excludes the psychological, environmental and social influences this model assumes that illness and their causes can be identified using scientific methods (Bown, 2015). It embraces sophisticated technology and medicines such as drugs and surgery as cures and goes as far to say that medical experts as they are trained and possess the necessary skills to identify and treat ill health (Chapman, 2011). Environmental factors are not seen to be considered as this model believes that it is the individual who carries the illness. It sees the body like a mechanic sees a car, occasionally parts wear and need either repairing or replacing (Haralambos, 2004).
Although there are many strengths to this model one being that life expectancy is extended and improves quality of life as someone can be returned back to full health it has also been critisised, Ivan Illich (1975) critisised the model and used the term iatrogenesis, which means doctor-generated illness and suggests to sickness as been produced by medical activity. Another criticism could be the fact that it ignores the mental causes of illness and says that mental disorders such schizophrenia and depression are diseases of the brain and that they are biologically based. It can be argued that the biomedical model focuses too much on curing an illness rather than preventing it and as believes that medical experts and fully trained professionals are the only ones who can identify and treat illness that this can lead to long waiting times and can also be very costly even though it receives the majority of the governments healthcare funding.
Although the social model doesn’t dismiss the bio medical model of health and illness, the social model likes to look to broaden its focus and not only look at health and illness as disease and injury but how health and illness may be linked to things such as class, gender and age and that believes premature death is more likely to happen in more deprived areas and how educating society on health could impact on the lifestyle choices and behaviours towards health (Bown, 2015). According to Ash (2014) there is a strong link between smoking and social groups and death rates. A study in 2012 showed that 14% of adults in managerial roles and professional occupations smoked compared to 33% of those in routine and manual occupations, and that it can be as high as 75% in extremely deprived areas, what this shows is that the connection between the stresses of poverty and smoking can be linked. Although there are advantages to the social model of health by way that it is available to a wider selection of society and it is less costly then the bio medical model by looking to prevent illness rather than just treat and cure it, it could also be critisised as habits such as smoking and drinking require willpower to stop therefore take longer to change. Another criticism could be that not all illnesses are not preventable illness such as cancer, although studies have shown that 4 in 10 cases of cancer may have been prevented had they been educated better thus leading to better making lifestyle choices and staying away from things that have been linked to it, like not smoking, eating red meat or too much sun.
Functionalist Talcott Parsons developed the what is known as the highly controversial model of the sick role, ‘the sick role is a pattern of behaviours that is expected of an individual when they’re sick’ (Browne, 2008). This concept focuses more on the sociological properties of sickness rather than medical. (UKessays, 2019). Parsons was more interested in the social control of behaviour and argued that the sick role is learned, he believed that people could decide to be sick to avoid everyday responsibilities. Despite this Parsons also believes that people who are genuinely sick should receive sympathy and benefits such as sick pay, but that to receive these benefits that they should follow doctors’ orders and instructions on how to restore themselves back to full health. Although this is one of the most favourable models and is aimed at creating a more social stability and healthy society it seems to be very dated and doesn’t fit with all illnesses and assumes that recovery is always possible although some illnesses are chronic and incurable.
American professor Eliot Freidson offered an alternative to Parsons work and came up with the labelling approach. ‘Freidson identified three legitimacies of illness: Conditional legitimacy, deviants temporarily exempt from their normal obligations, gaining some privileges that enable them to return to a normal role; Unconditional legitimacy, where deviants are permanently exempt from their obligations and allowed additional privileges in view of illness that is believed to be incurable; And Illegitimacy, deviants to be exempt from some normal obligations, with the person not held responsible for their condition, and gaining few privileges’.(Morgan, M. 1993: p.53). Freidson also believed that deviant behaviour is socially created and that differences in social and cultural groups may impact on what an individual deems as sick.
