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G672 How can we measure how healthy our society is? Two indicators are used: Morbidity and Mortality. It is impossible to measure morbidity with any validity or reliability because definitions of health and illness are so subjective. Therefore, mortality rates are the most commonly used to measure health/illness. What do you think has happened in the UK to explain this continuous decline in mortality? In pairs, identify and explain a minimum of five explanations. Ext: - Which explanations would be favoured by the biomedical model? The Social Model of Health is an umbrella term for a range of ideas and strategies about health and healthcare. It emerged as a result of criticisms against the biomedical model. RECAP: What were the key criticisms of the biomedical model? Write down at least two! The biomedical model looks for the causes of illness within the individual. The social model looks for the causes of illness within society. The work of McKeown (and other medical historians) is one of the biggest criticisms of biomedicine – and demonstrates the importance of the social model. The McKeown Thesis states that medical intervention has been largely ineffective in curing illness and disease. What is tuberculosis? http://www.nhs.uk/Conditions/Tuberculosis/Pa ges/Introduction.aspx McKeown used tuberculosis as a case study (though the same has been applied to other diseases) If medical treatment was so irrelevant, what were the social causes of improvement? 1. Nutrition Improvement in people’s diet – due to advances in agriculture (e.g. new crops, increased availability) – from end of C17th onwards. Better nutritional levels increase resistance to infectious disease (and reduce death by starvation). 2. Public Hygiene E.g. Cleaner, piped water and better sewage disposal. This reduces exposure to disease (esp. waterborne diseases like cholera). Improved food hygiene from 1900 also helped (e.g. Introduction of sterilisation and bottling). 3. Birth Limitation Fall in birth-rate and family size in the middle-classes from 1870s. Limits on population crucial for health of a society. Drop in birth-rate also nearly eliminates infanticide by reducing unwanted pregnancy. Not all diseases respond to an improvement in the social environment. Medicine was the decisive factor in curing/treating diseases like diphtheria and polio. List five other social or environmental factors that might influence health. Health and illness are not biological facts. They are relative. The society you live in Your gender Your Social Class Your ethnicity Your age In pairs: Identify at least two ways in which EACH ONE of the above could influence how healthy/ill you feel (5 mins) The society you live in (e.g. obesity) Your gender (e.g. men less likely to define themselves as “ill”) Your social class (e.g. working class accept higher levels of illness) Your ethnicity (Punjabis in Bradford suffer from a ‘sinking heart’) Your age (e.g. joint pains being accepted as normal) Nettleton (2006) Health and disease are socially patterned. Illness is not randomly distributed: There are clear patterns in terms of class, gender and ethnicity. This suggests it is social and environmental factors that make some groups more vulnerable to disease than others. Promotes the view that the definitions and judgements of lay people are just as valid as professional assessments. Much illness is diagnosed and treated within the family. Illness is a personal experience, not a medical one. McKeown developed his work into a critique of modern healthcare. He argues that we spend too much money on treating disease and not enough on prevention and health education. Most of the time, illness exists. It’s not relative or subjective: If you’re ill, you’re ill. The social model doesn’t ‘replace’ the biomedical model: It puts it into perspective. Create a presentation promoting your own healthcare company that only uses the social model to treat illness/disease. How would such an approach work? 20 mins then present. Identify and explain two reasons why sociologists might prefer a social model of health [17]