Models of Health and Health Promotion

Biomedical Model of Health

The biomedical model of health is a “bandaid” approach which seeks to treat and cure illness and prevent complication, but doesn’t explicitly aim to stop diseases before they arise biologically (although it generally includes vaccines). This model views the body as a machine that can be fixed when a part breaks down. It involves diagnosis, treatment using antibiotics and technologies like surgery to remove disease or repair the body.

There are several limitations with this model:

  • some conditions can’t be ‘cured’ with current medicine (such as HIV, some cancers, asthma, diabetes and Alzheimer’s)
  • very costly as it relies on expensive technologies and health professionals
  • encourages people to rely on health professionals to fix their ill health, rather than take responsibility for their own health
  • doesn’t address underlying social, environmental and economic determinants that influence health

Social Model of Health

The social model of health began to emerge in the 1970s, as people began to realise that not only people’s behaviours but their environment, upbringing and socio-cultural situation impact health.

It’s a conceptual framework within which improvements in health and wellbeing and achieved by directing effort towards addressing the social, economic and environmental determinants of health.  It’s based on the understanding that for health gains to occur, social, economic and environmental determinants must be addressed.

These determinants include: shelter, food, soecio-economic status (employment, education, income), culture, access to healthcare, location, and social connectedness.

This model has five guiding principles, or areas.  The social model of health:

  • addresses the broader determinants of health
  • acts to reduce social inequities
  • empowers individuals and communities
  • acts to enable access to healthcare
  • involves inter-sectorial collaboration

Ottawa Charter of Health Promotion

The Ottawa Charter of Health Promotion is an approach to health development, developed from the social model of health by the World Health Organisation, which attempts to reduce inequalities in health.  It aims to make prerequisites for health – peace, shelter, education, food, income, a stable ecosystem, sustainable resources, and social justice and equity – available to all so all can improve their health.  It defines health promotion as ‘the process of enabling people to increase control over, and improve, their health.’

Five action areas

Building Healthy Public Policy

Governments make laws which affect the health of communities and individuals. When these laws enable people to live healthier lives, this is building healthy public policy. Examples include schools require student hat wearing, bike helmet and seat belt legislation, etc.

Creating Supportive Environments

Maintaining a healthy lifestyle is made easy when your community and area are supportive. Examples of creating supportive environments include installing shade sails at playgrounds to help enable sun-smart kids, building safe bike paths to allow people to safely use cycling as transport and banning smoking from workplaces.

Develop Personal Skills

Developing personal skills is often about education and sharing knowledge, as this enables people to take control of their own health and then pass these skills on to others, in particular their children. Examples include pamphlets at doctors’ surgeries, workshops and programs in school about the dangers of smoking, first aid courses, etc.

Reorienting Health Services

Health services should be involved in preventative strategies, and not just curative or medicinal care. The charter suggests that health services and professionals should be involved in areas such as education, policy-making and community action.

Strengthening Community Action

Finding a common goal and acting as a community makes promoting and achieving health more attainable, and so community action is encouraged. This can be achieved in various ways such as putting communal pressure on local government to make a positive health change in a public space, for example.

Three basic health promotion

Enable: this aims to empower people to make healthy choices and control the things that influence their health, by providing a supportive environment and access to information, life skills and opportunities.

Mediate: this involves coordinated action by all (the health sector, NGOs, industry, the government, media) working together to improve health.

Advocate: groups and individuals lobby governments to improve public policy and healthcare provision.