What is health?
Session Aims
• To explore the complexities of health as a
concept
• To reflect on your own perspective on health
• To summarise and critique key debates about
the concept of health
Definitions of health
• Dependent on a wide range of perspectives,
subjectivities and experiences
• Socially, historically and culturally located
• Health is an abstract concept (Earle et al,
2007)
• Health is a contested concept
• No universally agreed definition (Pridmore &
Stephens, 2000)
Definitions of Health
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Health as the absence of disease
Health as a continuum (positive/negative)
Holistic health
Health as well being
Health as being able to function
Definitions of Health (Johnson, 2007)
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Dictionary definitions
Assumptive definitions
Determinist definitions
Spiritual definitions
Theoretical Perspectives
The Medical Model of Health
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Based in science
Focuses on the individual
Health is ‘located’ in the individual body
Ill-health is caused by biology or physiology
Health is the absence of disease or abnormality
Forms the basis of healthcare provision
Theoretical Perspectives
The Social Model of Health
• Health is determined by a range of factors
• Ill-health is caused by structural factors such
as poverty and inequalities
• Health is socially constructed
• Health is socially produced
• Lay perspective is key
Comparing and Contrasting the
Medical and Social Models
Medical Model
Social Model
Narrow or simplistic understanding of
Broad or complex understanding of
health.
health.
Medically biased definitions focusing
More holistic definitions of health
on the absence of disease or dis-
taking a wider range of factors into
ability.
account such as mental and social
dimensions of health.
Doesn’t take into account the wider
Takes into account wider influences on
influences on health (outside the
health such as the environment the
physical body).
impact of inequalities.
Influenced by scientific and expert
Takes into account lay knowledge and
knowledge.
understandings.
Emphasises personal, individual
Emphasises collective, social
responsibility for health.
responsibility for health.
Theoretical Perspectives
Salutogenesis (Antonosky)
• The origins of health
• Challenges the pathogenic nature of the
medical model of health
• Focuses on what makes people healthy not
what makes people sick
• Suggests a health-ease-dis-ease continuum
which everyone is located on
Theoretical Perspectives
The Holistic Model of Health
• An integrated approach
• Takes into account the interactiob of
biologicalm psycholgocial and social factors
(Earler 2007)
• Person is viewed as a ‘whole’
Other perspectives
• Philosophical
• Psychological
• Social Constructionist
Lay Perspectives on Health
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‘Non-expert’ understandings
Not homogenous
Complex
Differ across individuals, communities,
cultures, contexts and time
• Differ with age, levels of education, social
class and gender
• Valuable in understanding what health is
Lay Perspectives – Blaxter (2004)
1.
2.
3.
4.
5.
Health as not-ill
Health as physical fitness, vitality
Health as social relationships
Health as function
Health as psychosocial well-being
Lay Perspectives – Stainton-Rogers (1991)
1. Body as machine (links with medical model
understandings)
2. Body under siege (external factors influence health i.e.
germs)
3. Inequality of access (i.e. to medical services)
4. Cultural critique (linked with ideas about exploitation and
oppression)
5. Health promotion (linked with ideas about responsibility
for health as being individual and collective)
6. Robust individualism (linked with rights to a satisfying life)
7. Willpower account (linked with ideas about individual
control)
Culture and Health - examples
• Ideas of beauty and slenderness being
equated with health in a Western context
(Burns & Gavey, 2004)
• Differences between lay persons and
professional understandings of mental health
in Zambia (Aidoo & Harpham, 2001) –
different definitions of ‘ill-health’ used by
both.
Social Class and Health - examples
D’Houtard & Field – study of 4000 French people
• Higher & middle social classes – health was about
hedonism, equilibrium, vitality and the body;
lower classes – health was about absence of
sickness, and linked to hygiene and psychological
well-being
• Blaxter & Paterson (Blaxter, 2004) poor socioeconomic status defined health as ‘not being ill’
Lifespan and Health - examples
• Children understandings of health are wideranging and include being happy, thinking
positively about yourself and being kind
(Burrows & Wright, 2004)
• Older people define health more in terms of
being able to look after yourself and declining
health as being an inevitable part of aging
(Lawton, 2003)
Gender and Health - examples
• Women are more likely to focus on caring and
reproductive roles; men more on the
disadvantages of their ‘provider’ roles (Emslie
& Hunt, 2008)
• Assumptions that women are more interested
in health than men.
Key issues
• The nature of health is contested, varied and
changeable
• A range of different perspectives should be
taken into account
• Lay perspectives on health are important and
influential
• Understanding what health is about is crucial
to promoting and researching it
Summary
• Health is a complex concept and is difficult to define. Many
different definitions and understandings exist.
• Understandings of health differ according to experience
and expertise. Factors such as age, social class and gender
impact on these. Theoretical perspectives about health can
aid our understandings of subjective health experience.
• Lay and expert understandings of health may differ but
both are central to developing understandings about what
health is, how it may be explored and how it may be
maintained.