The social determinants of health comprise of the situations in which people are born, work, develop , reside and age along with a wider structure of resources and mechanisms which shape the circumstances of everyday life.They comprise of social norms , developmental agendas , economic policies and systems and various systems of administration. These situations are based on the dispersal of money, resources and authority at the international, national and local levels. The social determinants are accountable for the various inequalities of health and the unfair and avoidable variations in the status of health amongst various countries (WHO, 2018).
So, in this article, the social determinants of health shall be explained with the help of sociological theories, concepts and perspectives. The differences between the sociological theories from the medical model would also be discussed.
The Social Conflict theory views the society as a scenario of disparity thereby generating social change and conflict. The key fundamentals in this aspect are that the society is organized in such a way which benefits few people at the cost of many. The factors such as race, caste, creed and age are associated with social inequality. So, in a social conflict theory, the dominating group is dominant over the minority groups. Karl Marx is the father of social conflict theory.
Mr. Marx proposed a theory of capitalism which is based on the concept that humans are productive and for their survival, they have to work. According to him, people are associated with the means of production in two ways – they either are the owners of the productive property or they work for somebody who is the owner.
Since the inequalities in health exist all over the world and in every society and state. They manifest themselves in numerous ways such as malnutrition levels, inability to access the fresh foods, rates of captivity, diabetes, and exposure to environmental hazards. There is a relation between the lower socioeconomic status and the worsening health conditions of a person. Thus there is an impact of the elements of conflict on the health disparities (Bury, 2013).
The individual risk factors are focused on epidemiology and the risk factors comprise of an individual causal relationship like lung cancer, smoking, high pressure and heart diseases. In the context of population levels, it is crucial to comprehend the variations between the biological markers like levels of cholesterol and behaviors relating to the selection of smoking. Due to the recognition of differences, the social determinants can be unpacked. So, the conflict as a determinant model (CDM) can be used to respond to the health crisis which is caused by the conflict. Thus the CDM framework accounts for the risk factors and wider social settings which impact the behavior, access to the basic services and selection (Martin & Evans, 2015).
Feminist sociology is a form of conflict theory and an approach in which gender is observed in the context of power at the levels of reflexivity and face to face interface within the social structure as a whole. It comprises of sexual orientation, race, nationality and economic status. The ideology of methodical subjugation of women forms the basis of feminist sociology. The chronological supremacy of men in most of the societies also forms the core of this theory. The feminist thought has a rich history which can be classified into three waves: The third wave is contemporary and highlights the concept of post colonialism, globalization, postmodernism and post-structuralism.
As per the researchers conducted all over the world, it has been found that hypertension and depression are caused due to the gender differentiation. The problems in health obstruct the developmental process of humans. They weaken the quality of life and opportunities for youth, children and families, especially who are exposed to potential threats. Significant disparities have been observed in the quality of health and life options in the children with racial and ethnic minorities, experience of neighborhoods and low-income groups (Stenberg et al., 2014).
As per López (2016), there are several connections between environmental, social and health factors. As per the feminist methodology, for improving health, the social determinants must be considered. These factors influence health and consist of employment, income and housing. It believes that without prevention and promotion of health, populace’s health cannot be improved. Since health is the matter of social justice, so the governments cannot renounce its accountability to pass the laws in all the areas which affect the determinants of health.
Another pillar of the feminist approach is taking care of own self. It has been promoted in the health centers for women. It also comprises of a personal effort in order to comprehend the association of health and circumstances of life (Peng et al., 2012).
The approach towards health can also be measured by the medical model. It was coined by psychiatrist R.D. Laing in the year 1971. It can be defined as a set of processes through which the training of doctors can be conducted. It comprises of the complaint, physical examination, history of the case, diagnosis, treatment, ancillary tests if required and prognosis with and without treatment.
There are various differences between conflict theory and medical theory. The conflict theory explains the social inequalities which are characterized by the quality of health and healthcare. It has been observed that disabled people are more likely to become sick and receive inappropriate care towards health. The doctors have tried to explain social problems as medical problems (Macdonald, 2013).
While the conflict theory has been criticizing the efforts made by doctors to govern the practice of medicine and define the social difficulties as the medical ones. On the other hand, it has been said in the medical model that assessment of health and medicine is harsh in conflict theory and the motivation of the physician is pessimistic. The role of scientific medicine has been emphasized to improve the health of the people all over the globe (Leventhal & Ian, 2012).
The medical model is viewed as the problem of the disabled people and it states that they need to be adapted to accommodate into the world as it is. If it is not possible, they need to be in a specialized organization or must be secluded at home, where their basic needs are met. It also talks about their independence, where their lives are handed over to the medical professionals. On the other hand, the social model fights for the rights of the disabled and states that they have the right to belong to and be valued in their communities.
With the help of conflict theory, the strengths of the person are viewed along with the disabilities at the physical and social level which obstruct them. It defines that impairment and disability are two different ways to observe the situation (Brown & Harris, 2012).
The Feminist theory considers gender to be a strong determinant of social position and status, mental health and strongest determinant to exposures to actions and situations which put the mental health and stability in danger. There has been a positive relationship between the severity of social stressors and frequency of mental health amongst the women (Steptoe et al., 2013).
The theory describes the basics for health and the freedom from fear of war and the equivalent prospect for all. It also describes the satisfaction for basic necessities for water, food and satisfaction, education and secure work, useful role in society and political will and public support. This theory emphasizes the accessibility to these fundamentals which are molded by gender as well as social class and many societal and traditional factors. For instance, the threat of war diminishes the health of the women. It is not only through the threat of rape, death or devastations of the conditions of working and living but also through emotional distress which is associated with the safety and survival of committees and family members (Hankivsky, 2012).
In the case of the medical model, it is doctor-centered and of an objective approach. It consists of body and mind dualism and in it, the selection of risk is not possible. It applies the statistical and biological approach. It depicts that the birth of the child is a pathological and every woman is at risk in the phase of her pregnancy. According to the medical model, every woman should follow the instructions of the doctors for safely delivering the child.
However, the social model claims that the medical model only controls women and shapes their approach towards delivering the child in a safer manner but their families, friends and health care providers also have an impact on their pregnancy and delivery. Therefore through comprehending the social models of pregnancy can help various stakeholders to develop their ideas and put their issues around the perception of normal birth (Teijlingen, 2017).
Conclusion
Hence to conclude, it can be said that the social and medical models vary in their approaches towards a particular incident. If obesity is perceived as a medical problem, the solution is to use drugs which can suppress the appetite. If it is observed as a social model, then the solution lies in imposing the tax on sugary drinks and implementing lifestyle changes at the community level.
References
Brown, G. W. & Harris, T. (2012). Social origins of depression: A study of psychiatric disorder in women. NY: Routledge.1-10.
Bury, M. (2013). Health and illness in a changing society. NY: Routledge.1-20.
Hankivsky, O. (2012). Women’s health, men’s health, and gender and health: Implications of intersectionality. Social science & medicine, 74(11), 1712-1720.
Leventhal, H. O. R., & Ian, B. (2012). The common-sense model of self-regulation of health and illness. The self-regulation of health and illness behavior .NY: Routledge. 56-79.
López, N.(2016). Health Inequities, Social Determinants, and Intersectionality. National Academy of Medicine. Retrieved August 12th , 2018 from https://nam.edu/wp-content/uploads/2016/12/Health-Inequities-Social-Determinants-and-Intersectionality.pdf
Macdonald, J. J. (2013). Primary health care: medicine in its place. NY: Routledge.1-20.
Martin , L.S. & Evans, D.P.(2015) . Conflict as a Social Determinant of Health. SM Journal of Public Health and Epidemiology, 1(2),1-4.
Peng, L., Zhang, J., Li, M., Li, P., Zhang, Y., Zuo, X. & Xu, Y. (2012). Negative life events and mental health of Chinese medical students: the effect of resilience, personality and social support. Psychiatry research, 196(1), 138-141.
Stenberg, K., Axelson, H., Sheehan, P., Anderson, I., Gülmezoglu, A. M., Temmerman, M. & Sweeny, K. (2014). Advancing social and economic development by investing in women’s and children’s health: a new Global Investment Framework. The Lancet, 383(9925), 1333-1354.
Steptoe, A., Shankar, A., Demakakos, P. & Wardle, J. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110(15), 5797-5801.
Teijlingen , E.R.V.(2017). The medical and social model of childbirth. Kontakt 2 (2017) ,81–82.
WHO (2018). About social determinants of health. Retrieved August 12th , 2018 from https://www.who.int/social_determinants/sdh_definition/en/
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