IDSB04 Sept 21 (week 2, lecture 2)
The political economy of health and development
-what are the underlying causes of health and illness?
-how do the main models of understanding of health and disease address these factors?
Biomedical model (p133)
-views health and illness at individual level
-body conceptualized as a machine with constituent parts (ex. Organ systems, genes, etc.) that
can be manipulated and repaired.
- health is understood primarily in terms of the absence of disease rather than an integrated
sense of well-being.
- largely curative and considers the role of behavioural determinants of health in terms of risk
predispose individuals to disease (ex. Smokers, obesity, sedentary lifestyles).
- appeal stems from dramatic technological advances in medical treatment over the last century,
such as surgery (including anesthesia and asepsis) and pharmacotherapy.
Behavioral model (p134)
-views health and illness primarily as a consequence of individual or household actions and
beliefs; and either as a reward for healthy living or the (inevitable) outcome of poor lifestyle
choices and personal deficiencies.
-focuses on the regulation or changing of personal conduct and cultural attitudes through
education, counselling, and incentives in order to achieve desirable health outcomes.
banning smoking from public places, fines, price of cigarettes went up.
-primarily views the individual (and sometimes the household or community) as responsible for
-in many cultures, the behavioural model is also filtered through spiritual beliefs, whereby good
or ill health may be linked to supernatural phenomena.
Political economy model (p134)
-considers the political, social, cultural and economic contexts in which disease and illness arise.
- examines the ways in which societal structures (ex. Political and economic practices and
institutions, and class interrelations) and interact with the particular conditions that lead to
good or ill health.
-views health as a function and reflection of linked determinants that operate at multiple levels:
individual, household, community, workplace, social class, nation, and the global political and
-argues tat underlying determinants need to be addressed in order to improve health through,
for example, public policy aimed at improving transportation and housing conditions, medical
care, social empowerment strategies (genter equity, unionization) and social-class-mediated
political involvement aimed at bettering redistribution and overall welfare.
-efforts include, but are not reduced to, biomedical technologies and behaviour/lifestyle.
-WHO and most international organization are concerned with obesity. (table 4-3)