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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)
Political economy of health approach
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-Latin American social medicine (141-2)
-Chilean Medico-Social Reality (in text)
-(table 4-1) Navarro argues if you are trying to understand health conditions in any country the
right question to ask has to do with economic, social and political structure. Who owns what?
Who produces? Who works in what sector? What are the class, race and gender structure in
political relations and labor?
- (figure 4-3) Sub-^Zvo](ÆvÇPvvÁv}Áv]vZíõôì[µo
of HIV/AIDS. In Eastern Europe life expectancy also went down, as a result of the collapse of the
Soviet Union and because of the loss of social safety networks.
-(figure 4-4) huge drop in life expectancy in Sub-Saharan Africa.
What is development? (152-3)
- Progress, advancement, economic growth, productivity, profitability, striving for equality,
better health and education, democracy, improved quality of life, economic integration
- In the international context it involved, big business, foreign affairs ministries, multilateral
agencies, technical experts, politician, AND workers and citizens
- Development ideas and practices are closely linked to foreign assistance in terms of aid from
- Ironically, the most successful development effort was the US rebuilding of post- WWII
Europe and japan.
-GDP tells what the total wealth of a country is per year.
-limitations include income gaps and inequalities.
- (figure 4.6) political economy-based classification of countries. Gross national income or product is not
important alone. The nature of domestic welfare state is also important, since some countries are highly
redistributive, partially redistributive or marginally redistributive and that affects the citizen[s welfare. If
Cold War Politics and development (155-160)
-raise the living standard of the developing world through the provision of technical skills,
knowledge, and equipment
-green revolution- RF 1940s-1960s
-technology to stop hunger?
-Commonwealth Colombo Plan- 1951
-eg. Canadian economic aid to Southeast Asia
-Alliance for progress 1961
-era of bilateral trade
-Lester Pearson and 0.7% of GNP to development aid- 1970