-behavioural changes were heavily mediates by education level, social class, indoor plumbing, etc.
-mortality declines in underdeveloped settings: estimated that 20% of life expectancy improvemtns
associated with increases in income, leaving deliberate social policy as a far more important explanatory
factor. Ex. Female education lead to lower mortality
-^Zv}hysio evolution: interaction among caloric intake, productivity, and longevity.
-low-income countries reached life expectancy similar to wealthier countries due to socialist political
systems favouring economic and social redistribution.
-20th century: rise of germ theory led to dominance of medical model. Focused on role of agent in
-agent and society overlapped: improved nutrition, ventilation, neighbourhood, work
conditions, decreased exposure to disease agents.
-focus on individual (genetic and lifestyle factors) combined with medical interventions, reduced the
importance of social environment in health outcomes.
-behavioural medical approach: individual deficiencies that needed to be corrected through personal
behavioural change combined with agent interventions.
Case Study: S.A Mines
-TB one of the most sensitive indicators of social and political conditions in a society.
-Black miners in 20th century compared to British workers in 19th century.
-exploitation of working class: white S.A miners experienced modest improvements in conditions, black
workers continued to live in poverty.
-biomedical and behavioural models: poor hygiene, racial susceptibility, inadequate diet used to explain
TB rates among blacks, instead of addressing underlying conditions.
-preventable through improved housing, nutrition, infrastructural factors. Curable with antibiotics.
-WHO and most international organization are concerned with obesity. (table 4-3)
Political economy of health approach
-this approach analyses the ways political, economic, and social structures, relations and interests affect
and interact with health conditions in local, national and international settings.
-political and economic factors intertwined with individual and social factors.
-approach analyzes organization of society: race, gender, class, and extent to which certain groups are
-approach assesses organization and distribution of power at local, national and global levels.
-&]]ZvPo[µÇWo]vlZZÁ}l]vPand living conditions of factory workers to specific health
-emphasized that typhus outbreak result of political and economic factors.
-recommended creation of public health services to respond to medical EMGs and improvement
in work conditions, housing, redistributive taxation system-> Structural prevention approach
-Latin American social medicine (141-2)
- ^]]]u}]oo give health and knowledge to a people who are malnourished, who wear
-Chilean Medico-Social Reality : outlined relationship between poor social condition & ill health.
-(table 4-1) Vicente 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