IDSB04H3 Chapter Notes - Chapter 4: White South African, Global Health, Universal Declaration Of Human Rights

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Chapter 4
The biomedical model views health and illness at the individual level, with the body
conceptualized as a machine with constituent parts that can be manipulated or repaired—
health is understood as the absence of disease
The behavioral model views health and illness primarily as a consequence of individual or
household activities and beliefs—the individual is responsible for their own health
The political economy approach to understanding health and illness considers the political,
social, cultural and economic contexts in which disease and illness arise, and examines the
way societal structures interact with the particular conditions that lead to good or ill health
—this approach views health as a function and reflection of linked determinants that operate
at multiple levels: individual, household, community, workplace, social class, national and
the global political and economic context
The one factor consistently associated with mortality declines in developing countries is a
high level of female education
Historically, societal factors/environment were central to explanations of and interventions
against disease
Case Study: Working Conditions, Poverty and TB in South African Mines
TB epidemics surged in conjunction with industrialization
Mining towns in South Africa brought workers in contact with TB, once workers and their
families contracted the disease, they were unable to resist it due to persistent poor living
conditions and working conditions. White South Africans experienced working
improvements to discourage a black dominated force, while the Black workers continued to
suffer. Even when some received TB drugs, people continued to migrate and keep the
prevalence high. People blamed the biological differences between the workers.
According to the political economy perspective, social structures and the ideology that
perpetuates these structures are largely determined by economic forces
Political economy of health approach seeks to understand how power relations influence
absolute and relative access to the medical, behavioral, economic and social determinants of
The political economy framework is based on the notion that political and economic factors
are intertwined with individual and social factors
Virchow was one of the first people to demonstrate systematically the political-economic
underpinnings of health
The World Bank leaves out the political economy when analyzing countries as it challenges
prevailing political and economic forces, so its sticks to biomedical and behavioral
approaches to maintain the status quo of the international distribution of power
It attribute all successes to technological advances and major public health efforts
For example, attributing HIV in Africa to having more sexual partners when in reality
they’re equal with other countries
When the Soviet Union dissolved in 1991 it produced social disruption, sharp declines in
per capita income and deteriorating health outcomes
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Mortality rates increased dramatically (particularly among working-age people)
Increased in violent and occupational death, suicide, chronic diseases, and a resurgence of
formerly rare infectious diseases
The world bank offered a behavioral analysis that individuals cut back on alcohol, smoking,
watch their diet and lead health lives – ignored structural influences on population health of
free market economics and the breakdown of the social welfare state (such as collapse of
public infrastructure and social safety nets, significant declines in living standards and
minimum wage, loss of employment protection)
Today we tend to think of development in terms of a range of social and economic activities
within and across countries, but historically development ideas and practices have been
closely linked to foreign assistance in terms of aid from industrialized countries
The U.S addressed Europe’s and Japan’s problems by donating billions of dollars –this
was aimed at keeping Soviet influence out of region
First was the Green Revolution which, starting with the Rockerfeller foundation’s efforts in
mid-1940’s Mexico, invested in agricultural equipment and technologies (across various
countries)—it’s affects were uneven and generated economic problems for the hundreds of
thousands of small farmers who could not afford these methods
Emphasis was on modernizations and industrialization in development processes rather
than improving rural conditions
Modernization Theory
Promoted a linear path from underdevelopment to capitalism
Developed in the 1950’s by economist Walter Rostow, it’s goal was to create a partnership
for economic growth and democracy in association with the non-Communist politicians and
Theory maintains that just as Western industrial democracies has started out as
underdeveloped, most developing countries could—and should—follow a parallel path of
developmentl central to this process was the exchange of traditional cultures and values of
underdeveloped primitive countries for modern, technological, and market values
Theory holds that traditional societies can make the transition to modernity through
education, urbanization, and the spread of mass media
Western foreign aid organizations and institutions are considered critical
Dependency Theory
Argued that underdevelopment was not the fault of the developing countries’ values or
cultures but rather stemmed from foreign political and economic domination and
Dependency theory holds that Western colonialism and economic imperialism turned
Africa, Asia and Latina America into sources of cheap resources for the colonial powers,
allowing Western countries to develop on the backs of those nations
Theorists maintained that long after developing nations obtained political independence
from colonizers, industrialized countries continued to use their political powers to
perpetuate an international division of capital, resources and profits
World Systems Theory
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