Chapters 4, 5 & 7

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International Development Studies
Anne- Emanuelle Birn

Chapter 4 MODELS FOR UNDERSTANDING HEALTH & ISSUE 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 beliefsthe 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 factorsenvironment 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. THE POLITICAL ECONOMY OF HEALTH APPROACH 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 health 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 theyre 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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