1. What is health?

2. Session Aims To explore the complexities of health as a concept
To reflect on your own perspective on health
To summarise and critique key debates about the concept of health

3. Definitions of health
Dependent on a wide range of perspectives, subjectivities and experiences
Socially, historically and culturally located
Health is an abstract concept (Earle et al, 2007)
Health is a contested concept
No universally agreed definition (Pridmore & Stephens, 2000)

4. Definitions of Health Health as the absence of disease
Health as a continuum (positive/negative)
Holistic health
Health as well being
Health as being able to function

5. Definitions of Health (Johnson, 2007)
Dictionary definitions
Assumptive definitions
Determinist definitions
Spiritual definitions

6. Theoretical Perspectives
The Medical Model of Health
Based in science
Focuses on the individual
Health is ‘located’ in the individual body
Ill-health is caused by biology or physiology
Health is the absence of disease or abnormality
Forms the basis of healthcare provision

7. Theoretical Perspectives
The Social Model of Health
Health is determined by a range of factors
Ill-health is caused by structural factors such as poverty and inequalities
Health is socially constructed
Health is socially produced
Lay perspective is key

8. Comparing and Contrasting the Medical and Social Models
Medical Model
Social Model
Narrow or simplistic understanding of health.
Broad or complex understanding of health.
Medically biased definitions focusing on the absence of disease or dis-ability.
More holistic definitions of health taking a wider range of factors into account such as mental and social dimensions of health.
Doesn’t take into account the wider influences on health (outside the physical body).
Takes into account wider influences on health such as the environment the impact of inequalities.
Influenced by scientific and expert knowledge.
Takes into account lay knowledge and understandings.
Emphasises personal, individual responsibility for health.
Emphasises collective, social responsibility for health.

9. Theoretical Perspectives
Salutogenesis (Antonosky)
The origins of health
Challenges the pathogenic nature of the medical model of health
Focuses on what makes people healthy not what makes people sick
Suggests a health-ease-dis-ease continuum which everyone is located on

10. Theoretical Perspectives
The Holistic Model of Health
An integrated approach
Takes into account the interactiob of biologicalm psycholgocial and social factors (Earler 2007)
Person is viewed as a ‘whole’

11. Other perspectives
Philosophical
Psychological
Social Constructionist

12. Lay Perspectives on Health
‘Non-expert’ understandings
Not homogenous
Complex
Differ across individuals, communities, cultures, contexts and time
Differ with age, levels of education, social class and gender
Valuable in understanding what health is

13. Lay Perspectives – Blaxter (2004)
Health as not-ill
Health as physical fitness, vitality
Health as social relationships
Health as function
Health as psychosocial well-being

14. Lay Perspectives – Stainton-Rogers (1991)
Body as machine (links with medical model understandings)
Body under siege (external factors influence health i.e. germs)
Inequality of access (i.e. to medical services)
Cultural critique (linked with ideas about exploitation and oppression)
Health promotion (linked with ideas about responsibility for health as being individual and collective)
Robust individualism (linked with rights to a satisfying life)
Willpower account (linked with ideas about individual control)

15. Culture and Health - examples
Ideas of beauty and slenderness being equated with health in a Western context (Burns & Gavey, 2004)
Differences between lay persons and professional understandings of mental health in Zambia (Aidoo & Harpham, 2001) – different definitions of ‘ill-health’ used by both.

16. Social Class and Health - examples
D’Houtard & Field – study of 4000 French people
Higher & middle social classes – health was about hedonism, equilibrium, vitality and the body; lower classes – health was about absence of sickness, and linked to hygiene and psychological well-being
Blaxter & Paterson (Blaxter, 2004) poor socio-economic status defined health as ‘not being ill’

17. Lifespan and Health - examples
Children understandings of health are wide-ranging and include being happy, thinking positively about yourself and being kind (Burrows & Wright, 2004)
Older people define health more in terms of being able to look after yourself and declining health as being an inevitable part of aging (Lawton, 2003)

18. Gender and Health - examples
Women are more likely to focus on caring and reproductive roles; men more on the disadvantages of their ‘provider’ roles (Emslie & Hunt, 2008)
Assumptions that women are more interested in health than men.

19. Key issues The nature of health is contested, varied and changeable
A range of different perspectives should be taken into account
Lay perspectives on health are important and influential
Understanding what health is about is crucial to promoting and researching it

20. Summary
Health is a complex concept and is difficult to define. Many different definitions and understandings exist.
Understandings of health differ according to experience and expertise. Factors such as age, social class and gender impact on these. Theoretical perspectives about health can aid our understandings of subjective health experience.
Lay and expert understandings of health may differ but both are central to developing understandings about what health is, how it may be explored and how it may be maintained.