1. BIOPSYCHOSOCIAL MODEL OF DISEASE

2. Human Disease: Three Models Medical Model Epidemiological Model Biopsychosocial Model Human Disease

3. Medical Model  Emphasis on medical treatment  You’re either healthy or you’re not.  Missing important dimensions of health  Psychology and Social aspect are separate  Address disease but may not consider quality of life (QOL)

4. OECD Health Data

5. Source: CIA World Factbook, 2011

6. Medical Model continued  By medical model standards….  U.S. should have the best health and longest life expectancy. Picture source: onefoundation.org

7. Epidemiological Model Host Agent Environment

8. Problems with disease models Individuals Picture Source: google images

9. Problems  Families Picture source: Google images

10. Problems  Natural Disasters Picture Source: Google images

11. Problems  Pollution Picture Source: Google images

12. Problems  Poverty Picture source: Google images

13. Problems Picture source: Google images

14. Biopsychosocial Model  Health (and illness) are caused/influenced by many factors.  Mind and body are not separate  Relationships are significant to health  Health is on a continuum

15. Implications  Consider biological, psychological, and social factors  Relationships are significant to health  Patient and doctor  Patient and family, friends, others  Keep people healthy rather than wait to treat them when they become ill.

16. Challenges  Poverty as underlying issue  Lack of resources, education  Behavior and/or lifestyle  Misuse of antibiotics  Gaps in immunizations  Lack of access to healthcare  New diseases and re-emerging strains

17. Biopsychosocial Model of Disease Biology Age, sex Disease state Genetics/heredity Physical symptoms Meds/drugs/addiction Psychology Attitudes/beliefs Mood state Behaviors Religiosity/spirituality Social Support: formal/informal Roles: work/family/peers Physician-patient relationship Socioeconomic status Environment School/work place Church Social norms / cultural norms Community / Health services Neighborhoods / National economy Mass media Policy / laws

18. Example: Diabetes Biology Diabetes No family history Skin bumps, fuzzy vision, fatigue, burning feet, pruritis, erectile dysfunction Agent Orange exposure Psychology “It’s always in the back of my mind” Guilt: can’t work as much Depression, stress “I just miss eating junk” Social Marriage suffering Doesn’t trust doctor (non- compliant) Boss did not promote Can’t play with grandkids Environment Healthcare at VA, has to travel Diabetes class offered Fast food everywhere; supersized portions 2 nd hand smoke triggers desire to smoke Cultural norm – embarrassed by weight Gov’t will not compensate for agent orange exposure

19. Example: Fibromyalgia Biology Female Fatigue Joint stiffness Tender points Widespread aches Psychology Depression Information seeker Difficult to get motivated Uses stress management Social Supportive friends/family members However, husband is not very supportive Work role is stressful Teaches water aerobics Environment Good access to health care Environment is conducive to exercise She tries to surround herself with a healthy environment.