The Biomedical model of health is perhaps the oldest of health paradigms, where freedom from disease, pain or defect is the core focus. The physician typically inspects the patient ‘after’ the onset of an ailment and studies the pathology of disease, physiological mechanisms at play, as well as the biochemical processes. Under the biomedical model, the emphasis is on ‘cure’ and ‘healing’ through scientific application of medical principles as and when a medical condition presents itself. While this goal is perfectly legitimate, the critics of the Biomedical model point out its narrow focus, which largely leaves aside the social, economic and psychological factors that often precede and determine the health of an individual. (Wyman, 2000, p.77) It is due to this lack of wholeness in the conventional biomedical model of health, that scholars and thinkers have devised other wholesome perspectives of health. They have added newer dimensions to the study of human health, and the result is the invention of alternative perspectives such as the Biopsychosocial model of health (loosely referred to as the social model). The dominant discourse of the social determinants of health paradigm
“assumes a socio-environmental approach to health primarily “concerned with risk conditions rather than risk factors”. These conditions include poverty; income, gender, racial, and sexual inequality; stressful environments; housing and living conditions; education and early child care; food security; employment and working conditions; social inclusion and exclusion; and globalization. Efforts to attend to health inequities by anyone working under this paradigm would, therefore, address some or all of these issues.” (Ashcroft, 2010, p.251)
The Biopsychosocial paradigm was first expressed by physician George Engel in 1977, where he asserted that human beings are “dynamic systems whose functioning depends on the holistic integration of biological, psychological, and social factors; indeed, according to the biopsychosocial model, these factors are fundamentally interrelated and interdependent.” (Garland & Owen, 2009, p.191) What Engel was critiquing was the reductionism of the then dominant biomedical model, “which assumed that molecular biological processes (for example, genes, biochemistry) immutably dictated physiology and behaviour, a simpleminded biological determinism nonetheless took root, becoming widely and uncritically accepted.” (Garland & Owen, 2009, p.191) At the time of Engel’s introduction of this new model, he was met with much scepticism. But recent evidence and empirical data validate his theory.
The Biomedical model is as old as the history of modern medicine, where the emphasis is laid on scientific and rational understanding of pathology. This included a thorough approach to comprehending the biological mechanisms down to their molecular level. While this model largely holds forte within the confines of the clinic, it proves inadequate in explaining or addressing why some individuals/communities are more prone to certain illnesses than others. In other words, vast strides were made under the Biomedical model, in terms of advances in technology and the standards of medical professions. Yet, there was also the accompanying thought that people’s health conditions do not purely depend on advances in science and the medical professions but are also greatly influenced by social factors of well-being. And this is where, one begins to see chinks in model’s armour. A classic case in point is the spread of tuberculosis. As statistics on this feared epidemic shows,