Social determinants of health such as geographical location, gender, age, ethnic origin, education level, governance and socioeconomic status are all factors that determine a nation’s healthcare system. Even as contemporary society enjoys technology aided interconnectivity, hundreds of thousands of people are still living under hostile health conditions. While the rich among us are getting richer, a significant percentage of our compatriots are still confronting poverty, hunger, illiteracy and threat of infectious disease on a day to day basis. Such a situation betrays the socio-political realities of our communities, with its attendant failure to invest in public health projects. On the one hand the cultural, economic and social conditions of social groups and populations influence their health needs. This correlation has been identified and widely documented by numerous studies, especially in the case of health conditions in developing countries. (Eisenberg, et.al., 2007, p.1216) The health conditions of a population are, in this regard, an inseparable facet of the general state of well-being. Some fundamental indicators of health, such as morbidity rates, mortality rates and life-expectancy at birth show a strong link not only with
“indicators related to aggregate socioeconomic conditions (income, employment, nutrition, etc.) but also with indicators related to other indirect variables of well-being. For instance, education, especially women’s education, rates have a significant impact on human development indicators, such as the life expectancy at birth rates. (1) Equally significant is the correlation between political variables–such as the presence of democratic institutions, the degree of participation in public life–and the population’s conditions of well-being, of which, as we mentioned above, health is an important component. (2) Together, the inequalities between countries and within a country, i.e., the imbalances, discrimination and exclusion from access to economic, social, cultural and political resources, are a crucial factor in explaining the unequal exposure to diseases on the part of individuals, social groups and populations.” (Leonardis, 2006, p.19)
As an acknowledgement of the injustices, inequalities and disadvantages inherent in the dominant biomedical model, a consensus is emerging within the international community toward the formation of a more equitable public health system. Such conceptions as the international development targets, which were discussed in recent WHO meetings try to deal with diseases of poverty head on. Simultaneously, there has been a growing concern from private corporations to involve themselves in civil society organizations. The global health initiative is a product of these developments. If implemented properly, we may see a more equitable global health system in the not-distant future. But for this dream to be fulfilled, private corporations and government health agencies need to put in concerted and coordinated efforts based on shared values. In these times of radical change to economic organization of the world, the need to build bridges between medicine and public health and between ethics and human rights become all the more important. (Lietz, 2006)
Even in the public health system in the United Kingdom, the influence of the biopsychosocial model is becoming evident. The National Health Service (NHS), which is a government run public health care enterprise, is an important institution in Britain. Both the Tory party and the New Labour Party have competed to claim the NHS as their own and no election campaign in Britain is without numerous references to the benefits offered by the NHS. While some of the claims made by politicians might be overstated and exaggerated, it is indeed true that the NHS is an indispensible and integral part of the lives of British citizens. Several public opinion polls also show that people living in the UK are generally happy and appreciative of the services offered by the NHS. There are good reasons why this is so. For example, the NHS provides free healthcare service to all citizens at point of delivery, and made available on the basis of need and not on the ability to pay. In the years before its creation, nearly half the general population could not avail of basic healthcare. Back then, access to basic healthcare was a matter of social class and the ability to pay. But all that changed for good with the unveiling of NHS in the year 1948. The success, sustainability and the goodwill generated by the NHS is a strong proof for the veracity of the biopsychosocial model of health. This success is made possible by the fact that the NHS stands for protecting the greater common good as opposed to profits of private interests.