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DEFINITIONS OF HEALTH AND WELLBEING 2.1.1 - Coggle Diagram

- - - - A combination of physical, social, intellectual and emotional factors
    - - The achievement and maintenance of physical fitness and mental stability
    - - The absence of physical illness, disease and mental distress.
  - - - –Affordable
      - –High quality
      - –Address public health (safe water, sanitation, food, housing, health information and education and gender equality)
- - - - Modifiable risk factors
      - Negative social determinants
      - Illnesses and disease
      - Trends and patterns
    - - Protection from abuse and harm
        
        Rights
        
        Education and training
        
        Environment
        
        Community involvement
        
        happy socially, physically and mentally
        
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    - - Child: PIES - welfare (development)
- - - - Determinants: The causes of the causes
        
        The social model believes that the circumstances in which people are born, grow, live, work and age impacts upon health
        
        Society creates barriers to good health
        
        Social determinants: The social cultural, political, economic, commercial and environmental factors that shape the conditions in which people are born, grow, live, work and age
        
        The main determinants of health
        
        These causes of the causes influence health and wellbeing including through people's health behaviours
        
        Yet individual control over such behaviours is often very limited
        
        Unhealthy behaviours are usually not the origin of poor health but the end point of a long chain of causes and consequences in peoples lives
        
        Social determinants are complex:
        
        Some diseases are due to genetics (biomedical) but these are less significant in shaping a person's health than social determinants
        
        Marmot (2010) and the WHO suggest that determinants should be viewed as conditions that determine the likelihood of positive health and wellbeing outcomes across an individual's lifespan
        
        EG: someone who doesn't have the opportunity to do well at school, They are:
        Less likely to have a job
        More likely to suffer poor health outcomes in life
        
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      - Social inequalities:
        
        Socially disadvantaged people are more likely to face conditions that lead to poorer health and an earlier death.
      - Health inequalities: span the population and affect people of all ages, at every stage of life and across all major diseases
        
        in 2010: Marmot review - it propose an evidence based strategy to address the social determinants of health, the conditions in which people are born, grow, live, work and age and which can lead to health inequalities
        
        It concluded that reducing health inequalities in the UK requires a series of objectives to be met these are:
        
        giving every child the best possible start in life
        
        creating job opportunities and fair working conditions for all
        -ensuring a healthy standard of living for the whole population
        
        developing health - creating physical environments
        
        empowering communities
        
        strengthening health prevention
        
        Health Equity in England The Marmot Review 10 years on:
        
        people can expect to spend more of their lives in poor health
        
        improvements to life expectancy have stalled and declined for the poorest 10% of women
        
        the health gap has grown between wealthy and deprived areas
        
        place matters - living in a deprived area of the North East is worse for your health than living in a similarly deprived area in London, to the extent that life expectancy is nearly five years less
    - - Identifies that individuals do not start and finish with the same opportunities in society - the social gradient of health - where poor social and economic status yastly increases the likelihood of poor health and wellbeing outcomes, including a reduced lifespan
        
        Individuals with protected characteristics, such as disabled people are more likely to illness or impairment, but barriers are imposed by society due to discriminatory and disabling attitudes, systems and environments
        
        It places the burden of responsibility on society, which because of social barriers (attitudes) and structural barriers (e.g building design) makes it harder for disabled people to fulfil their full potential
        
        Measured public health outcomes - if progress is poor, the health and wellbeing of individuals is likely to reflect this
    - - Redefines the problem
        
        Addresses the cause behind the cause: of ill health - the barriers that prevent good health for all and actions for social change using a holistic community approach
        
        The cause is seen as external social determinants outside the individual's control
        
        However, the biomedical model assigns the problem as being with the individual
        
        Promotes early intervention
        
        Interventions need to happen at an early stage to prevent a person's health and wellbeing from deteriorating further
        
        EG: a young person threatened with homelessness receives advice, information or referral to alternative accommodation before they are on the street and their outcome is improved
        
        The social model requires sectors and services to work together to address the diverse aspects of lives
      - Weakness
        
        External determinants do not solely account for health - individuals have free will, choice and personal responsibility
        
        Individual decisions impact health, regardless of their start in life
        
        High economic status (affluence) does not guarantee good health - factors such as genetics and abuse also impact health
      - Strengths
        
        Recognises diverse factors that contribute to HWB
        
        Emphasises that good outcomes rely on needs being met - support is key
        
        Barriers can be removed to promote good health
  - - - Traditional approach to health and wellbeing
        
        Focuses on biological and physical causes of ill health and diseases and excludes/ ignores other factors
        
        Good health = not ill
      - Biomedical model looks for biological symptoms/ causes to identify a disease/ condition/ illness and needs to be fixed/ cured/ put right
        
        People who have poor mental health = disease or illness caused by a genetic abnormality or brain abnormality/ chemical imbalance
        
        Biological cause means solutions involve interventions -> clinical diagnosis, medical treatment and medication
    - - Stops an individual from living an independent and fulfilling life and nothing else is considered
    - - Strengths
        
        Respected for underpining health with science
        
        Focus on assessment diagnosis and treatment can cure disease and broken bones etc
        
        Medical intervention in pregnancy and birth reduced infant mortality rates
        
        NHS originally founded on this model
        
        Assigning medical causes to mental health conditions can relieve stigma
        
        Quick fix
      - Weaknesses
        
        Assumes all complex health issue can be attributed to genetics/ biological causes - Treatment of mental health as a medical condition
        
        Chemical imbalances --- with drugs does not always work
        
        Medicalised pregnancy and birth -- took control away from women -- leads to higher rate of unnecessary interventions
        
        Concerns about safety/ side effects/ dependency on medication
        
        Negative perspective of health can:
        
        Define people with disease illness as invalid -- leads to stereotypes and discrimination
        
        Believe that disability stops meaningful contributions to society/ unable to be independent
        
        People become reliant on someone else "fixing" them
  - - - Bio- pain
        Psycho- Low mood social- unemployment
      - stress - unemployment, low mood and underlying cause for headache = stress
      - New job= removes stress and relieves pain and low mood
    - - Strengths
        
        Encourages a holistic and enquiring approach
        
        sees factors as interactive and interdependent
        
        Acknowledges the complexity of causes of HWB
        
        An assessment of need may focus on multiple methods of support to address different aspects concurrently
        
        Supports co-production with an individual - work together to address factors to improve HWB
      - Weakness
        
        Can create uncertainty - which intervention has contributed to which outcome
        
        Hard to establish which interventions were needed and which were unnecessary if delivered concurrently (at same time)
        
        EG: which simultaneous intervention can be attributed to making a difference? or is it a combination?