Approaches to health care

1. Approaches to health care Area of study 2 - promoting Australia's health

2. Key areas • Key Knowledge • Models of health and health promotion including: • Biomedical model of health • Social model of health • The Ottawa Charter for Health Promotion • Key Skills • Analyse the different approaches to health and health promotion.

5. Key questions • What is the biomedical model of health? • What is the social model of health? • What is the focus of each model? • What are the advantages and disadvantages of each model? • Why is the biomedical model more expensive? • Why is it important to have both the biomedical model and the social model of health if we are to improve health status? • What are the differences between the two models? • Where does the Ottawa Charter fit in here? • Can you answer any of these with the person next to you???

6. Approaches to health care • As the understanding of health status and its contributing determinants have developed over many years, so have the approaches intended to improve health. • In order to assess the adequacy and effectiveness of Australia’s health care system it’s important to understand the nature and role of each approach to health care.

7. Biomedical model of health • Definition • ‘Focuses on the physical or biological aspects of disease and illness. It is a medical model of care practiced by doctors and/or health professionals and is associated with the diagnosis, cure and treatment of disease.’ (VCAA) • Also copy definition from text p.227.

8. Biomedical model of health cont. • It is sometimes referred to as: the ‘fix it’, ‘band aid’ or ‘quick fix’ approach as it involves trying to diagnose and treatillnesses and conditions once symptoms are present. • It centres around doctors, health professionals and hospitals, who administer treatment. • Focuses on INDIVIDUALS and attempts to return the physical health of the person to a pre-illness state. • Focuses on ‘ill health’ – provision of health care is seen as a response to the ‘breakdown’ of the body. The body is treated as a machine – it’s thought to be capable of repair if one part breaks down. • The reasons for the illness are not at the center of this model.

9. Biomedical model • Using this view of health and illness, the body (focusing on the ‘physical’ aspects of health) is seen in isolation from behavioral, social and environmental factors. • It suggests that the absence of disease = ‘health’.

10. Biomedical model of health cont. • Name three examples of the biomedical approach to health care

11. Biomedical model of health cont. Use the information on pp 229 of your textbook to complete the table

12. THE BIOMEDICAL MODEL OF HEALTH • Examples include:

13. THE BIOMEDICAL MODEL OF HEALTH Medical technologies (eg: xrays, ultrasounds etc) Laboratory testing • Examples include the use of: Professional health workers (eg: Doctors, Nurses etc)

14. THE BIOMEDICAL MODEL OF HEALTH Medication (eg: antibiotics) Hospitalisation Surgery Diagnosis

15. Biomedical model of health cont. • As technologies and treatments were discovered in the 20th Century, there was increased pressure on hospitals and health professionals to diagnose disease accurately and to find cures and treatments. • Medical science and technologies are pivotal in this model and many medical advances have occurred as a result of the Biomedical Model of Health. • This approach to health care has been dominant form many years and has played a large role in prolonging life expectancy in Australia. • The Biomedical Model of Health receives the majority of health care funding (over 90%). It’s important to remember that the cost of diagnosis, treatment and research into illness and cures are VERY expensive!

16. THE BIOMEDICAL MODEL OF HEALTH – KEY SKILLS EXAM PRACTICE There are many biomedical approaches to health and dental care. Identify one biomedical approach to health care and explain how it could assist in the maintenance of dental health in children. VCAA: Written exam 2003 One mark was available for naming an appropriate biomedical approach to health care and one mark for the explanation of how it could assist in the maintenance of dental health in children. One student wrote: One biomedical approach to health care in association with dental health in children would be having fillings put in the child’ tooth or teeth when there are holes found. This assists in the maintenance of dental health of children as it allows the holes in the teeth to be filled, ensuring that the teeth will be safe from holes becoming any bigger which will ensure there are less of a chance of there becoming more serious dental problems.

17. SOCIAL MODEL OF HEALTH • Definition • A conceptual framework which improvements in health and well-being are achieved by directing efforts towards addressing the social, economic and environmental determinants of health. The model is based on the understanding that in order for health gains to occur, social, economic and environmental determinants must be addressed. VCAA • Also copy the definition from the text p.227

18. THE SOCIAL MODEL OF HEALTH • The Social Model of Health is an approach to health that attempts to address the broader influences of health rather than disease and injury • What are some of the broader influences? • Eg Socio economic a status, access to health care • Policies, education and health promotion activities are the key aspects of the Social Model of Health • The Social Model of Health is based on an understanding that, in order for health to improve the social, economic and environmental factors need to be addressed.

19. Relationship between the determinants of health and health status If all these causes can be addressed many diseases and illnesses can be prevented altogether

20. THE SOCIAL MODEL OF HEALTH • Policies, education and health promotion activities are the key aspects of the Social Model of Health If all these causes can be addressed many diseases and illnesses can be prevented altogether How can this be achieved? Community Approach Not the individual

21. The principles of the social model of health Read p.230 and summarise the 5 principles

22. The Social Model of Health The social Model of health allows individuals and communities to participate in decision making about their health. Individuals are more likely to participate in health behaviours if they feel they have a sense of power and control over their situation This involves a range of government and nongovernment organisations working together to promote health and to implement programs. As health care is a significant determinant of health and health status, the social model acts to enable all people to have appropriate health care regardless of their social situation Seeks to address the social determinants, which include gender, culture, race, socioeconomic status, location and physical environment. The Social Model looks at addressing the broader determinants of health that have a strong relationship with health status. Includes: gender, culture, race, ethnicity, SES, location and physical environment,

23. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH

24. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Involves inter- sectorial Collaboration Only by involving all interested and concerned groups can the social determinants be adequately addressed The social and environmental determinants of health cannot be addressed by the health sector alone Collaboration or Working together

25. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Involves inter-sectorialCollaboration • Employment, Education • Finance • Social Security • Environment • Sanitation • Vic Health • Nutrition Australia • BeyondBlue • Hospitals • Doctors • Research • Medicare • PBS • Water supply • Energy supply • Transport • Manufacturers

26. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH • Acts to enable Access to health care • The social model of health acts to enable all people to have access to appropriate health care regardless of their social situation • Health services should be affordable and available according to people’s needs. Health information should be available to all in accessible and appropriate formats

27. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Addresses the broader Determinants of health Addressing the broader determinant of health is a key aspect of the social model of health. Behavioural Determinants These need to be addressed to improve health These are often influenced by other broader determinants of health such as:

28. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH • Acts to reduce social Inequities • The social model of health aims to promote equity for all people and to achieve this, the social determinants be adequately addressed • Gender, • Culture, • Race, • Socioeconomic Status, • Location • Physical Environment.

29. THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH • Empowersindividuals and communities • Empowering individuals and communities with health knowledge and skills means that they are in a position to make positive changes to their health • People have the right to participate in decision-making about their health and to access skills and resources they need to change factors which influence their health.

30. THE OTTAWA CHARTER FOR HEALTH PROMOTION The principle of the Ottawa Charter was founded on the Social Model of Health The Ottawa Charter outlines guidelines to help organisations and key stakeholders incorporate health promotion ideas into strategies, policies and campaigns. The Ottawa Charter was adopted by Australia as a means of promoting health

31. THE OTTAWA CHARTER FOR HEALTH PROMOTION The Ottawa Charter identifies certain prerequisites or basic conditions and resources that must be available if any gains in health are to occur. Peace Education Stable ecosystem Our ecosystem provides resources for health – water, air, food – balance between the landscape and plants/animas Shelter Food Social justice and equity Refers to all people being valued and receiving fair treatment Income Sustainable resources Resources such as food, water, fish, oil, timber. These must cause little or no damage to the environment - able to continue for a long time

32. The oc’s Strategies for health promotion • Enable • Focuses on reducing variations in health status • Ensure equal opportunities and health resources to enable all people to reach their full health potential • Mediate • Coordinated action by all levels of government, the health sector, non-government organisations, industry and the media • Advocate • Favourable advocacy for health through political, economic, social, cultural, environmental, behavioural and biological factors

33. THE OTTAWA CHARTER FOR HEALTH PROMOTION ACTION areas The Ottawa Charter sets out five priority or action areas that should be taken into account when devising health promotion initiatives

34. THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action area 1 • Relates directly to decisions made by governments and organisations in relation to laws and policies that directly affect health • health sector • local councils - recreation • work place policies • housing and transport • school policies • Examples: • healthier environments – banning smoking • influence behaviour – compulsory wearing of seat belts • wearing hats during play at school • removing the GST on unprocessed foods

35. THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 2 A supportive environment is one that promotes health and assists people in making healthy lifestyle choices.Its aim is to provide a: Healthy Physical Environment: ●Where we work, live, go to school. EG Providing shaded areas in schools - ● Protect the physical environment – investing in sustainable energy production Healthy Social Environment: ●Help and support to others. EG Quitline – support to smokers wanting to quit ● Help and support from others ● Fulfilling social life

36. THE OTTAWA CHARTER FOR HEALTH PROMOTION Action area 3 ● This action area is centred around the community working together to achieve a common goal ● The more people working together towards a common goal, the greater the chance of success. ● Communities work together to identify and set health priorities, and plan and implement strategies to achieve better health Example: Government immunisation scheme higher immunisation rates

37. THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 4 ● Education is the key aspect of this priority area ● People gain knowledge and skills necessary to make decisions that will affect their health ● People who have knowledge and life skills have greater control over their lives and choices to enhance health Examples: Talking to people to resolve conflict rather than using violence

38. THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 5 • ● Movement away from the biomedical model to one that promotes health and prevents ill health • + • ● Includes all members of the community • Doctors + hospitals + individuals + community groups + health professionals + government departments • ● Examples : • Healthy eating to reduce impact of CVD rather than surgery • Physical activity to reduce obesity and type 2 diabetes

39. THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 5 ● A health system that reflects the Social Model of Health must therefore address all the determinants of health, not just disease This requires a shift towards health promotion(The process of enabling people to increase control over, and to improve their health)Doctors take on a role of educator or provide preventive health care messages not just curative care

41. THE OTTAWA CHARTER FOR HEALTH PROMOTION For each of the statements listed below indicate which of the 5 priority or action areas of the Ottawa Charter are represented.