Biomedical and Biopsychosocial Models of Health
Prior to 1977, the biomedical model was the key model used by physicians to explain the causes of illness and disease. It postulates that illness is a consequence of abnormalities/malfunctions in the physiological body processes, and that social and psychological factors are not in any way related to the disease process (Taylor, 2009). In addition to this single-cause aspect, the biomedical model was driven by three other major assumptions; i) the mechanical metaphor -- that the body works as a machine; ii) mind-body dualism -- that our values, beliefs, and ideas, which are matters of the mind, play a significant role in the physiological/biological processes of the body; and iii) the discounting emotion factor -- that physicians could not rely on the patient's opinion when making a diagnosis because patients are likely to be biased about their health.
The biopsychosocial model, on the other hand, recognizes disease as a consequence of the interaction of various social, psychological, and biological factors (Taylor, 2009). It takes into account the entire scope of a patient's well-being and recognizes the effect of such factors as strain and stress, emotion, and environmental surroundings on the occurrence of illness and disease (Taylor, 2009).
The biomedical model is the traditional model of health and offers a number of crucial benefits in the study of illness and disease, particularly in relation to the effect of germs on biological processes. However, it also had its own share of liabilities, and it is these liabilities that led scientists to develop the new biopsychosocial model of health. To begin with, its assumption of mind-body dualism wrongly portrayed the body and the mind as two separate entities. Additionally, the model appeared to place more emphasis on the causes of illness as opposed to the conditions that promote health (Taylor, 2009). Moreover, its 'body as a machine approach' was thought to be a wrong oversimplification of reality that failed to recognize the fact that factors external to the human body such as inadequate food supply, domestic abuse, and dangerous neighborhoods also had an effect on a person's health (Taylor, 2009). Of crucial significance, however, was its emphasis on the single-cause aspect of illness and disease. The model assumed that disease was caused solely by germs; however, this assumption began to gradually lose relevance after it was established that most modern illnesses are largely associated with lifestyle factors and stress and cannot be associated with a one single cause (Taylor, 2009).
The biopsychosocial model of health essentially addresses the shortcomings of the biomedical model. First, by recognizing the possible effect of external environmental factors on biological processes, the model is able to explain why, for instance, out of ten people who are exposed to measles, only five would actually develop the disease (Taylor, 2009). Moreover, by appreciating the effect of somatic factors, the model provides a more realistic framework for explaining the leading causes of death in modern society including diabetes, cardiovascular diseases, and high blood pressure, which are largely associated with lifestyle factors. Further, the model is able to clearly explain how social and psychological factors influence the effectiveness of treatment (Taylor, 2009). It is because of these relative strengths that that biopsychosocial model has been increasingly adopted by practitioners and researchers.
Clinical Implications: under the biomedical model, physicians were expected to make diagnoses by considering only the effect of biological factors such as biochemical imbalances, and how these could have contributed to the reported malfunctions. In contrast, however, the biopsychosocial model requires physicians to "consider the interacting role of biological, psychological, and social factors in assessing an individual's health or illness" (Taylor, 2009, p. 7). Moreover, a physician must ensure that his treatment recommendations involve all the three factor sets, and that consequently, target therapy is designed as to fit the unique health statuses of individual patients, and to deal appropriately with multiple health problems (Taylor, 2009).
Part Two: Risk and Resilience Factors for Stress and Disease
Max faces quite a number of risk factors that predispose him to stress and disease.
Job stress - he works in an auto parts factory, where he is most certainly exposed to unfavorable levels of noise, hostile working conditions that he has very little control over, and a demanding work schedule that requires him to work in the evenings and on weekends. He has very little time to rest and the fact that his body is constantly in a state of activation predisposes his biological systems to higher levels of wear and tear. Ultimately, the risk of disease increases as the body gets increasingly fatigued, and its ability to repair damaged tissues and defend itself from harm is seriously compromised.
Relationship problems -- he is unable to negotiate higher wages given that he has little control over the terms of his employment. As a result, he faces financial constraints and is under constant pressure from his wife, who perhaps feels that he is not giving enough, in terms of time and finances, to support his family. He also faces the pressure of being a good employee, and at the same time, a family man. The combined effect of these pressures places him at a very high risk of suffering a psychological breakdown.
Smoking and unhealthy eating habits - his frequent intake of fatty diets increases the levels of cholesterol in his blood, and causes a plaque build-up in his coronary arteries. This places him at a high risk of cardiovascular disease. Smoking increases this risk, as well as that of lung cancer.
Unfavorable surroundings/neighborhoods - he lives in a crime-prone neighborhood and is under intense pressure to protect his hard-earned assets. He also faces additional pressure from not having enough time to guide his children from being influenced into engaging in crime. These factors make him more predisposed to stress and mental disease.
These include those factors that enhance his ability to cope with the aforementioned risk factors.
Strong social network -- he has a strong social network of caring family members and good friends, who offer assistance in the form of financial and friendly advice, essentially helping him deal with his financial constraints and psychological pressures.
Regular exercise -- he exercises regularly, which essentially helps him burn excess cholesterol and boost his levels of 'good' cholesterol, essentially minimizing the risk of heart disease. Further, regular exercise reduces the risk of psychological breakdown as it provides an emotional lift, making one feel happier and more confident.
Part Three: HIV-Prevention Plan
The Center for Disease Control and Prevention (CDC) estimates that approximately 29% of persons living with HIV in America today are women (Morokoff, et al., 2011). It is further estimated that women have a 12% likelihood of getting infected through heterosexual contact, whereas men have a 4% risk of exposure to the same (Morokoff, et al., 2011). Injection drug use has been found to be the greatest cause of HIV infection among women, with approximately 46% of the current population of women living with AIDS having been exposed through this medium (Morokoff, et al., 2011). Moreover, 38% of this population was exposed through unprotected intercourse with an infected person. This plan seeks to reduce the rates of HIV infection among women in Franklin County, New York. The CDC recently named New York as the second-leading state in terms of HIV infections among women. The plan will focus on educating women in Franklin on how to reduce their exposure to HIV. It will emphasize three major areas -- infections through injected drug use, infections through sexual behavior, and mother-child transmissions during birth and breastfeeding.
Injected Drug Use -- the CDC identifies amphetamines, cocaine, and heroine as the most commonly injected substances among women. Sharing of injection paraphernalia such as needles exposes women to the risk of HIV infection. This infection could also occur through water used to unclog equipment, cotton used for drug filtration, and drug cookers for melting heroine, all of which come into contact with blood at some point during the injection process (Morokoff, et al., 2011). Majority of women who get infected with HIV through this medium do so from a relational context -- sharing injection equipment with their IDU sex partners. This form of transmission can be prevented through educating women on how to use bleach to clean their drug injection paraphernalia. Further, needle exchange programs (NEPs) can be initiated. However, unlike in other programs, where women are required to travel physically to the distribution center to exchange their equipment for new ones, this program will emphasize a door-to-door distribution mechanism so that child care responsibilities do not bar women from benefiting from the program.
Sexual Behavior: although the rate of women-to-women transmission is not as high as that of men-to-men, the CDC estimates that homosexual sexual behavior still accounts for a significant percentage of HIV transmission among women (Morokoff, et al., 2011). Oral sex is the most common form of transmission in this regard. Condoms have been found to be an…