Biopsychosocial Multidisciplinary Model

‘Health’ is a very broad notion, affected by a wide range of individual characteristics, behaviours and contextual factors.

In 1946 the World Health Organisation (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This definition integrates the main concepts of health and identifies that health can be viewed differently by individuals and groups (Bowden, 2006). Health and well-being are the result of a combination of physical, social, intellectual and emotional factors (Dunkley, 2000a).

As stated by the World Health Organization (WHO), ‘health’ is defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1948). The health and wellbeing of individuals is generally determined by their circumstances and environment, a phenomenon referred to as the social determinants of health. WHO describes the social determinants of health as:

Naidoo and Wills(2001, p.47) “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ - WHO (1946).” This definition falls into a holistic way of defining health, which believes that there are more areas to look at when thinking of health than just simply the absence of a disease. It considers the cause of why someone is ill and not just simply about ’fixing it’.

Our bodies are not simply a matter of biology when it comes to health problems. Health behaviors can come from a vast amount of sources. Our diet, hazardous habits, such as smoking cigarettes and drinking alcohol, and genetic hereditary concerns, are factors we are used to acknowledging as the cause for a decline in our health. Biology is not the only factor that creates health issues in our bodies. It is intertwined with social and economic situations in complex ways that build upon each other to contribute to health issues as well. They are considered to be health variations because they are not only measured by biological factors that affect a healthy environment, but also measure unequal accessibility to important factors, socially and economically. Because of health variations, our physical condition is affected by social and economic determinants that also shape the way we perceive and categorize our well-being and how the body reacts to such determinants.

The determinants of health are economic and social conditions that affect people’s health status. These influence the living and working conditions that impacts people’s everyday living condition. Factors such as the place and the environment we live in, genetics, educational level or work status and income, as well as friends and family are some of the aspects that affects our health condition. On the other hand, the people that have an access to good health care and have financial stability are less susceptible and are often less affected. (NANB, 2009)

“The social determinants of health are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life” (World Health Organisation (WHO), 2009). The social determinants of health can be divided into 5 categories, age, sex and hereditary factors, individual lifestyle factors, social and community networks, living and working conditions and general socioeconomic, cultural and

Communication is a vital part of our daily lives, even more so if an individual is part of the health care field. Effective communication will help prevent misunderstanding, and create a sense of comfort between the physiotherapist and patient. In correlation with physiotherapists needing to possess effective communication skills, physiotherapists need to be familiar with the biopsychosocial model. “The physiotherapy profession has undergone a paradigmatic shift in recent years, where a ‘biopsychosocial’ model of care has acquired popularity in response to mounting research evidence indicating better patient outcomes when used alongside traditional physiotherapy.” (Sanders et al., 2013)

World Health Organisation (2015) states there are many factors that contribute to the health of many individuals and communities. Whether people are healthy or not is decided upon their situation and environment. On a far wider scale such as friends, family, education, income, relationships, where we live, and the condition of our environment all have a huge influence on health.

The biopsychosocial model aims to explain an individual’s health as a culmination of his unique biological factors (comprising of genetics, temperament and biochemicals), psychological factors (such as mood, affect, personality, etc.) and social factors (cultural background, society within which one operates, familial factors, social interactions, etc.). Distorted biological factors such as composition of neurochemicals in the brain or abnormality in any other bio physiological processes can lead to ill health and diseases occurring in the body. Psychological factors such as clinical symptoms, psychopathology or even perpetual distress and negative thinking could lead to release in cortisol in the body. This is also known as the stress hormone

It has been proved by research that various mechanisms -- social cohesion, social support, age, stress, socioeconomic status (SES) and social capital – can modify health. This knowledge is vital to the public health sector because it pinpoints the reality that if these mechanisms can be adjusted, improved personal health is possible for

(WHO, 1948) describes health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease of infirmity’? There are other dimensions of health such as physical health, mental health and emotional health which can be broken down and looked at individually.

“Healthy individuals cannot survive when society is sick.” On the other hand, aspects of social structure influence health and illness. Social factors not only affect life expectancy, but the possibilities the one will experience diseases and in turn, the health care that they will receive.

Social determinants of health arbitrate the extent to which a person possesses the physical, social and personal resources to identify and achieve personal aspirations, gratify needs and cope with the environment (Dennis Raphael, 2008). The concern with social determinant is not new (CDC, 2014). It has been known since the mid 19th century that living conditions are the primary determinants of health (Dennis Raphael, 2008). A disease is not something personal and special, but only a manifestation of life under modified conditions (Winter, 2009). Rudolf Virchow provided the direct links between social conditions and health. It is generally known that mental illnesses and substance use disorder is greatly influenced by social factors. Social determinants are the main factors that help structure global health system. Most people in the world are not aware that their health is well structured by the distribution of wealth and income and also employment status. Mental health as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. Significantly, the absence of mental disorder does not necessarily mean the presence of good mental health (WHO, 2009). Most

Health is “the normal functioning of an organism” (Alexander & Thompson, 2008, p. 433). Health is also determined by several social influences including genetics, personal behavior, access to quality medical care, and the quality of the environment such as air, water, and living conditions (IOM, 2006). There has been a wealth of research that has supported the association between social and cultural factors and health. For some types of social factors, such as socioeconomic class has been studied as contributors to health and health outcomes.