It is simply assumed to be true, and a considerable amount of public and political discourse in Australia is based on the more-or-less uncritical adoption of this view.However, there have been serious challenges to this apparently obvious assumption.His analysis was based on a particular social, epidmiological and historical context, and the time since then has been marked by significant advances in health care treatments, technology and organisation.
It is simply assumed to be true, and a considerable amount of public and political discourse in Australia is based on the more-or-less uncritical adoption of this view.However, there have been serious challenges to this apparently obvious assumption.His analysis was based on a particular social, epidmiological and historical context, and the time since then has been marked by significant advances in health care treatments, technology and organisation.Tags: Buying An EssaySocial Networking Thesis FilipinoSocial Work Courses Distance LearningBusiness Plans In KenyaEssays On Look Back In AngerThe Giver Essay QuestionsAssign A Static Ip Address
Thirty years on, most workers in the field would agree in broad terms with Mc Keown’s hypothesis.
Nevertheless, his theory has been refined and updated, and most theories advanced in recent years see the provision of health care as at least a part of the explanation for better health.
Fortunately there is a substantial international literature that deals with this point, and it is to this literature that we turn now. 8 For a concise examination of the social determinants of health, see Wilkinson, R. 12 We note, for example, how following the 1989 National Aboriginal Health Strategy in Australia, there was a powerful emphasis in national public policy on the need for better infrastructure – especially improved housing, water quality and sanitation – as the way to make progress in Aboriginal health, almost to the detriment of the provision of health services at all.
The work of Thomas Mc Keown in the 1970s and more recently, substantial evidence of the importance of the social determinants of health, have critically challenged the ‘common-sense’ idea that improved population health is simply the result of better health care. This is of course was very different to the intent of the Strategy.
Top of page Accordingly, there is now a general consensus that health care systems’ contribution to population health is far from negligible.
The epidemiological transition model describes the changing relationship between humans and their diseases.
Alternatively, while neither Mc Keown nor the researchers and theorists on the social determinants of health claim that health care has no effect on the health of populations, there have been times when their implicit or explicit critiques of the ‘medical model’ have led some to abandon the belief that the health system has any effect on the health of populations at all. (2005) The health status of Indigenous and non-Indigenous Australians, Discussion Paper No. UK Australia Seminar: Federalism, Financing and Public Health.
Top of page While neither of these reactions may be very useful or strategic, the question remains about the extent to which health services contribute to population health. Social Determinants of Health: the Solid Facts, World Health Organization Regional Office for Europe. Social determinants of Health: The Solid Facts, 2nd edition, Marmot, M and Wilkinson, R (eds.), International Centre for Health and Safety, Denmark. 486, Centre for Economic Policy Research, ANU, Canberra, and their estimate that income, employment status and education accounted for between one-third and one-half of the gap in health status between Indigenous and non-Indigenous Australia. Canberra, The Nuffield Trust and Australian Government.
While explanations of illness cast in terms of exposure to certain individual risk-factors (for example viruses, bacteria, smoking, alcohol misuse, or being overweight) are a powerful way of understanding disease and illness, considerable evidence has now emerged that in addition to these individual causes lie other deeper causative factors.
These are, of course, the social determinants of health.