Explanations for patterns and trends in health and illness

Materialist Explanations

Materialist explanations of health and illness look primarily at socio-economic factors.
They suggest that socio-economic status determines health outcomes due to differences in lifestyle and living conditions including diet, housing, work environment etc.
The Black Report (1980) highlights four types of explanation for health inequalities: artefact, natural or social selection, cultural and material/structural.
‘Artefact’ explanation suggests that statistics showing health differences are due to the way in which data is collected.
‘Natural or social selection’ theory posits that people with poor health would naturally move down the social scale.
The ‘cultural’ explanation highlights learned behaviour and lifestyle choices (e.g. smoking, diet, exercise).
The ‘material/structural’ explanation argues that inequalities derive from socio-economic conditions such as poor housing, diet and healthcare.

Behavioural/Cultural Explanations

Behavioural or Cultural explanations focus on individual choices and actions as determining health outcomes.
The Health Belief model, for instance, suggests the decision to seek medical help is based on individual’s perception of severity, susceptibility, benefits and barriers.
Supporters of this approach highlight the increasing role of personal lifestyle choices in the rise of ‘modern epidemic’ diseases like obesity, diabetes, or heart disease.
Critics, however, caution against the danger of ‘blaming the victim’ i.e. making individuals solely responsible for their health status by downplaying the impact of the wider socio-economic environment.

Psychosocial Explanations

Psychosocial explanations focus on the impact of social relationships, stress and emotional well-being on health.
They argue not only material factors, but also perceived social status and relationships, can affect health outcomes.
Examples include Marmot’s Whitehall studies which found that the higher a person’s rank in the civil service, the better their health, indicating that status and job control play a significant role in health.
This approach also places emphasis on social support and community networks as protective health factors.
Critics note these explanations may overestimate the role of psychosocial factors while underestimating material factors such as poverty or income inequality.

Remember, understanding patterns and trends in health and illness requires a nuanced approach that considers the interplay of various material, behavioural and psychosocial factors.