1) biologistic- reduces illness to natural to natural biological processes- seeks out a single, clearly identifiable pathogen- loses sight of the social context of the disease

Five characteristics of Individualist Health Promotion (IHP)

1. is located at the conservative end of public health continuum

- that is, it does not require or advocate significant structural change in society

2. focuses on behavioural patterns and lifestyle factors in order to explain the origins of ill health - that is, it looks upstream form biology, regarding diseases as the end product of the way in which people to lead their lives. Ultimately, it is consistent with a psychological orientation

3. aims to educate individuals about the risk factors associated with particular lifestyle choices; with a view to promoting healthy behavioural changes (eg. the ‘smoking kills’ campaign

4. encourage individuals to take responsibility for their health, that is , they are expected to take on board the information provided by health experts, and to use this to monitor numerous lifestyle factors, including diet, alcohol consumption, smoking habits, exercise participation, stress level etc. this process involves ‘internalising the gaze’ of a range of health expert, and it renders more and more area of life ‘relevant’ to one’s health status

5. has a proactive preventative ( is opposed to reactive curative emphasis, whereby it seeks to prevent diseases from occurring by positively influencing health – related behaviours

Social Medicine

- The ‘radical’ end of the public health continuum

- focuses on life chances and social structure

- advocates the structural transformation of society

- preventative emphasis

1. not only is health influenced by behavioural and lifestyle factors that exist ‘upstream’ from biology, it is also profoundly shaped y board social processes that occur even further ‘upstream’ , and which serve to structure behavioural and lifestyle ‘choices’ in the first place.

2. there is a clear social gradient in the distribution of most diseases , that is, as a general rule, the higher the location in the social hierarchy, the lower the incidence of disease, and vice versa

3. with heart disease, the standard biological predictors (cholesterol levels, blood pressure) and behavioural predictors (smoking, poor diet) account for only one-quarter to one-third of the identifiable social gradient.

4. To adequately explain the social gradient of disease, one must take into account the fundamental, although often subtle, social determinants of ill health.

5. It is not only absolute poverty that causes ill health, but also:

- relative inequality (or one’s place in the social hierarch)

- the amount of power and control one exercise; at work, and in life more generally

- one’s degree of integration into a supportive social network

6. in the workplace and beyond, control over one’s destiny, is a pivotal factor in determining an individual’s health prospects and such control is socially mediated.