MODELS OF HEALTH AND ILLNESS

BIOMEDICAL MODEL

When you hear the word hospital, what comes to mind? Perhaps it’s white-coated doctors briskly
moving through sterile corridors, patients lying in beds surrounded by beeping machines, or the
distinct smell of antiseptics and medicines. Maybe you think of long queues of patients waiting
their turn to consult a physician, or high-tech diagnostic tools like MRI scanners and X-ray
machines. These images feel instinctively “normal” to us today—but for our ancestors,
especially those living before the 19th century, such scenes would have seemed foreign or even
unthinkable.

This modern image of healthcare is rooted in what is known as the biomedical model, the
dominant framework guiding medical practice in most parts of the world since the 1800s.
Sometimes referred to as the medical model, it emerged in the wake of scientific and
technological advances and has profoundly shaped how we understand disease, health, and
treatment.

The term biomedical combines the Greek word bios (meaning life) and the Latin medicus
(meaning healer or physician), reflecting its scientific approach to understanding life and disease
in purely biological terms. Below are the key assumptions and characteristics that define this
model:

1. What Causes Illness?

The biomedical model holds that illness has biological origins. Diseases are seen as the result of
identifiable physical or biochemical malfunctions within the body. These may be caused by:

●​ Pathogens such as bacteria or viruses

●​ Genetic inheritance and mutations
●​ Chemical imbalances (e.g., neurotransmitter dysfunction)
●​ Physical trauma or structural abnormalities

Illness, from this perspective, is likened to a mechanical breakdown in a machine. It is

observable, measurable, and typically traceable to a single, physical cause.

2. Who Is Responsible for Illness?

According to this model, individuals are not responsible for falling ill. Since disease arises from
biological factors beyond personal control—such as infections or faulty genes—the patient is
seen as a passive recipient or victim of an external or internal malfunction. There is no blame or
moral judgment attached.

3. How Should Illness Be Treated?

Treatment under the biomedical model is geared toward curing or managing the physical
abnormality. Standard interventions include:

●​ Surgery to remove or repair damaged tissues

●​ Pharmacological therapy (e.g., antibiotics, antidepressants, chemotherapy)
●​ Radiotherapy or other medical technologies
●​ Vaccination to prevent infection

The primary goal is to restore the body to its former biological functioning, often without much
consideration for psychological or social influences.

4. Who Is Responsible for Treatment?

Healthcare professionals, particularly medical doctors, are seen as the key agents of treatment.
They possess specialized knowledge and are expected to take the lead in diagnosing and treating
illness. Patients are expected to comply with medical advice rather than take an active role in
their own care.

5. What Is the Relationship Between Health and Illness?

In the biomedical framework, health and illness are binary opposites. A person is either ill (with
identifiable pathology) or healthy (with no detectable disease). There is little room for
recognizing degrees of wellness or chronic conditions that may not fit neatly into these
categories.

6. What Is the Relationship Between Mind and Body?

The biomedical model adopts a dualistic view—a sharp separation between the mind and the
body. This Cartesian dualism, inherited from Enlightenment philosophy, holds that:

●​ The body is a physical entity subject to scientific study.

●​ The mind is abstract, housing emotions and thoughts but not seen as capable of
influencing bodily health.

Consequently, psychological factors are largely excluded from diagnosis or treatment unless they
manifest as measurable physical symptoms.

7. What Is the Role of Psychology in Health and Illness?

Psychology, within the traditional biomedical model, is marginalized. It is acknowledged only as

a secondary consequence of physical illness, not as a potential cause or contributing factor. For
instance:

●​ A person with cancer may experience depression, but that depression is not considered
part of the disease process.
●​ Stress or emotional trauma is rarely considered a trigger for physical illness in this model.

Thus, the biomedical model prioritizes physical evidence and undervalues the complex
interactions between psychological, behavioral, and social variables that modern health
psychology seeks to address.

Conclusion: Strengths and Limitations

The biomedical model has been instrumental in advancing modern medicine, particularly in the
treatment of acute and infectious diseases. It has enabled remarkable innovations in diagnostics,
surgery, and pharmacology. However, its reductionist approach, which focuses solely on
biological factors, has come under increasing criticism for ignoring the broader psychosocial
dimensions of health. Conditions like chronic pain, mental health disorders, and lifestyle-related
illnesses demand a more holistic understanding—one that the biopsychosocial model, developed
later, seeks to provide.

BIOPSYCHOSOCIAL MODEL

As limitations of the purely biological approach to health became more evident—especially in

addressing chronic illnesses, mental health issues, and lifestyle-related diseases—medical
thinkers and practitioners began to advocate for a broader, more holistic understanding of human
wellbeing. This shift gave rise to the biopsychosocial model, introduced by psychiatrist George
L. Engel in 1977.

This model integrates biological, psychological, and social dimensions of health and illness,
recognizing that human beings are complex and dynamic organisms whose health is influenced
by a wide range of interrelated factors. The biopsychosocial model does not reject the biomedical
model, but expands upon it to include aspects of individual experience, mental processes, and
environmental context.

1. What Causes Illness?

The biopsychosocial model views illness as resulting from a complex interplay of:

●​ Biological factors (e.g., pathogens, genetic predisposition, chemical imbalances)

●​ Psychological factors (e.g., stress, coping mechanisms, thought patterns, personality
traits)
●​ Social factors (e.g., family dynamics, cultural beliefs, socioeconomic status, community
support)

For example, while heart disease may have a biological basis in terms of high cholesterol or
hypertension, psychological stress and unhealthy lifestyle behaviors—often shaped by social
circumstances—are significant contributors to both its development and progression.

2. Who Is Responsible for Illness?

Unlike the biomedical model, which treats patients as passive victims of disease, the
biopsychosocial model sees individuals as active participants in their health. It recognizes that
behavioral choices, thought patterns, and even social relationships can influence the likelihood of
developing certain conditions.

However, it avoids blame; instead, it encourages shared responsibility between the individual
and the broader social and healthcare systems that shape behavior and access to care.

3. How Should Illness Be Treated?

Treatment under this model is multidimensional and often collaborative. It may include:
 ●​ Medical interventions (drugs, surgery)
●​ Psychological therapies (e.g., cognitive-behavioral therapy, counseling)
●​ Social support strategies (e.g., family therapy, community programs, social work
interventions)
●​ Lifestyle modifications (e.g., stress management, improved diet, regular exercise)

This model supports patient-centered care, which tailors treatment to the unique needs,
preferences, and values of the individual.

4. Who Is Responsible for Treatment?

The responsibility for treatment is shared among multiple professionals, including:

●​ Doctors
●​ Psychologists or counselors
●​ Social workers
●​ Nutritionists
●​ Physical therapists
●​ Community health workers

Moreover, patients are encouraged to take an active role in managing their health, including
self-monitoring, goal setting, and decision-making in their care plans.

5. What Is the Relationship Between Health and Illness?

Rather than seeing health and illness as opposite ends of a binary, the biopsychosocial model
conceptualizes them as points on a continuum. A person may live with a chronic condition (like
diabetes or depression) but still experience high levels of functioning and well-being in other
domains.

This perspective allows for a more nuanced understanding of health, recognizing that people can
feel unwell without a clear medical diagnosis, or conversely, feel well even while living with
disease.

6. What Is the Relationship Between Mind and Body?

In contrast to the dualism of the biomedical model, the biopsychosocial model sees the mind and
body as interdependent. Mental and emotional states can directly affect physical health and vice
versa. For instance:

●​ Stress and anxiety can weaken the immune system, increase blood pressure, or trigger
digestive issues.
●​ Chronic illness can lead to depression, which may, in turn, worsen physical symptoms.

This integrative approach breaks down the artificial barrier between “mental” and “physical”
health, promoting a more holistic understanding of well-being.

7. What Is the Role of Psychology in Health and Illness?

Psychology is a central pillar in this model. Thoughts, emotions, behaviors, and mental states are
not merely consequences of illness—they can be causes and mediators as well. For example:

●​ Negative thought patterns may contribute to anxiety, which in turn can exacerbate
cardiovascular issues.
●​ Positive coping strategies and resilience can improve recovery outcomes and reduce
hospital readmissions.

This model supports the use of psychological screening and support in routine medical care,
especially in managing long-term and chronic conditions.

Conclusion: A Holistic Approach

The biopsychosocial model offers a richer, more inclusive view of health and illness, especially
in a world where lifestyle diseases, mental health issues, and social inequalities play significant
roles in public health outcomes. It encourages interdisciplinary care, promotes patient
empowerment, and acknowledges that healing involves more than just treating the body—it
involves addressing the whole person.

Biopsychosocial Model of Health and Illness

Developed by George L. Engel (1977)

As medicine advanced through the 20th century, it became increasingly clear that the biomedical
model, which focused solely on physical causes and treatments, was inadequate for addressing
the full scope of human health—especially chronic diseases, mental health challenges, and
lifestyle-related illnesses. In response to this, George L. Engel introduced the biopsychosocial
model in 1977, calling for a more inclusive medical paradigm that could account for the
psychological and social realities of patients in addition to their biological conditions.

The Need for a New Model

Engel argued that a medical model must go beyond simply identifying pathogens or bodily
dysfunctions; it must also consider:

●​ The patient’s subjective experiences

●​ The social context in which they live
●​ The healthcare system and its role in the illness experience

According to Engel, humans are inherently biopsychosocial organisms in whom biological,

psychological, and social processes are inextricably linked. While Engel did not reject the
biomedical model, he emphasized the need to give equal weight to psychological and social
aspects during both diagnosis and treatment (Melchert, 2007, p. 37).

Three Domains of the Biopsychosocial Model

1.​ Biological Factors​

These include genetics, infections, structural defects, and physiological processes.
Conditions such as diabetes, cancer, or hypertension clearly have physical origins, but
these factors are only one piece of the health puzzle.
2.​ Psychological Factors​
These refer to a person’s thoughts, emotions, and behaviors. Examples include:
○​ Cognitive beliefs (e.g., fatalism or optimism about recovery)
○​ Emotional responses (e.g., anxiety about treatment)
○​ Behaviors (e.g., smoking, alcohol use, diet, exercise)
3.​ Social Factors​
These encompass the wider cultural, economic, and interpersonal influences on health,
such as:
○​ Social norms (e.g., acceptance or rejection of smoking)
○​ Peer and family influences
○​ Socioeconomic status
○​ Access to healthcare
○​ Ethnicity and cultural beliefs about health
This model reframes health as multidimensional, in contrast to the medical model which focuses
almost exclusively on the physical body.

Key Insights Offered by the Model

Engel's biopsychosocial approach brought three major shifts in healthcare thinking:

1.​ The patient’s lived experience is just as crucial as objective clinical data.
2.​ Understanding illness requires a comprehensive, multi-causal framework that includes
more than just biology.
3.​ Patients should be active participants in their treatment—not passive recipients.

Conceptual Questions Addressed by the Biopsychosocial Model

Let’s break down the model by exploring the core conceptual questions it answers:

1. What Causes Illness?

The model posits that illness is not caused by a single factor but arises from a dynamic
interaction between biological, psychological, and social elements. Health psychology supports
this multi-causal view, replacing linear thinking with a systems-based approach. For example,
depression might stem from a combination of:

●​ Genetic predisposition (biological)

●​ Cognitive distortions (psychological)
●​ Job loss or isolation (social)

2. Who Is Responsible for Illness?

Responsibility becomes shared under this model. While individuals are not “blamed” for
becoming ill, their behaviors and mental habits may play a role. For instance, someone who
develops heart disease may have biological risk factors—but their smoking habits, stress levels,
or social environment likely contributed as well. This model encourages accountability without
victim-blaming.
3. How Should Illness Be Treated?

Treatment must address the whole person, not just the disease. This may include:

●​ Medical interventions (e.g., medication)

●​ Psychological therapies (e.g., cognitive-behavioral therapy)
●​ Social strategies (e.g., strengthening family support, workplace accommodations)

The model encourages behavior change, enhanced coping strategies, and attention to a person’s
beliefs and emotions. Holistic care, rather than symptom suppression, is the goal.

4. Who Is Responsible for Treatment?

Patients are viewed as active collaborators. They are responsible not only for following medical
advice but also for making changes in lifestyle, managing stress, and seeking emotional or social
support. Health professionals work with the patient, not just on the patient.

5. What Is the Relationship Between Health and Illness?

Health and illness are seen as points on a continuum, not a strict either/or state. A person may be
living with a chronic condition yet feel mentally and socially well. Likewise, someone without a
diagnosable disease may experience emotional or social dysfunction. This continuum view
reflects a more realistic understanding of human experience.

6. What Is the Relationship Between Mind and Body?

The model rejects dualism (the idea that mind and body are separate). Instead, it emphasizes
their constant interaction. Emotions and thoughts can influence bodily processes (e.g., stress
leading to ulcers), and physical health can impact mental well-being (e.g., chronic pain causing
depression). This holistic approach encourages integrated care.

7. What Is the Role of Psychology in Health and Illness?

Psychology is not just a consequence of illness; it is also a contributing cause and a potential
treatment path. Thoughts, emotions, habits, and coping mechanisms are deeply intertwined with
physical outcomes. Health psychology draws on:

●​ The biopsychosocial model

●​ The concept of a health-illness continuum
●​ Direct and indirect psychological pathways to disease
●​ Individual variability in health behaviors

Visualizing the Biopsychosocial Model

Here is a conceptual breakdown of domains:

Biological Psychological Social

Age, Gender, Genetics Mental health Social support systems

Physiological reactions Emotions & stress levels Socioeconomic status

Tissue health Coping mechanisms Cultural and family beliefs

Medical history Personality traits Community and peer influence

Conclusion

The biopsychosocial model radically redefined how we think about health and illness. It accounts
for the full complexity of human life and emphasizes that healing requires attention not just to
the body, but to the mind and social world as well. As we face growing challenges in mental
health, chronic disease, and health inequalities, this model continues to guide a more integrated,
patient-centered, and effective approach to care.
ADVANTAGES OF THE BIOPSYCHOSOCIAL MODEL

1.​ Holistic Understanding of Health​

The model recognizes that biological, psychological, and social factors all play crucial
roles in determining health and illness. This leads to a more complete and realistic
understanding of human well-being, beyond the limitations of the purely biomedical
model.​
Example: A patient with high blood pressure may not only have a genetic predisposition
(biological) but may also suffer from work stress (psychological) and lack a supportive
social network (social), all of which contribute to the illness.
2.​ Integration of Macro and Micro-Level Processes​
It acknowledges that macro-level factors (like social support and cultural norms) and
micro-level processes (such as neurochemical imbalances or immune responses) interact
to affect health outcomes.​
Example: Depression can be influenced by both a traumatic event (macro-level) and a
serotonin imbalance in the brain (micro-level).
3.​ Multifactorial Causes and Effects​
Health is seen as resulting from multiple interrelated causes rather than a single pathogen
or defect. Likewise, treatments can have multiple outcomes, including physical, mental,
and social benefits.​
Example: Exercise improves cardiovascular health (biological), reduces anxiety
(psychological), and encourages social interaction (social).
4.​ Mind-Body Integration​
The model rejects the outdated dualism of mind and body, emphasizing that mental and
physical health are inseparable. Emotional distress can manifest physically, and physical
illness can trigger mental health issues.​
Example: Chronic pain can lead to depression, and depression can worsen pain
perception.
5.​ Focus on Both Health and Illness​
Unlike models that treat illness as simply the absence of health, the biopsychosocial
model emphasizes health promotion, disease prevention, and recovery. It encourages
maintaining well-being, not just treating disease.​
Example: Promoting mental resilience in communities is as vital as treating psychiatric
disorders.
6.​ Facilitates Innovation and Research​
The model supports technological development and interdisciplinary research, leading to
more effective diagnosis and treatment methods.​
Example: Modern therapy for PTSD may include medication (biological),
cognitive-behavioral therapy (psychological), and community support groups (social).
 7.​ Improved Life Expectancy and Quality of Life​
By treating the whole person, the model contributes to longer, healthier lives and helps
reduce recurrence of disease.​
Limitation: Overreliance on advanced diagnostics and technology can make treatments
expensive and may reduce emphasis on low-cost preventive strategies.

CLINICAL IMPLICATIONS OF THE BIOPSYCHOSOCIAL MODEL

1.​ Comprehensive Diagnosis​

Practitioners must assess biological, psychological, and social contributors to illness.
Interdisciplinary teamwork(doctors, psychologists, social workers) ensures holistic care.​
Example: Treating diabetes with medication (biological), counseling for stress eating
(psychological), and family education (social).
2.​ Tailored Treatment Plans​
Treatments should be individualized by evaluating all three dimensions. This approach
leads to personalized careand greater effectiveness.​
Example: A cancer patient may receive chemotherapy, therapy for anxiety, and family
support sessions.
3.​ Patient-Practitioner Relationship​
Trust and communication between patient and provider increase treatment adherence and
accelerate healing.​
Example: A patient is more likely to follow a rehabilitation plan when they feel heard and
understood.
4.​ Role of Health Habits​
Good health behaviors, such as exercising and eating well, enhance health; negative
habits increase disease risk.​
Example: Smoking cessation programs often combine medication (biological),
counseling (psychological), and peer support (social).
5.​ Recovery is Multifactorial​
Recovery involves interplay between body, mind, and environment. Each must be
considered for full rehabilitation.​
Example: Post-surgery recovery may be delayed if the patient is socially isolated or
depressed.

BIOPSYCHOSOCIAL MODEL IN RESEARCH

 ●​ Health outcomes are best understood by simultaneously measuring biological,
psychological, and social variables.
●​ Interventions should reflect this interaction. Focusing solely on one factor without
accounting for the others may lead to misleading conclusions.​
Example: Studying the effects of stress on immunity must consider the person’s immune
baseline (biological), coping mechanisms (psychological), and social context (social).
●​ Assumptions in research must acknowledge context.​
For instance, claiming a virus always causes illness assumes the person's psychological
stress and environmental exposure don’t alter the outcome.

GLOBALIZATION AND HEALTH

Gochman (1997) defined health behaviour as those personal attributes such as beliefs,
expectations, motives, values, perceptions and other cognitive elements; personality
characteristics, including affective and emotional states and traits; and overt behaviour patterns,
actions and habits that relate to health maintenance to health restoration and to health
improvement. In the broadest sense, health behaviour refers to the actions of individuals, groups
and organisations, as well as their determinants, correlates and consequences, including social
change, policy development and implementation, improved coping skills and enhanced quality of
life (Parkerson and others 1993).

Health behaviors are actions individuals take that affect their health. They include actions that
lead to improved health, such as eating well and being physically active, and actions that
increase one's risk of disease, such as smoking, excessive alcohol intake, and risky sexual
behavior.

Definition:​
Globalization refers to increased global interconnectedness—economic, political, cultural, and
technological—which directly and indirectly affects health.

Positive Effects:

●​ Technological and medical advancements improving diagnosis and treatment.

●​ Improved global communication allows rapid health information exchange.
●​ Increased life expectancy in many regions.

Negative Effects:

●​ Spread of infectious diseases due to international travel.

●​ Lifestyle changes leading to obesity and non-communicable diseases.
 ●​ Widening inequalities due to erosion of traditional healthcare systems.
●​ Increased mental health problems, especially in aging and displaced populations.
●​ Environmental degradation affecting air, water, and food safety.

HEALTH EDUCATION AND THE ROLE OF THE HEALTH EDUCATOR

Who is Responsible?

●​ Everyone in health and community work has a responsibility.

●​ Health Extension Workers play a key role in educating families and promoting health at
the community level.

Importance:

●​ Drugs alone are insufficient—without education, patients risk recurrence of disease.

●​ Educators must also lead by example, showing healthy behaviors in daily life.

Role of Health Educator:

1.​ Listen actively to community problems.

2.​ Identify behaviors causing or preventing disease.
3.​ Understand underlying reasons for these behaviors.
4.​ Help people reflect and generate their own solutions.
5.​ Facilitate community-based action tailored to local realities.

HEALTH BEHAVIOR AND CLASSIFICATION

Definition (Gochman, 1997):

Health behavior includes beliefs, emotions, habits, and actions that impact health maintenance,
restoration, or improvement—both at individual and societal levels.

Examples:

●​ A man stops smoking to prevent lung cancer.

●​ A teen exercises daily for fitness.
●​ A woman follows a thyroid-friendly diet.
●​ An older adult goes for age-appropriate health screenings.
 ●​ A sex worker practices safe sex to prevent STIs.

Classification (Kasl & Cobb, 1966):

1.​ Preventive Health Behavior:​

Actions to avoid disease or detect it early.​
E.g., Wearing masks and hand washing during COVID-19.
2.​ Illness Behavior:​
Steps taken when feeling unwell to find out what’s wrong.​
E.g., Visiting a doctor for persistent fever.
3.​ Sick Role Behavior:​
Behavior adopted after diagnosis to get well.​
E.g., Resting and taking medicine as prescribed after a diagnosis.

HEALTH SEEKING BEHAVIOR

Definition:

Actions taken by individuals to remedy perceived ill-health.

Influencing Factors:

1.​ Type and Severity of Illness​

E.g., A mild cough may be ignored; chest pain prompts immediate help.
2.​ Accessibility and Availability​
E.g., A remote village might lack a hospital, limiting treatment options.
3.​ Socioeconomic Status​
Poverty may discourage people from seeking formal healthcare due to cost or mistrust.
4.​ Cultural Beliefs and Education​
Traditions may favor herbal remedies over hospitals; education can counteract
misconceptions.

CHARACTERISTICS OF HEALTH BEHAVIOR

1.​ Complex Nature:​

Influenced by a mix of beliefs, environment, emotions, culture, and social norms.
2.​ Dynamic Nature:​
Health behavior changes with context—age, location, time, and environment.​
 Example: A man may not smoke at home due to family disapproval but smokes at work
where it’s socially accepted.

QUESTIONS

ANSWER THE questions WITH explanation AND examples:

Question 1

A. By answering the following questions, using both models, what do you say about health
and illness?

i. What is the relationship between health and illness? [5 marks]

ii. How should be treated? [5 marks]

iii. Who is responsible for treatment? [5 marks]

iv. What causes illness? [5 marks]

V. What is the relationship between the mind and the body? [5 marks]

vi. What is the role of psychology in health and illness? [5 marks]

vii. Who is responsible for illness illness? [5 marks]

B. As a Health Educator, what are your roles in the community? [5 marks]

[Total 40 marks]

ANSWERS

Question 1A: Using Both Models, What Do You Say About Health and Illness?

i. What is the relationship between health and illness?

Health and illness are interconnected concepts that reflect the state of an individual’s physical,
mental, and social functioning. In the biomedical model, health is narrowly defined as the
absence of disease or physical dysfunction. Illness is seen as a deviation from this norm and is
usually diagnosed based on symptoms and clinical tests. This model sees health and illness in
binary terms: one is either healthy or ill, based on biological indicators.

However, the biopsychosocial model, developed by George Engel in 1977, views health and
illness as points on a continuum. This model integrates biological, psychological, and social
dimensions in understanding health. Illness, in this context, is not merely a biological
malfunction but may also be influenced by emotional stress, social relationships, and lifestyle.
For example, a person experiencing chronic stress due to financial hardship may develop high
blood pressure. Though the biomedical model would focus on lowering blood pressure with
medication, the biopsychosocial model would also explore and address the stressors causing it.
Therefore, health is a dynamic state of overall well-being rather than just the absence of illness.

ii. How should illness be treated?

According to the biomedical model, illness should be treated through medical interventions that
target the underlying physical causes. These treatments include surgery, medication, and other
clinical procedures. The approach is doctor-centered, with the patient playing a passive role in
the healing process. For instance, if someone suffers from bacterial pneumonia, the treatment
would involve antibiotics to eliminate the infection.

In contrast, the biopsychosocial model promotes a more holistic approach to treatment. It

recognizes that medical interventions alone may not lead to full recovery. Psychological
counseling, behavioral therapy, lifestyle changes, and social support systems are often
incorporated into the treatment plan. For example, in managing diabetes, besides prescribing
insulin, a comprehensive plan would involve educating the patient about diet, encouraging
physical activity, addressing any underlying depression or anxiety, and involving family
members for support. This model ensures that the root causes and not just the symptoms are
treated.

iii. Who is responsible for treatment?

Under the biomedical model, responsibility for treatment lies almost entirely with healthcare
professionals. Doctors, nurses, and specialists are viewed as the experts, and the patient is
expected to comply with their recommendations. This approach sees the patient as a passive
recipient of care, with little involvement in the decision-making process.

The biopsychosocial model advocates for shared responsibility in the treatment process. While
medical professionals still play an essential role, patients are encouraged to be active participants
in their own care. They are educated and empowered to make informed decisions about their
health. For example, in treating depression, the patient may work closely with a psychologist,
attend support groups, and make lifestyle changes such as regular exercise and mindfulness
practice. Family and community members may also be involved to provide emotional and social
support. This collaborative approach enhances treatment outcomes.

iv. What causes illness?

In the biomedical model, illness is caused by identifiable physical agents such as bacteria,
viruses, genetic mutations, or biochemical imbalances. The model follows a reductionist
approach, seeking to identify a single root cause of a disease and treat it directly. For instance,
tuberculosis is caused by the bacterium Mycobacterium tuberculosis, and the treatment focuses
on administering antibiotics to eliminate the pathogen.

However, the biopsychosocial model recognizes that illness can arise from a complex interplay
of biological, psychological, and social factors. For example, cardiovascular disease may result
not only from genetic predisposition and poor diet (biological), but also from high levels of stress
(psychological) and lack of social support or community resources (social). This comprehensive
understanding helps in developing more effective and personalized treatment strategies.

v. What is the relationship between the mind and the body?

The biomedical model traditionally views the mind and body as separate entities, a concept
known as mind-body dualism. Illness is treated solely as a physical condition, and mental or
emotional aspects are often referred to separate disciplines, such as psychiatry or psychology.
For example, a patient with chronic headaches would be examined for physical causes like brain
tumors or neurological disorders, with less attention given to emotional stress or psychological
trauma.

In contrast, the biopsychosocial model sees the mind and body as interconnected and mutually
influential. Mental states can significantly affect physical health, and physical conditions can
impact mental well-being. For example, chronic pain can lead to depression, and unresolved
emotional trauma can manifest as physical symptoms like fatigue or digestive issues. This
integrated view encourages healthcare providers to consider both psychological and
physiological aspects in diagnosis and treatment.

vi. What is the role of psychology in health and illness?

In the biomedical model, psychology plays a minimal role. Emotional and behavioral factors are
typically seen as separate from the physical causes of illness. Psychological disorders are treated
independently, and little attention is given to their impact on physical health.

Conversely, in the biopsychosocial model, psychology is considered a critical component of

health and illness. Psychological factors such as stress, coping mechanisms, emotions,
personality traits, and mental health status can influence both the development and progression
of diseases. For instance, individuals with high levels of stress are more prone to developing
ulcers, heart disease, and weakened immune responses. Cognitive-behavioral therapy (CBT),
mindfulness, and other psychological interventions are now widely recognized as effective
components in the treatment of many chronic conditions.

vii. Who is responsible for illness?

The biomedical model usually attributes illness to biological causes that are beyond the
individual's control. Responsibility is rarely placed on the patient unless it is linked to clear
behavioral causes like smoking or substance abuse.

The biopsychosocial model, while not blaming the individual, encourages personal responsibility
in maintaining health and preventing illness. It acknowledges that lifestyle choices, coping
strategies, and social behavior can influence health outcomes. For example, someone who
maintains a sedentary lifestyle, eats an unhealthy diet, and avoids medical checkups may be
contributing to their risk of developing diabetes or hypertension. Thus, health is seen as a shared
responsibility between the individual, the healthcare system, and society.

Question 1B: As a Health Educator, What Are Your Roles in the Community?

As a health educator, my role in the community is to promote health literacy, encourage healthy
behaviors, and support disease prevention efforts. One of the key responsibilities is conducting
health education sessions in schools, churches, and community centers to raise awareness about
topics such as hygiene, nutrition, sexual health, and immunization. This helps empower
individuals with knowledge to make informed health decisions.

Another important role is to act as a liaison between healthcare providers and the community. I
help to bridge cultural and communication gaps, ensuring that health services are accessible and
acceptable to the population. For example, in rural communities, I may work with local leaders
to address traditional beliefs that hinder immunization programs.

Additionally, I participate in program planning and implementation. I help identify community

health needs, design relevant interventions, and evaluate the effectiveness of health campaigns.
For example, during a cholera outbreak, I might coordinate with local clinics and sanitation
officers to educate the public on water purification and handwashing techniques.

Lastly, I advocate for policy changes and resource allocation that improve community health. By
working with NGOs, government agencies, and other stakeholders, I help ensure that vulnerable
groups such as children, the elderly, and people with disabilities receive the attention and
services they need.

In summary, a health educator serves as an agent of change, communicator, advocate, and

bridge-builder who fosters a healthier and more informed society.
Question 2

a. Explain the effects of cancer on cancer patient and their relatives. Your answer must
include causes, types of cancer and prevention with regards to psychological, social and
physical effect. [15 marks]

b. A Mentally Healthy Persons need to have certain characteristics to enable them function
well in the society. Explain Mental Dimension of Health with five (5) characteristics. [15
marks]

[Total 30marks]

ANSWERS

Question 2

a. Effects of Cancer on Cancer Patients and Their Relatives (15 marks)

Cancer is a complex and multifaceted group of diseases characterized by the uncontrolled

division and growth of abnormal cells in the body. These cells can invade and destroy nearby
healthy tissue and, in many cases, spread (metastasize) to distant parts of the body through the
blood or lymphatic systems. Cancer is not just one disease but includes over 100 different types,
each with unique causes, symptoms, and treatments.

Cancer usually arises due to mutations in genes that control cell division and repair. These
mutations can be caused by various factors. First, carcinogens such as tobacco smoke, industrial
chemicals, and asbestos can induce genetic mutations. Second, exposure to radiation, including
ultraviolet (UV) rays from the sun and ionizing radiation from X-rays or nuclear materials, can
damage DNA. Third, infectious agents like viruses—such as the Human Papillomavirus (HPV)
and Hepatitis B and C—and bacteria such as Helicobacter pylori contribute to cancer
development. Fourth, lifestyle factors such as poor diet, physical inactivity, alcohol consumption,
and obesity increase the risk of cancer. Lastly, some individuals inherit gene mutations that
significantly increase their risk, for instance, BRCA1 and BRCA2 in breast cancer.

There are various types of cancer. Breast cancer originates in the breast tissues and is more
common in women, although it can also occur in men. Lung cancer is strongly associated with
smoking and exposure to pollutants. Prostate cancer affects the prostate gland and is common in
elderly men. Colorectal cancer begins in the colon or rectum and is linked to age, genetics, and
diet. Skin cancer, which includes melanoma and non-melanoma types, usually results from
prolonged UV exposure. Leukemia affects the blood and bone marrow, while lymphoma is a
cancer of the lymphatic system that impacts immune function.

Preventing cancer requires proactive health choices and public health interventions. Avoidance
of tobacco products can prevent several cancers including those of the lung, mouth, and throat. A
healthy diet rich in fruits, vegetables, and fiber, alongside regular physical activity, can lower the
risk of various cancers. Screening and early detection through procedures like Pap smears,
mammograms, and colonoscopies help identify cancers in their early stages. Vaccinations against
HPV and Hepatitis B can prevent cervical and liver cancers, respectively. Lastly, environmental
protection by reducing exposure to toxins, radiation, and pollution also plays a critical role in
prevention.

The effects of cancer on patients and their relatives are wide-ranging.

1.​ Physically, patients often experience symptoms such as fatigue, persistent pain, weight
loss, and localized swelling. Treatments like chemotherapy and radiation lead to side
effects including hair loss, nausea, weakened immune system, and infertility. Surgeries
can result in disfigurement or loss of function, such as in cases of mastectomy or
amputation. Furthermore, chronic side effects like lymphedema or neuropathy may
persist even after treatment has ended.
2.​ Psychologically, patients may suffer from anxiety, depression, or post-traumatic stress
due to fear of death or recurrence. Changes in self-image and self-esteem are common,
especially after surgeries that alter physical appearance or result in hair loss. Relatives are
also emotionally impacted; they may experience anticipatory grief, stress, or a sense of
helplessness. For instance, children of cancer patients may develop emotional or
behavioral problems due to the uncertainty and changes in the household.
3.​ Socially, patients may face isolation as a result of stigma, embarrassment, or physical
exhaustion. Family roles often shift; for example, a person who was previously the
breadwinner may become dependent. Caregivers—usually spouses or children—may
face burnout, strained relationships, and a loss of social life. The economic impact is
significant, as families may incur substantial costs from treatment, face a loss of income,
or have to relocate for care. These financial burdens can lead to long-term socioeconomic
challenges.

An example that illustrates these multifaceted effects is that of a woman diagnosed with breast
cancer who undergoes a mastectomy. She may struggle with body image, leading to emotional
withdrawal from her spouse and social circles. Her teenage daughter might take on caregiving
responsibilities, which could negatively affect her education and social development.
Simultaneously, the family could experience financial difficulties due to the loss of income and
the high cost of treatment.
In summary, cancer’s impact extends far beyond the physical symptoms of the disease. It affects
the psychological, social, and financial well-being of both patients and their families. A
biopsychosocial approach that addresses all these dimensions is essential for providing
comprehensive and effective care.

b. Mental Dimension of Health and Characteristics of Mentally Healthy Persons (15 marks)

Mental health refers to an individual’s emotional, psychological, and social well-being. It

influences how people think, feel, and act, and also determines how they manage stress, interact
with others, and make decisions. A person with good mental health can cope with the demands
of daily life, work productively, and contribute meaningfully to their community.

The mental dimension of health emphasizes cognitive functions, emotional stability,

decision-making, and the perception of self. It involves the ability to adapt to change, build
resilience, and find purpose in life. Mentally healthy individuals are able to maintain a balance in
their thoughts and emotions, which positively influences their personal relationships,
productivity, and overall sense of fulfillment.

There are several key characteristics that define a mentally healthy person.

1.​ The first is self-awareness and self-acceptance. This means the person understands their
own strengths, weaknesses, emotions, and motivations, and accepts themselves without
harsh self-judgment. For example, a teenager who realizes they are struggling
academically might choose to seek help and work towards improvement rather than
internalize feelings of failure.
2.​ The second characteristic is emotional regulation. This is the capacity to manage
emotions appropriately and to remain composed under stress or provocation. For
instance, a worker who receives critical feedback does not respond with anger but instead
reflects on the feedback and uses it as a tool for growth.
3.​ Thirdly, effective stress management is a defining trait. This involves employing healthy
coping strategies like time management, physical exercise, relaxation techniques, or
professional therapy to ensure that stress does not hinder day-to-day functioning. An
example would be a student who, while preparing for exams, schedules breaks, ensures
sufficient rest, and practices mindfulness.
4.​ The fourth trait is the ability to maintain healthy relationships and demonstrate good
social skills. This includes forming and sustaining respectful, supportive, and meaningful
relationships. An employee who communicates well with colleagues, resolves conflicts
peacefully, and empathizes with others is a good example of this trait.
5.​ Lastly, constructive decision-making and goal setting are essential. This means the
individual can set realistic personal goals, assess possible outcomes, and make decisions
 aligned with their values and current situation. For example, a young adult might choose
to save money and pursue higher education, even when peers prioritize immediate
gratification.

In conclusion, mental health plays a central role in an individual’s overall well-being. Mentally
healthy individuals are better equipped to handle life’s challenges, foster supportive
relationships, and achieve their personal and professional goals. In an increasingly complex and
fast-paced world, maintaining mental health is not just beneficial—it is essential for personal
growth and social harmony.

Question 3

a) What are the merits of Biopsychosocial model? [5 marks]

b) How does globalization affect the health system of your country? Explain. [10 marks]

c). Explain with five (5) example how chemical/ nutrients stressors affect our health.
[5marks]

d. Discuss the determinants of health or ill health. [10marks]

[Total 30marks]

ANSWERS

Question 3 [Total: 30 marks]

a) What are the merits of the Biopsychosocial model? [5 marks]

The biopsychosocial model, developed by George L. Engel in 1977, revolutionised the medical
field by proposing that health and illness cannot be understood solely through the lens of biology.
Engel's critique of the traditional biomedical model was based on its limitation: it viewed the
body as a machine and disease as a deviation from normal functioning, ignoring the human
experience of illness. The biopsychosocial model asserts that health is a result of interactions
between biological, psychological, and social factors, and therefore calls for a comprehensive
approach to diagnosis and treatment.

Biological Factors include genetics, pathogens, nutritional deficiencies, and physiological

functions. These remain central to understanding diseases like diabetes, hypertension, and
infections.
Psychological Factors consist of emotional states, cognitive beliefs, and behaviour patterns. For
instance, a patient’s level of stress, coping mechanisms, and perceptions about illness can
profoundly affect both their experience of disease and their treatment adherence.

Social Factors encompass family dynamics, cultural norms, socioeconomic status, access to
health services, and the broader societal environment. A person's social support system and
community health infrastructure are critical for recovery and well-being.

Engel's model was not meant to discard the biomedical perspective but to complement and
enrich it, advocating for a patient-centred approach where the clinician recognises the
importance of empathy, communication, and context. Melchert (2007) notes that this model
encourages healthcare providers to listen to the patient's narrative and consider their psychosocial
realities alongside biological findings.

The biopsychosocial model has practical implications: it promotes holistic treatment plans,
enhances doctor-patient relationships, and supports multidisciplinary approaches to
care—especially for chronic and mental illnesses. Moreover, it aligns well with current trends in
public health, where interventions target not only individual behaviours but also social
determinants such as poverty, education, and housing. The follow are some merits of the model:

1.​ Holistic Approach to Health​

One of the key merits of the Biopsychosocial model is that it promotes a comprehensive
understanding of the patient. Instead of viewing illness as a result of only biological
malfunction, it takes into account how psychological conditions (like stress or
depression) and social circumstances (such as family support or cultural beliefs)
contribute to a person’s health. For instance, a patient with chronic pain may benefit more
from a combination of medication, cognitive-behavioral therapy, and social support than
from drugs alone.
2.​ Personalized and Patient-Centered Care​
The model encourages healthcare providers to tailor interventions based on each patient’s
unique circumstances. For example, two patients with asthma may have different
outcomes depending on their emotional state or living conditions. By assessing these
variables, treatment becomes more effective and meaningful.
3.​ Better Communication and Therapeutic Relationship​
This model fosters empathy and active listening between healthcare providers and
patients. By understanding the emotional and social aspects of a patient’s life, a stronger
therapeutic alliance is built, which improves patient satisfaction and compliance with
treatment.
4.​ Improved Health Outcomes​
When mental health and social well-being are considered alongside biological health,
patients are more likely to respond positively to treatment. For example, addressing a
 patient’s depression may also help reduce their blood pressure or improve diabetes
management.
5.​ Promotes Preventive Healthcare​
The Biopsychosocial model supports proactive healthcare by identifying and addressing
risk factors early. Educational campaigns that promote exercise, stress reduction, and
healthy eating are examples of how this model guides prevention.

b) How does globalization affect the health system of your country? Explain. [10 marks]

Globalisation refers to the growing interconnectedness of nations through trade, communication,

cultural exchange, and technological advancement. While often discussed in terms of economics
and politics, globalisation has a profound impact on health and health behaviour. On one hand, it
has led to significant positive effects: technological and medical advancements have improved
diagnostic tools and treatment protocols; global communication networks allow for rapid
dissemination of health information and coordination during pandemics; and many populations
have seen increases in life expectancy due to improved access to health knowledge and
interventions. However, globalisation also brings several challenges. The ease of international
travel has facilitated the spread of infectious diseases, as witnessed during the COVID-19
pandemic. Additionally, global cultural shifts have contributed to lifestyle changes that promote
sedentary behaviour and consumption of ultra-processed foods, leading to a rise in obesity and
non-communicable diseases. Traditional healthcare systems in low- and middle-income countries
are sometimes undermined by Western models of care, resulting in widening health inequalities.
Mental health issues have also increased, especially among aging populations and those
displaced by conflict or environmental degradation. Furthermore, global environmental
crises—like climate change and pollution—directly affect air and water quality, thereby
influencing public health outcomes. Thus, while globalisation presents numerous opportunities
for health improvement, it simultaneously poses serious risks that require coordinated global
responses and local resilience. In the context of healthcare, globalization has significantly
influenced Ghana’s health system, shaping how services are delivered, financed, and accessed.
globalization has positively influenced Ghana’s health system by improving access to
technology, funding, and expertise. However, it also brings challenges such as brain drain and
increased disease risk, which require policy interventions and sustainable local capacity building.

1.​ Access to Medical Technology and Expertise​

Globalization has facilitated the importation of modern medical equipment, such as MRI
scanners, diagnostic tools, and surgical instruments. It has also allowed Ghanaian health
professionals to be trained abroad or online, leading to improvements in local skills and
knowledge.
 2.​ Improved Pharmaceutical Supply Chains​
Ghana benefits from the global pharmaceutical market by importing life-saving
medications, including antiretroviral therapy for HIV/AIDS and vaccines for childhood
diseases. International collaborations such as Gavi have supported immunization efforts
across the country.
3.​ Disease Transmission and Epidemics​
Increased international travel and trade also mean that diseases can spread rapidly.
Ghana’s health system had to respond quickly to COVID-19, demonstrating the risk of
cross-border infections. Globalization requires stronger surveillance and public health
systems to prevent and manage such outbreaks.
4.​ Brain Drain of Healthcare Workers​
One of the negative impacts of globalization is the emigration of qualified healthcare
professionals to countries with better pay and conditions. This has led to staffing
shortages in Ghanaian hospitals, particularly in rural areas, affecting service delivery.
5.​ Adoption of Western Lifestyles​
Exposure to global media and fast food culture has led to lifestyle changes that contribute
to a rise in non-communicable diseases like obesity, hypertension, and type 2 diabetes.
This epidemiological shift requires changes in public health policy and health education.
6.​ Increased Health Funding and Partnerships​
Ghana has received substantial financial and technical support from global health
institutions such as the World Health Organization (WHO), the Global Fund, and
international NGOs. These partnerships have helped combat diseases like malaria and
tuberculosis and supported maternal and child health programs.
7.​ Health Policy Reforms​
Globalization promotes the adoption of international best practices and policy reforms.
Ghana’s implementation of the National Health Insurance Scheme (NHIS) was
influenced by global movements toward universal health coverage.
8.​ Medical Tourism and Research​
Ghana has also begun to explore opportunities in medical tourism and international
research collaborations, allowing local facilities to gain recognition and funding from
global academic institutions.

c) Explain with five (5) examples how chemical/nutrient stressors affect our health. [5 marks]

Chemical and nutrient stressors are harmful substances that enter the body through food, air,
water, or consumer products. They can disrupt the body’s biological systems, leading to short- or
long-term health issues. chemical and nutrient stressors are silent but dangerous threats to health.
Monitoring food and environmental safety, along with public education on nutrition, are key
strategies to reduce their impact. The following are five examples:
 1.​ Pesticide Residues in Food​
Pesticides used in agriculture can remain on fruits and vegetables. When consumed over
time, they may accumulate in the body and are associated with cancer, reproductive
problems, and neurological disorders.
2.​ Heavy Metals (e.g., Lead and Mercury)​
Exposure to heavy metals through contaminated water, old paints, or industrial waste can
severely affect health. Lead poisoning causes developmental delays in children, while
mercury affects kidney and brain function.
3.​ Trans Fats and Saturated Fats in Processed Foods​
Common in fast foods and baked goods, trans fats raise LDL cholesterol and lower HDL
cholesterol, increasing the risk of heart disease and stroke. These dietary stressors also
contribute to obesity.
4.​ Excess Sugar and Refined Carbohydrates​
High intake of refined sugar leads to insulin resistance and type 2 diabetes. It also
contributes to dental problems, liver fat accumulation, and metabolic syndrome.
5.​ Industrial Pollutants and Airborne Chemicals​
People living near factories or in cities with poor air quality may inhale chemicals like
carbon monoxide and sulfur dioxide. These stressors lead to asthma, chronic obstructive
pulmonary disease (COPD), and cardiovascular problems.

d) Discuss the determinants of health or ill health. [10 marks]

Health behaviour has been defined in various ways to capture the breadth of individual and
societal actions that influence health. According to Gochman (1997), health behaviour includes
personal attributes such as beliefs, expectations, motives, values, perceptions, and other cognitive
elements, as well as personality characteristics—including affective and emotional states and
traits—and overt behaviour patterns, actions, and habits that relate to health maintenance, health
restoration, and health improvement. This definition captures not only observable behaviour but
also the underlying psychological and emotional factors that drive it. In the broadest sense, as
Parkerson and others (1993) suggest, health behaviour encompasses the actions of individuals,
groups, and organisations, along with their determinants, correlates, and consequences. These
include social change, policy development and implementation, improved coping skills, and
enhanced quality of life. In simple terms, health behaviours are actions people take that affect
their health. They range from positive behaviours such as exercising, eating nutritious food, and
avoiding smoking, to negative behaviours such as substance abuse, poor dietary habits, and
engaging in risky sexual activities. These behaviours are influenced by a mix of biological,
psychological, and social factors, underscoring the need for a holistic understanding of what
shapes them. Determinants of health are the various factors that influence an individual’s health
status. They can act as protective factors promoting well-being or as risk factors leading to
illness. These determinants interact in complex ways, and their combined effects often shape the
health outcomes of populations. Health is not determined solely by biology or medicine, but by a
range of interlinked social, economic, environmental, and psychological factors. Addressing
these determinants holistically is key to achieving better health for individuals and communities.

1.​ Biological Factors​

These include genetics, sex, and age. Some people inherit conditions such as diabetes or
sickle cell disease, which predispose them to certain illnesses. Ageing is also associated
with declining immunity and higher risk of chronic disease.
2.​ Health Behaviors and Lifestyle​
Choices such as diet, physical activity, smoking, alcohol use, and sexual behavior
influence health. For instance, excessive alcohol intake may lead to liver cirrhosis, while
regular exercise lowers the risk of cardiovascular diseases.
3.​ Social and Cultural Factors​
Social support networks, cultural beliefs, and traditions impact health-seeking behavior.
In some communities, mental illness is stigmatized, discouraging individuals from
seeking help. Conversely, strong family support can reduce stress and improve recovery.
4.​ Economic Status​
Poverty restricts access to nutritious food, healthcare, and safe housing. Low-income
individuals often experience higher rates of infectious and chronic diseases due to poor
living conditions.
5.​ Educational Attainment​
Education is closely linked to health literacy. People with higher education are more
likely to understand health information, adopt preventive behaviors, and access
healthcare services effectively.
6.​ Environmental Conditions​
Living in areas with clean water, good sanitation, and low pollution supports health.
Conversely, exposure to environmental hazards such as unclean water or air pollution
increases the risk of disease.
7.​ Access to Healthcare Services​
Physical availability, affordability, and quality of healthcare significantly determine
health outcomes. Rural areas in Ghana often lack hospitals or qualified personnel, leading
to delayed treatment and preventable deaths.
8.​ Government Policy and Infrastructure​
Public policies on healthcare funding, disease prevention, and health insurance influence
the quality and equity of health services. Effective health governance contributes to
healthier populations.
 9.​ Employment and Working Conditions​
Job security and safe work environments contribute to physical and mental well-being. In
contrast, hazardous jobs or unemployment can lead to stress, injuries, and poor health.
10.​Psychological and Emotional Factors​
Chronic stress, depression, and anxiety can weaken the immune system and contribute to
illnesses such as ulcers, hypertension, and even cancer. Mental health is an essential but
often overlooked determinant.

Question 4

a). Explain stress with an example. [2 marks]

b) Wite short note on the following with two (2) examples each.

i. Health seeking behavior. [5 marks]

ii. Health behavior. [5 marks]

Primary prevention of illness. [5 marks]

iv. Secondary prevention of illness. [5 marks]

V. Tertiary prevention of illness. [5 marks]

c). With regards to biopsychosocial model, what does research say? [5 marks]

[Total 30marks]

ANSWERS

Question 4

a). Explain stress with an example. [2 marks]

Stress is a physical and psychological response to demands or threats—whether real or

perceived—that exceed a person's adaptive capacity. It involves the release of hormones such as
cortisol and adrenaline, which prepare the body for a "fight-or-flight" reaction. While short-term
stress can enhance performance and alertness, chronic stress can negatively impact physical
health (e.g., hypertension, ulcers) and mental well-being (e.g., anxiety, depression).​
Example: A university student who is anxious about final exams may experience increased heart
rate, trouble sleeping, and poor concentration—signs of academic stress.
b) Write short notes on the following with two (2) examples each.

i. Health seeking behavior. [5 marks]​

Health seeking behaviour refers to actions taken by individuals when they perceive a health
problem or symptoms, with the aim of finding an appropriate remedy. This includes choosing
between self-treatment, consulting traditional healers, visiting healthcare facilities, or delaying
care. Cultural beliefs, accessibility, education level, and past experiences all influence this
behaviour.​
Examples:

1.​ A mother takes her child with a fever to a hospital rather than administering herbs at
home.
2.​ A young man experiencing chest pain seeks help from a pharmacist instead of consulting
a doctor.

ii. Health behavior. [5 marks]​

Health behaviour encompasses personal actions taken by individuals that affect their health
status, either positively or negatively. As defined by Gochman (1997), these include beliefs,
values, perceptions, and habits relating to health maintenance, restoration, and improvement.
Parkerson et al. (1993) also point out that health behaviour extends to social and policy-related
actions aimed at enhancing quality of life.​
Examples:

1.​ A person who exercises regularly, eats balanced meals, and avoids smoking is engaging
in positive health behaviours.
2.​ Conversely, someone who drinks excessively and avoids regular health check-ups is
engaging in negative health behaviours.

iii. Primary prevention of illness. [5 marks]​

Primary prevention aims to prevent disease before it occurs by reducing risk factors and
promoting protective measures. It focuses on health promotion and specific protection across the
general population.​
Examples:

1.​ Vaccination against hepatitis B to prevent liver infection.

2.​ Public campaigns encouraging handwashing to reduce the spread of communicable
diseases.
iv. Secondary prevention of illness. [5 marks]​
Secondary prevention focuses on early detection and prompt intervention to halt or slow the
progress of a disease in its early stages. It aims to reduce the severity and prevent complications.​
Examples:

1.​ Routine blood pressure checks to detect and manage hypertension before it leads to
stroke.
2.​ Breast cancer screening through mammograms to detect abnormalities early.

v. Tertiary prevention of illness. [5 marks]​

Tertiary prevention occurs after a disease has been diagnosed and treated, and it aims to reduce
its long-term impact. It involves rehabilitation and strategies to restore function and improve
quality of life.​
Examples:

1.​ Physiotherapy for a stroke patient to regain mobility.

2.​ Support groups for individuals recovering from substance addiction.

c). With regards to the biopsychosocial model, what does research say? [5 marks]​
Research supports the biopsychosocial model as a more comprehensive and effective framework
for understanding and treating illness compared to the traditional biomedical model. It
recognizes that biological factors (e.g., pathogens, genetics), psychological elements (e.g., stress,
behaviour), and social contexts (e.g., socioeconomic status, cultural norms) interact to influence
health outcomes.

Studies have shown that integrating mental health care with physical health services leads to
better treatment adherence and overall outcomes. For example, patients with chronic illnesses
like diabetes or hypertension achieve better control when their treatment plans also address
depression, lifestyle habits, and social support systems. Moreover, the model has influenced the
rise of patient-centred care, which values patients' narratives, emotional states, and life
circumstances as much as clinical diagnostics. It has also encouraged the use of interdisciplinary
teams in healthcare—comprising doctors, psychologists, social workers, and nutritionists—to
address complex health issues more holistically.

Overall, the biopsychosocial model fosters a more empathetic, individualized, and effective
approach to health, reinforcing that treatment should not focus on disease alone but on the person
as a whole.
Question 5

a. Lifestyle diseases are becoming common. In your own words explain the causes of it with
five examples and factors contributing to its upsurge. [10 marks]

b. Briefly explain how to prevent and manage lifestyle diseases. [5 marks]

c. With regard to biopsychosocial model, body and mind cannot be separated. Explain.
[5marks]

d. Stress has become part of our daily life. As a counsellor, explain how to relief stress using
five different Techniques. [10 marks]

[Total 30]

ANSWERS

QUESTION 5

a. Lifestyle diseases are becoming common. In your own words, explain the causes of it with
five examples and factors contributing to its upsurge.

[10 marks]

Lifestyle diseases are non-communicable chronic illnesses that result primarily from the daily
habits, choices, and routines of individuals. These diseases arise from behavioral risk factors
such as poor nutrition, physical inactivity, tobacco use, and excessive alcohol consumption.
Unlike infectious diseases that are transmitted through pathogens, lifestyle diseases develop
gradually due to long-term exposure to unhealthy patterns, making them preventable yet difficult
to reverse once established.

The biomedical model views lifestyle diseases from a purely biological lens, focusing on the
physical or biochemical abnormalities in the body. For example, Type 2 diabetes is attributed to
insulin resistance; hypertension is linked to the narrowing of blood vessels. While this model
helps in diagnosis and treatment, it often ignores the underlying behaviors, psychological
conditions, and social environment that led to the condition.

The biopsychosocial model, on the other hand, provides a more holistic understanding. It
recognizes that biological factors (like genetics), psychological factors (such as stress, trauma, or
low motivation), and social influences (such as peer pressure, economic hardship, and cultural
norms) all play a role in the development and management of lifestyle diseases. This model is
especially useful in prevention and counseling because it looks at the root causes of behavior and
their context.

lifestyle diseases are a growing global burden that cannot be addressed through medication
alone. While the biomedical model treats symptoms, the biopsychosocial model enables
prevention by targeting the full range of influencing factors.

Examples of lifestyle diseases include:

1.​ Type 2 Diabetes – Caused by excessive sugar intake, obesity, and inactivity. A person
working long hours on a computer without physical activity and consuming sugary drinks
daily may develop this condition.
2.​ Obesity – Accumulation of excess body fat due to poor dietary habits and sedentary
living. It often begins in childhood and is influenced by fast food culture, lack of physical
education, and emotional eating.
3.​ Hypertension (High Blood Pressure) – Often caused by a high-salt diet, obesity, smoking,
and chronic stress. Urban living with limited green spaces and fast-paced lifestyles
contributes to this condition.
4.​ Coronary Artery Disease – Linked to fatty deposits in arteries due to smoking, poor diet,
and inactivity. It’s often diagnosed after a heart attack or chest pain during exertion.
5.​ Certain types of cancers (e.g., lung, colon) – These are strongly associated with lifestyle
factors like smoking, alcohol, poor diet, and lack of screening.

Factors contributing to the upsurge:

●​ Urbanization and technological advancement have reduced physical activity and

increased access to unhealthy foods.
●​ Economic challenges often lead to reliance on cheap, processed foods.
●​ Mental health issues such as stress and anxiety push individuals to adopt harmful coping
mechanisms like smoking or drinking.
●​ Lack of public education on health-promoting behaviors.
●​ Peer and media influence, particularly among youth, who are vulnerable to adopting
high-risk lifestyles.

b. Briefly explain how to prevent and manage lifestyle diseases.

[5 marks]

Preventing and managing lifestyle diseases requires both individual responsibility and supportive
environments. According to the biopsychosocial model, lasting health outcomes depend not only
on biological treatment but also on behavioral change and community influence. Prevention and
management strategies must be personalized and culturally relevant, addressing not only the
biology but also the beliefs, emotions, and environment of individuals.

Prevention involves:

●​ Healthy diet: Eating fruits, vegetables, whole grains, and lean protein helps prevent
obesity, hypertension, and heart disease.​
Example: A person replacing fast food with home-cooked meals rich in fiber reduces
their risk of colon cancer.
●​ Physical activity: Engaging in regular exercise like brisk walking, jogging, or swimming
helps maintain a healthy weight and improves heart health.​
Example: A person who walks 30 minutes daily lowers their risk of developing Type 2
diabetes.
●​ Avoiding harmful substances: Not smoking and limiting alcohol use prevent diseases like
lung cancer and liver cirrhosis.​
Example: A young adult who avoids peer pressure to smoke is less likely to develop
respiratory conditions.
●​ Health screening: Regular blood pressure, sugar, and cholesterol checks detect risks early.​
Example: A middle-aged woman who goes for annual check-ups can catch prediabetes
and reverse it early.
●​ Stress management: Practicing relaxation, setting boundaries, and seeking support
prevents burnout and related illnesses.

Management involves:

●​ Following medical prescriptions and adhering to lifestyle changes (like salt reduction for
hypertensives).
●​ Behavioral counseling and support groups to maintain motivation.
●​ Monitoring health progress through checkups and feedback systems.

c. With regard to the biopsychosocial model, body and mind cannot be separated.

[5 marks]

The biopsychosocial model of health emphasizes the integration of biological, psychological,

and social factors in understanding and treating illness. One of its key propositions is that the
body and mind are inseparable—that mental health influences physical health and vice versa.

Physical ailments often manifest or worsen due to mental distress. For instance, chronic stress
can lead to elevated blood pressure, headaches, or ulcers. This happens because psychological
stress activates the hypothalamic-pituitary-adrenal (HPA) axis, resulting in a hormonal cascade
that affects various organs.

On the other hand, physical conditions can trigger psychological reactions. A patient with a
chronic illness like cancermay experience anxiety, depression, and fear, which in turn affect their
recovery. Similarly, someone with chronic back pain might become irritable, hopeless, and
socially withdrawn—impacting their overall wellness.

This interconnection is also seen in psychosomatic disorders, where emotional issues cause real
physical symptoms, such as chest pain or gastrointestinal problems without clear medical
findings.

Moreover, social support and relationships—though not physical—can promote physical healing.
Studies show that patients with strong family and peer support recover faster after surgery or
major illness.

Therefore, separating the body and mind leads to fragmented care. Holistic treatment, which
integrates medical care with mental health support and attention to social context, is more
effective and sustainable.

d. Stress has become part of our daily life. As a counsellor, explain how to relieve stress using
five different techniques.

[10 marks]

Stress is the body's natural response to demands and pressures. However, chronic or unmanaged
stress can lead to serious physical and psychological problems, including depression,
hypertension, and burnout. As a counselor, it is essential to help clients understand the sources of
their stress and equip them with practical techniques to manage it.

Here are five effective techniques, explained with examples:

1.​ Deep Breathing and Progressive Muscle Relaxation (PMR):​

This technique helps calm the body’s stress response. Deep breathing involves slow,
deliberate inhalation and exhalation, which lowers heart rate and reduces tension.​
Example: A student overwhelmed before an exam can do 5 minutes of deep breathing and
PMR to feel calmer and more focused.
2.​ Mindfulness and Meditation:​
Mindfulness involves being present in the moment without judgment. Meditation
techniques such as focusing on the breath or body scan can reduce anxiety.​
 Example: A working mother who feels pulled in many directions can use a 10-minute
guided meditation each morning to gain mental clarity and calm.
3.​ Time Management and Prioritization:​
Many people feel stressed because they try to do too much without a clear plan. Helping
clients set priorities, delegate, and break tasks into smaller steps reduces mental overload.​
Example: A businessman can reduce work-related stress by scheduling tasks in a planner,
allowing breaks, and saying no to non-essential meetings.
4.​ Physical Activity:​
Exercise releases endorphins, which are natural mood enhancers. It also improves sleep
and boosts energy.​
Example: A teacher under pressure from administrative duties and student performance
can benefit from jogging in the evening, which improves sleep and mood.
5.​ Expressive Talking and Counseling:​
Encouraging people to talk about their feelings—either with a counselor or a trusted
person—helps process emotions and gain perspective.​
Example: A young adult dealing with relationship stress can benefit from talking to a
counselor who helps them reframe negative thoughts and explore healthier coping
mechanisms.