Question

What is the link between physical health and social factors? How is this explained by the biopsychosocial model?

Answer 1

In 1977, George Engel famously argued that medicine(link is external) in general and psychiatry in particular ought to shift from a bio-medical perspective of disease to a biopsychosocial (BPS) perspective on health. He argued that the bio-medical perspective was too reductionistic and that a holistic perspective grounded in general systems theory was necessary to address health related issues.

Engel argued that the bio-medical lens only focuses attention on the physiological mechanisms associated with the heart attack, which results in psychological and sociological factors being either systematically excluded or ineffectually reduced (i.e., conceptualized in physiological terms). Engel argued this was a big mistake and that to appreciate health in general we must consider the psychological, behavioral, and social dimensions that contribute to illness related events.The BPS model additionally allows for the consideration of such issues like the belief factors associated with healing (i.e., what bio-medicine refers to—or dismisses—as ‘placebo’ effects) and general the social conceptions of disease and the socially constructed elements that justify policies and the behaviors of healers and patients.

The advantages of the BPS model are found in its holism, awareness of levels in nature, and inclusiveness of diverse perspectives. Its advocates argue for the necessity in thinking about and treating illness via a BPS lens by pointing out that social and behavioral factors play an obvious and major role in human health overall (e.g., poor eating habits and obesity, smoking, excessive drinking, risk-taking behavior, war, stress/anxiety/depression, and on and on), and a reductionistic physicalism does not help in our understanding of these phenomena.