Summary literature Summary
Health in Society (201900017)
2025-2026
1
,Table of contents
Summary literature Summary Health in Society (201900017) 2025-2026 .......................................... 1
.................................................................................................................................................... 1
Part 1: Approaches to public health .............................................................................................. 3
Chapter 1: Understanding health: definitions and perspectives ........................................................ 3
Chapter 2: A history of public health ................................................................................................. 7
Chapter 3: The new public health evolves ....................................................................................... 11
Part 2: Political economy of public health ....................................................................................16
Chapter 4: Ethics, politics and ideologies: the invisible hands of public health ............................... 16
Chapter 5: Neo-liberalism, globalisation and health ....................................................................... 21
Part 4: Health inequities: profiles, patterns and explanations ..........................................................28
Chapter 11: Changing health and illness profiles in the 20th century: global and Australian
perspectives ................................................................................................................................... 28
Chapter 13: The social determinants of health inequity .................................................................. 31
Part 5: Unhealthy environments: global and Australian perspectives ...............................................39
Chapter 14: Global physical threats to the environment and public health ...................................... 39
Chapter 15: Urbanisation, population, communities and environments: global trends ................... 45
Part 6: Creating healthy and equitable societies and environments .................................................53
Chapter 16: Healthy economic policies .......................................................................................... 53
Chapter 17: Sustainable infrastructures for health, well-being and equity ....................................... 60
Part 7: Health promotion strategies for achieving healthy and equitable societies .............................66
Chapter 18: Medical and health service interventions ..................................................................... 66
Chapter 19: Changing behaviour: the limits of behaviourism and some alternatives ....................... 69
Chapter 20: Participation and health promotion ............................................................................. 77
Chapter 21: Community development in health .............................................................................. 84
Chapter 22: public health advocacy and activism ........................................................................... 93
Chapter 23: Healthy settings, cities, communities and organisations: strategies for the 21st century
....................................................................................................................................................... 98
Chapter 24: Healthy public policy ................................................................................................. 106
Part 8: Public health in the 21st century ...................................................................................... 115
Chapter 25: Thinking local, national and global public health ....................................................... 115
2
, Part 1: Approaches to public health
Chapter 1: Understanding health: definitions and perspectives
Introduction
People’s Health Movement: ‘Health is a social, economic and political issue and above
all a fundamental right. Inequality, poverty, exploitation, violence and injustice are at the
root of ill-health.’
Commission on Social Determents of Health: ‘A toxic combination of bad policies,
economics is, in large measure, responsible for the fact that a majority of people do not
enjoy the good health that is biologically possible.’
This book explores the underlying social and economic determinants of health in detail.
But first it is important to understand the many ways in which health is understood and
used as it carries considerable cultural, social and professional baggage and has a
contested nature. This chapter presents five main perspectives on health: health within
the medical ‘clockwork’ model, health as defined by ordinary people, critical
understandings of health, health as an ‘outcome’ and health as a characteristic of place
and environment. It concludes with a consideration of the difference between
population and individual perspectives on health.
Health: the clockwork model of medicine
The past two centuries, the discourse of Western health has been overshadowed by a
biomedical perspective which operates from a clockwork definition of medicine in
which the body is studied through its component parts. Health is defined as the body
operating efficiently like a machine and any breakdowns in the system mean that it is not
healthy. Biomedicine has not considered disease within the context of the lives of
people with disease.
Health as the absence of illness
Other perspectives on health have existed alongside the biomedical view that have
operated from a different view of health. Social medicine has been more concerned with
social and economic factors that affect health. Behavioural underscored the need to
protect and maintain the body by lifestyle behaviours that minimise risk of disease and
so the promotion of healthy lifestyles have become major factors in the professional
perspective on health over the past decades.
The clockwork model has some limitations:
- It ignores the social, psychological and spiritual aspects. It suggests that if a body
is not diseased then it must be healthy
- It assumes a mind/body dichotomy and does not place much emphasis on how
an individual’s mental health might affect physical health status
- It has less legitimacy than it has in the past as the medical definitions of health
reflect its culture (example: the medical labelling of homosexuality as a mental
disorder which reflected the contemporary values of society)
3
, - It has extended the definition of disease, as pharmaceutical companies seek
new markets. Risk factors, such as obesity, are now often conceptualised as a
disease.
- The absence of disease may be part of health, but health is more than the
absence of disease
Health and well-being
The limitations of health being defined as ‘the absence of disease’ led to the World
Health Organisation defining health has: ‘The complete state of physical, mental and
social well-being, and not merely the absence of disease or infirmity’.
However, the definition of a state of well-being has proved tricky. Aitkin explains that we
need something more positive than either being ‘healthy’ or ‘diseased’.
A recent focus on mental health has led to definitions that go beyond the concentration
on physical factors. VicHealth has defined mental health as: ‘Mental health is the
embodiment of social, emotional and spiritual well-being and provides individuals with
the vitality necessary for active living, to achieve goals and to interact with one another
in ways that are respectful and just.’
Health: ordinary people’s perspectives
Ordinary people may not see health in the same way as health professionals. Health is a
complex concept that combines a number of different dimensions. Three domains
relating to the definition of health are found:
- Health is not being ill
- It is a necessary prerequisite for life’s functions
- It is a sense of well-being expressed in physical and mental terms
→ Research suggests that health is variously viewed and is a complex and dynamic
concept involving a number of different perspectives.
Health in cultural and economic contexts
Interpretations of health reflect the cultural and economic context of people’s lives. For
most people health represents a status, socially recognised and admired. Crawford
found two main discourses of health, suggesting that health fulfils different functions for
different people:
- Health was seen by some as self-control
= Health was something to achieved through healthy behaviour (health is related
to self-discipline, self-denial and willpower)
- Health was seen by some as a release mechanism
= For others, health is the prerequisite for letting go and enjoying life. Here, health
is a means: by being healthy, you can party, exercise, travel, and enjoy life.
Spiritual effects
Some people see their health as dominated by external religious or supernatural
powers. Literature shows that different definitions of health are culturally and socially
embedded; health makes sense within the context of people’s everyday lives.
4
Health in Society (201900017)
2025-2026
1
,Table of contents
Summary literature Summary Health in Society (201900017) 2025-2026 .......................................... 1
.................................................................................................................................................... 1
Part 1: Approaches to public health .............................................................................................. 3
Chapter 1: Understanding health: definitions and perspectives ........................................................ 3
Chapter 2: A history of public health ................................................................................................. 7
Chapter 3: The new public health evolves ....................................................................................... 11
Part 2: Political economy of public health ....................................................................................16
Chapter 4: Ethics, politics and ideologies: the invisible hands of public health ............................... 16
Chapter 5: Neo-liberalism, globalisation and health ....................................................................... 21
Part 4: Health inequities: profiles, patterns and explanations ..........................................................28
Chapter 11: Changing health and illness profiles in the 20th century: global and Australian
perspectives ................................................................................................................................... 28
Chapter 13: The social determinants of health inequity .................................................................. 31
Part 5: Unhealthy environments: global and Australian perspectives ...............................................39
Chapter 14: Global physical threats to the environment and public health ...................................... 39
Chapter 15: Urbanisation, population, communities and environments: global trends ................... 45
Part 6: Creating healthy and equitable societies and environments .................................................53
Chapter 16: Healthy economic policies .......................................................................................... 53
Chapter 17: Sustainable infrastructures for health, well-being and equity ....................................... 60
Part 7: Health promotion strategies for achieving healthy and equitable societies .............................66
Chapter 18: Medical and health service interventions ..................................................................... 66
Chapter 19: Changing behaviour: the limits of behaviourism and some alternatives ....................... 69
Chapter 20: Participation and health promotion ............................................................................. 77
Chapter 21: Community development in health .............................................................................. 84
Chapter 22: public health advocacy and activism ........................................................................... 93
Chapter 23: Healthy settings, cities, communities and organisations: strategies for the 21st century
....................................................................................................................................................... 98
Chapter 24: Healthy public policy ................................................................................................. 106
Part 8: Public health in the 21st century ...................................................................................... 115
Chapter 25: Thinking local, national and global public health ....................................................... 115
2
, Part 1: Approaches to public health
Chapter 1: Understanding health: definitions and perspectives
Introduction
People’s Health Movement: ‘Health is a social, economic and political issue and above
all a fundamental right. Inequality, poverty, exploitation, violence and injustice are at the
root of ill-health.’
Commission on Social Determents of Health: ‘A toxic combination of bad policies,
economics is, in large measure, responsible for the fact that a majority of people do not
enjoy the good health that is biologically possible.’
This book explores the underlying social and economic determinants of health in detail.
But first it is important to understand the many ways in which health is understood and
used as it carries considerable cultural, social and professional baggage and has a
contested nature. This chapter presents five main perspectives on health: health within
the medical ‘clockwork’ model, health as defined by ordinary people, critical
understandings of health, health as an ‘outcome’ and health as a characteristic of place
and environment. It concludes with a consideration of the difference between
population and individual perspectives on health.
Health: the clockwork model of medicine
The past two centuries, the discourse of Western health has been overshadowed by a
biomedical perspective which operates from a clockwork definition of medicine in
which the body is studied through its component parts. Health is defined as the body
operating efficiently like a machine and any breakdowns in the system mean that it is not
healthy. Biomedicine has not considered disease within the context of the lives of
people with disease.
Health as the absence of illness
Other perspectives on health have existed alongside the biomedical view that have
operated from a different view of health. Social medicine has been more concerned with
social and economic factors that affect health. Behavioural underscored the need to
protect and maintain the body by lifestyle behaviours that minimise risk of disease and
so the promotion of healthy lifestyles have become major factors in the professional
perspective on health over the past decades.
The clockwork model has some limitations:
- It ignores the social, psychological and spiritual aspects. It suggests that if a body
is not diseased then it must be healthy
- It assumes a mind/body dichotomy and does not place much emphasis on how
an individual’s mental health might affect physical health status
- It has less legitimacy than it has in the past as the medical definitions of health
reflect its culture (example: the medical labelling of homosexuality as a mental
disorder which reflected the contemporary values of society)
3
, - It has extended the definition of disease, as pharmaceutical companies seek
new markets. Risk factors, such as obesity, are now often conceptualised as a
disease.
- The absence of disease may be part of health, but health is more than the
absence of disease
Health and well-being
The limitations of health being defined as ‘the absence of disease’ led to the World
Health Organisation defining health has: ‘The complete state of physical, mental and
social well-being, and not merely the absence of disease or infirmity’.
However, the definition of a state of well-being has proved tricky. Aitkin explains that we
need something more positive than either being ‘healthy’ or ‘diseased’.
A recent focus on mental health has led to definitions that go beyond the concentration
on physical factors. VicHealth has defined mental health as: ‘Mental health is the
embodiment of social, emotional and spiritual well-being and provides individuals with
the vitality necessary for active living, to achieve goals and to interact with one another
in ways that are respectful and just.’
Health: ordinary people’s perspectives
Ordinary people may not see health in the same way as health professionals. Health is a
complex concept that combines a number of different dimensions. Three domains
relating to the definition of health are found:
- Health is not being ill
- It is a necessary prerequisite for life’s functions
- It is a sense of well-being expressed in physical and mental terms
→ Research suggests that health is variously viewed and is a complex and dynamic
concept involving a number of different perspectives.
Health in cultural and economic contexts
Interpretations of health reflect the cultural and economic context of people’s lives. For
most people health represents a status, socially recognised and admired. Crawford
found two main discourses of health, suggesting that health fulfils different functions for
different people:
- Health was seen by some as self-control
= Health was something to achieved through healthy behaviour (health is related
to self-discipline, self-denial and willpower)
- Health was seen by some as a release mechanism
= For others, health is the prerequisite for letting go and enjoying life. Here, health
is a means: by being healthy, you can party, exercise, travel, and enjoy life.
Spiritual effects
Some people see their health as dominated by external religious or supernatural
powers. Literature shows that different definitions of health are culturally and socially
embedded; health makes sense within the context of people’s everyday lives.
4
