A Biopsychosocial Model of Health

One of my favorite articles of all time that I’ve posted here before is from Dr. Mindy Fullilove. An excerpt from her book Main Street in Non-Profit Quarterly from 2022 is one of the few bookmarks I keep in my browser.

What she says always struck me in that the places we live and the societal impacts they foster are just as important to our overall health outcomes as the doctors that treat specific illnesses in the hospital. She contrasts these two ways of thinking as the biopsychosocial model and the biomedical model. While the biomedical model focuses on the individual’s symptoms, the biopsychosocial model takes a look at the full sociology of illness.

By applying the biopsychosocial model, Dr. Fullilove was able to explain and understand the negative health impacts of cracking social ties and community displacement on individuals. When the full picture is apparent, it’s easier to diagnose the problem.

But what if Dr. Fullilove’s groundbreaking work on what she would come to call Root Shock was considered on a planetary scale? This is how I interpreted today’s piece in Noema Magazine. Now it’s not just the sociology of illness in humans, but how the the health of the planet’s ecosystems interconnect with and impact that model.

Systems thinking like this could create a risk of disconnection from collective solutions for climate change or environmental harms at the planetary scale. Humans are very social, but also very focused on individual decisions and self preservation if we feel out of control or helpless against the inertia of events that are happening.

In some ways it feels like this may be why we oppose change so much. We can protect ourselves by not changing, or we can adapt.

The authors in Noema Magazine shared the work of sociologist Aaron Antonovsky who wanted to know why a third of older women that were holocaust survivors had not been impacted by the horrors of their experience. What he came to understand was they had adaptability to an extremely stressful environment.

Antonovsky found that individuals could adapt to their surroundings and be resilient if they had a “sense of coherence” about the world around them. People need to feel like the world makes sense and is predictable, there are resources available to them to address challenges, and that their life has a purpose.

That “sense of coherence” creates a system that to me enhances Dr. Fullilove’s exploration of the biopsychosocial model by not just addressing problems impacting people, but finding the ways in which individuals as part of a whole can make their way through the world in good health.

I hope that we can also adapt this model to our work in cities. Creating the conditions for human adaptability seems like something we could ultimately foster. Giving people predictability, resources, and others to connect with seems like a great place to start.

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