Welcome to Unit AS 3: Health and Well-Being
Welcome to your study notes for Factors Affecting Health and Well-Being! This is a core topic in your CCEA AS Level Health and Social Care course (Unit AS 3). Unit AS 3 makes up 50% of your AS Level and 20% of your overall A Level, assessed through an external 2-hour written exam.
Don't worry if health definitions or classifications seem a bit overwhelming at first. We are going to break everything down step by step using real-life examples, memory aids, and clear explanations so that you feel fully prepared to score top marks.
Section 1: Key Concepts of Health and Well-Being
Before we can explore what influences our health, we need to understand exactly what words like "health," "ill health," and "well-being" mean in Health and Social Care.
1. The World Health Organization (WHO) Definition of Health
The classic definition created by the WHO states that health is:
"A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
Why is this important? It shows that being healthy isn't just about not having a cold or broken bone. You need your body (physical), your mind (mental), and your relationships and environment (social) to all be in a positive state.
2. Ill Health
Ill health is defined as a state in which an individual is unable to function normally and without pain. This can be physical (such as arthritis or asthma) or mental (such as depression or severe anxiety).
3. Well-Being
Well-being is a subjective state of being happy, healthy, or prosperous. Because it is subjective, it is based on how a person feels about their own life. For example, a person living with a long-term physical illness might still report a high sense of well-being if they have loving relationships, hobbies, and a positive mindset.
4. Two Contrasting Approaches to Health
In Health and Social Care, there are two distinct ways of looking at health:
• The Medical Model: This approach focuses strictly on biological and physical factors. It views health as the absence of disease. Treatment under this model is carried out by medical professionals (doctors, surgeons) who diagnose symptoms and cure the biological problem (using medication or surgery).
• The Social Model: This approach looks at the wider picture. It recognises that a person's health and well-being are heavily influenced by social, cultural, and environmental factors (such as housing, income, education, and community support), rather than just biological causes.
Quick Review: The Medical Model focuses on "fixing the biological illness," while the Social Model focuses on "improving the social conditions that lead to good health."
Section 2: Factors Affecting Health and Well-Being
The CCEA specification categorises the factors that influence health into four main groups: Physical, Social, Emotional, and Economic. In your exam, you must be able to explain both positive and negative impacts for each.
A. Physical Factors
Physical factors are directly related to the human body and lifestyle choices.
• Genetics (Inherited Conditions): A person's genes can predispose them to certain conditions. For example, Down's syndrome or Cystic Fibrosis are genetic conditions that directly impact physical development and daily health needs.
• Biological Factors: These include age and gender. For example, older adults may experience natural decline in mobility and joint function, while certain conditions are statistically more prevalent in specific genders.
• Lifestyle Choices:
- Diet: A balanced diet promotes healthy organ function and immune strength. A poor diet can lead to malnutrition or obesity, which increases the risk of heart disease and type 2 diabetes.
- Exercise: Regular physical activity strengthens muscles, improves cardiovascular health, and boosts mood. A lack of exercise increases the risk of circulatory diseases.
- Substance Use: Smoking damages lung tissue and increases the risk of lung cancer; excessive alcohol consumption can lead to liver damage and high blood pressure; illegal drug use can cause physical dependency and organ damage.
B. Social Factors
Social factors involve the environment you live in and the people around you.
• Family and Support Networks: A supportive family structure provides encouragement, care during times of illness, and practical help. Conversely, family conflict or lack of support can increase stress and reduce a person's resilience.
• Social Isolation: Loneliness and isolation can lead to poor mental health, a lack of practical assistance, and an increased risk of cognitive decline in older adults. On the other hand, strong social integration provides companionship and emotional security.
• Housing Conditions: Poor housing directly impacts physical health. Overcrowding makes it easier for infectious illnesses to spread. Dampness and mould trigger and worsen respiratory conditions like asthma. Poor sanitation increases the risk of bacterial infections.
C. Emotional Factors
Emotional factors relate to our feelings, thoughts, and psychological states.
• Self-Concept (Self-Esteem and Self-Image): Self-esteem is how much you value yourself, while self-image is how you see yourself. High self-esteem leads to confidence and proactive health choices. Low self-esteem can lead to social withdrawal, anxiety, and neglecting personal care.
• Stress and Life Events: Major life events such as bereavement, divorce, or even marriage cause stress. Chronic stress triggers high levels of cortisol, leading to sleep disturbances, weakened immune responses, and elevated blood pressure.
• Relationships: Positive, trusting interactions with friends, partners, or colleagues foster a sense of belonging and emotional safety. Toxic or abusive relationships cause prolonged emotional distress and anxiety.
D. Economic Factors
Economic factors relate to money, employment, and social standing.
• Income: A steady, adequate income allows individuals to afford nutritious, fresh food, warm and dry housing, and recreational activities. Low income forces difficult choices (e.g., choosing between heating and food), directly harming physical and mental health.
• Employment Status: Being employed provides financial security, a daily routine, and a sense of purpose. Unemployment often leads to poverty, a loss of identity, reduced self-esteem, and higher rates of depression.
• Socio-Economic Class: Socio-economic class is determined by occupation and education levels. Higher educational attainment generally leads to better employment opportunities, higher income, and greater health literacy (understanding health advice and accessing healthcare services effectively).
Top Exam Tip: Never simply state that a factor "affects health." Always show the cause-and-effect chain! For example: "Unemployment leads to a reduction in household income, which means an individual may be unable to afford adequate home heating, leading to cold living conditions that can trigger respiratory problems like bronchitis."
Section 3: Service User Needs (The PIES Framework)
When assessing how health factors impact an individual, health and social care professionals look at four core areas of need, known as PIES.
Memory Trick: Think of a complete pie. If one slice is missing, the pie is incomplete. A person needs all four areas met to experience total well-being!
• P - Physical Needs: Needs related to bodily care, safety, and health (e.g., pain relief, mobility assistance, nutritious food, warmth, medication administration).
• I - Intellectual Needs: Needs related to mental stimulation, learning, and thinking (e.g., problem-solving activities, education, reading, learning new skills, memory games for dementia patients).
• E - Emotional Needs: Needs related to feelings, psychological safety, and identity (e.g., being treated with dignity, feeling loved, feeling safe, having privacy respected, support with grief).
• S - Social Needs: Needs related to interacting with others and feeling part of a community (e.g., making friends, engaging in group activities, overcoming isolation, keeping in touch with family).
Section 4: Health Screening and Health Promotion
To improve health across populations, governments and health services use screening and various promotional strategies.
1. Health Screening
Health screening refers to medical tests and procedures designed to identify individuals who are at a higher risk of developing a specific condition, or to catch a disease in its early stages before symptoms appear.
Key examples include:
• Breast Screening (Mammography): Used to detect early signs of breast cancer in women before a lump can be felt.
• Cervical Screening (Smear Test): Checks the health of the cervix and detects cell changes that could develop into cervical cancer if left untreated.
2. Approaches to Health Promotion
Health promotion is the process of enabling people to increase control over and improve their health. There are five specific approaches you need to know:
• 1. Medical Approach: Focuses on reducing illness and premature death using medical interventions. Examples include childhood immunisation and vaccination programmes, or offering preventive medication.
• 2. Behaviour Change Approach: Encourages individuals to adopt healthier personal habits and lifestyles. Examples include national public health campaigns such as "Change4Life" or anti-smoking advertisements encouraging people to quit.
• 3. Educational Approach: Provides factual information and knowledge so that individuals can make informed choices about their own health (e.g., teaching nutritional facts and sexual health in school classrooms).
• 4. Empowerment Approach: Helps individuals and communities gain control over their own lives and health decisions by building self-confidence, skills, and self-advocacy (e.g., patient-led support groups where service users decide what support they need).
• 5. Social Change Approach: Aims to change the physical, legal, or social environment to make healthy choices easier or mandatory. Examples include legislation like the smoking ban in enclosed public places or the sugar tax on soft drinks.
Section 5: Summary of Common Exam Pitfalls
Make sure you avoid these common traps identified in CCEA examiner reports:
• Pitfall 1: Confusing the Medical and Social Models. Remember, the Medical Model is strictly biological/clinical (illness, diagnosis, cure). Do not call it "social" just because a doctor works in a community clinic!
• Pitfall 2: Treating "Well-Being" as Identical to "Health." Well-being is subjective. A person can have a chronic physical illness but still experience high emotional well-being if their emotional and social needs are well supported.
• Pitfall 3: Generic Use of "Social Class." If you mention socio-economic class in an exam, always explain the underlying components: occupation, education, and income, and explain how these link directly to health outcomes.
• Pitfall 4: Misapplying PIES. Keep physical needs (medication, pain management) distinct from emotional or social needs.
Key Takeaways Checklist
Before moving to the next topic, check that you can:
• State the WHO definition of health accurately.
• Distinguish between the Medical Model and the Social Model of health.
• Give positive and negative impacts for Physical, Social, Emotional, and Economic factors.
• Explain the four PIES needs for service users.
• Identify examples of health screening (breast and cervical screening).
• Name and explain the five approaches to health promotion (Medical, Behaviour Change, Educational, Empowerment, Social Change).