An Analysis of Public Health Paradigms and Their Implication for Healthcare Policy

Abstract

The aim of this paper is to examine the conceptual divisions which characterise the public health discourse andthe ramifications in operationalizing the concepts of space and place in public health practice. These postulations have stimulated a growing discourse on spatial and non-health sector aspects (determinants) of health and their impact on the different components of public health interventions and health outcomes. Through an analysis of evidence, this paper draws attention to one of the contentious divisions that has characterised the public health discourse and practice for some decades now. This is the contention between the developmental and biomedical paradigms. The biomedical paradigm is characterised by risk and individualization over context, and the development paradigm is characterised by vulnerability and gives priority to participation and context. While both paradigms directly relate to how health and public health are conceptualized in knowledge, they both also have significant influence and in ways that have direct consequences in practice on the following: the policy responses to the health problem, public health interventions and spatial disparities in health. This paper contends that the developmental paradigm and its articulation of a broad spectrum understanding of public health issues - from studying the dynamics of people in places to placing illness and disease within a wider-context provides the most useful framework for operationalizing the spatial aspects of health goegraphies.