In simple terms
A friendly intro before the formal notes — no formulas yet.
Health is a three-way conversation
Whether you stay well or get ill is rarely decided by one thing. Your biology, your mind and your social world are constantly talking to each other, and health is the outcome of that conversation — not of any single voice in it.
Think of a house catching fire. The biomedical model looks only at the spark (the pathogen). The biopsychosocial model asks the fuller question a fire investigator asks: was there a spark (biology), was the house full of dry timber because the owner never cleared it (behaviour driven by beliefs and stress), and was it built in a tinder-dry, poorly served neighbourhood far from a fire station (social environment)? Change any one of those and the outcome changes. Health works the same way — the spark alone rarely tells the whole story.
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Name the health outcome you are explaining (e.g. recovery from surgery, susceptibility to infection, developing an addiction).
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Identify determinants across all three domains — biological, psychological/cognitive, and sociocultural — and label each as a risk or a protective factor.
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Explain the mechanism that links the factor to the body (e.g. how chronic stress raises cortisol and suppresses immune function).
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USE a named study as evidence for that mechanism — state its aim, procedure and findings, then say what the finding proves about your argument.
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Evaluate: methodology, correlation versus causation, competing dispositional versus situational explanations, and cultural or individual variation.
Explore the concept
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Full topic notes
Formal explanation with the rigour you need for the exam.
From biomedical to biopsychosocial
For most of medical history the biomedical model dominated: illness was a malfunction of the body's biological systems, caused by pathogens, injury or genetic fault, and the mind was treated as separate from the body. This model was spectacularly successful against acute infectious disease. But it explains chronic, lifestyle-linked illness — heart disease, type 2 diabetes, many cancers — poorly, because those outcomes depend on how people live, feel and are situated, not just on their cells.
The biopsychosocial model replaces this with three interacting factors. BIOLOGICAL: genes, immune function, neurochemistry. PSYCHOLOGICAL (cognitive/behavioural): beliefs, stress appraisals, coping style, health behaviours. SOCIAL: relationships, socioeconomic status, culture and norms. The single most examined idea here is the word INTERACTING. The model is not 'biology plus a bit of social context bolted on'. Each factor modifies the others: social stress alters biology (cortisol, immunity); biological vulnerability shapes psychological coping; cultural norms determine which behaviours are even available. Miss the interaction and you have merely re-described the biomedical model with extra words.
Biomedical model — illness = biological malfunction; mind and body separate; strong for acute infection, weak for chronic lifestyle disease.
Biopsychosocial model — health = the INTERACTION of biological, psychological and social factors.
The examinable core — the factors interact and modify one another; they are not simply added together.
Consequence for treatment — it justifies interventions that target behaviour and social context, not only the body (e.g. stress management, social support, tackling socioeconomic inequality).
Risk factors and protective factors
It helps to sort determinants by the direction of their effect. A RISK factor raises the probability of poor health; a PROTECTIVE factor lowers it, or buffers the person against harm they are already exposed to. Crucially, the two are mirror images across the same dimensions, and a single variable can appear on either side depending on its level: strong social ties are protective, social isolation is a risk factor; optimism protects, hostility and chronic pessimism put you at risk.
Biological risk / protective — genetic predisposition, family history (risk); robust immune function, genetic resilience (protective).
Cognitive / dispositional — chronic stress appraisal, low self-efficacy, hostility (risk); optimism, high self-efficacy, adaptive coping (protective).
Sociocultural / situational — low socioeconomic status, social isolation, harmful norms (risk); high social support, high SES, health-promoting norms (protective).
Behavioural — smoking, poor diet, physical inactivity, harmful drinking (risk); exercise, adherence to treatment, help-seeking (protective).
Direction matters — the same dimension supplies both a risk and a protective pole; naming which pole you mean is what earns marks.
Determinants of health BEHAVIOUR: biological, cognitive, sociocultural
Many determinants act on health indirectly, by shaping what people DO. Health behaviour — smoking, exercising, adhering to treatment, seeking help — is itself driven by factors from all three domains, and a good essay keeps them distinct.
Biological determinants — genetic predispositions and neurochemistry. Individual differences in dopamine reward sensitivity, for example, make some people more likely to repeat rewarding but harmful behaviours such as drug use or overeating.
Cognitive determinants — beliefs and appraisals. Self-efficacy (belief you CAN change), perceived risk (belief the threat applies to you), and outcome expectancies all predict whether a person starts and sustains a health behaviour. Low perceived risk is why many people ignore good advice.
Sociocultural determinants — the social environment. Peer and family norms model behaviour; socioeconomic status shapes what is affordable and accessible; cultural stigma (e.g. around mental illness) suppresses help-seeking. We tend to do what those around us do, and what our circumstances permit.
Dispositional versus situational determinants
A recurring debate cuts across all of the above: is a health behaviour better explained by something stable INSIDE the person (a disposition) or by the person's CONTEXT (the situation)? Dispositional explanations point to optimism, self-efficacy, personality and resilience. Situational explanations point to stress, availability, socioeconomic conditions and norms. The honest answer is usually 'both, interacting' — but the debate is a rich source of critical thinking, because our intuition heavily over-weights disposition (the fundamental attribution error applied to health).
How stress, addiction and lifestyle become physical health
The determinants above only matter because they eventually reach the body. Three well-understood routes do that work.
Two named studies let you evidence these routes. Scheier & Carver (1985) followed 51 male coronary artery bypass patients, measuring dispositional optimism before surgery; optimists showed faster recovery and better quality of life six months on, consistent with optimism promoting adaptive, problem-focused coping and healthier behaviour. Cohen et al. (1991) exposed 394 healthy volunteers to a controlled dose of a cold virus after measuring their psychological stress; higher stress predicted a dose-dependent rise in the rate of clinical colds — a rare experimental demonstration of the stress–immune pathway. And Marmot et al.'s Whitehall studies of British civil servants found a steep social gradient in cardiovascular disease and mortality: lower employment grade meant worse health even with healthcare access equal, implicating psychosocial factors such as low job control — a powerful sociocultural/situational determinant.
Stress — a chronic stressor activates the HPA axis and sustains cortisol; prolonged cortisol suppresses immune activity, increasing susceptibility to infection and slowing wound healing. This is the mechanism that turns a psychosocial event into a measurable biological outcome, and it is the pathway most worth learning precisely.
Addiction — repeated use of a substance recruits the dopamine reward system, drives tolerance and withdrawal, and — via the biopsychosocial route above — is initiated and maintained by biological vulnerability, cognitive expectancies AND situational availability together.
Lifestyle — diet, physical activity, smoking and drinking are behaviours, but they accumulate into biological risk (arterial damage, insulin resistance, carcinogen exposure). They are the clearest case of psychological and social determinants writing themselves onto the body over years.
Command terms decide how far you must go. 'Explain' wants a detailed, evidenced account of a mechanism. 'Discuss' and 'Evaluate' want that PLUS developed critical thinking — weighing methodology, correlation versus causation, competing dispositional/situational explanations and cultural variation. For a 22-mark ERQ you are almost always in the second category, so plan your critical points before you write.
Evaluating the research and the model
Correlation versus causation — much of the evidence (optimism and recovery, SES and mortality) is correlational; a third variable such as SES can drive both the predictor and the outcome. Cohen's controlled-exposure and Marmot's prospective designs are stronger precisely because they narrow this gap.
Construct measurement — 'stress', 'optimism' and 'social support' are largely self-reported, and self-report is vulnerable to bias and to differing interpretations across individuals and cultures.
Generalisability and sampling — Scheier & Carver used only middle-aged men after one operation; Marmot studied British civil servants. Findings may not transfer across sex, age, culture or health condition.
Dispositional/situational balance — over-attributing outcomes to disposition ignores situation (Robins); over-attributing to situation ignores real biological vulnerability. The model's strength is that it demands both.
Strength of the biopsychosocial model — it is holistic, integrates the levels of analysis and justifies broader interventions; its weakness is that it is hard to test as a whole and can be so inclusive that it risks becoming unfalsifiable.
Common mistakes examiners penalise
Treating the biopsychosocial model as additive — writing 'biology plus social factors' without the INTERACTION. The interaction between the three factors is the whole idea; omit it and you have re-labelled the biomedical model.
Confusing risk with protective factors, or forgetting direction — say explicitly whether social support (protective) or social isolation (risk) is your point; naming the pole earns the mark.
Mixing up dispositional and situational — calling stress or availability a 'personality trait', or calling optimism an environmental factor. Internal-and-stable = dispositional; external-and-contextual = situational.
Describing studies instead of USING them — a full aim/procedure/findings with no sentence saying 'this shows that…'. Under our markband, description alone caps Criterion C; USE (linking the finding to the argument) is what reaches the top band.
Relying on a single study — one study, however detailed, caps Use of research. Bring two relevant studies you can genuinely use.
Claiming causation from correlational data — 'optimism causes health' overstates what correlational studies can show; state the limit and mention confounds such as SES.
Ignoring the command term — answering a 'Discuss' as if it were an 'Explain', with no developed critical thinking, forfeits Criterion D.
Where this leads
The determinants of health are the foundation of the whole option. Health problems (stress, addiction, obesity), health promotion, and the effectiveness of health-promotion programmes all return to the same question you have met here: which biological, psychological and social factors are in play, are they risk or protective, and is the behaviour better explained dispositionally or situationally? Master the interaction and the study-USE habit now, and the rest of the option is the same skill applied to new content.
Worked examples
See the formulas applied — reveal one step at a time, like the exam.
Worked example 1 — Explain, using one study, the difference between dispositional and situational determinants of a health behaviour. (short-answer style, ~9 marks)
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Set up the distinction. Dispositional determinants are stable internal characteristics of the person (personality, optimism, self-efficacy); situational determinants are external features of the environment (availability, stress, social context). Addiction is a useful test case because it is intuitively seen as dispositional ('an addictive personality') yet is strongly shaped by situation.
Paper 2 ERQ: Discuss the biopsychosocial model of health, or determinants of health. [22 marks]
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Model essay
How it all connects
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Tap a linked idea to see how it connects back to the main topic — that connection is what examiners reward.
Glossary
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Quick check
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Revision flashcards
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Biopsychosocial model
A model in which health and illness result from the interaction of THREE factors — biological, psychological and social — none of which is sufficient alone. The key word is 'interaction': the factors modify each other, they are not just added together.
Key takeaways
Review these before you close the topic — retrieval beats re-reading.
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Biomedical model — illness = biological malfunction; mind and body separate; strong for acute infection, weak for chronic lifestyle disease.
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Biopsychosocial model — health = the INTERACTION of biological, psychological and social factors.
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The examinable core — the factors interact and modify one another; they are not simply added together.
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Consequence for treatment — it justifies interventions that target behaviour and social context, not only the body (e.g. stress management, social support, tackling socioeconomic inequality).
Practice — then mark it
The whole point: a real Cambridge question, marked mark-by-mark.
Get a Paper 2 essay marked: Discuss the biopsychosocial model of health, or determinants of health
Get a Paper 2 essay marked: Discuss the biopsychosocial model of health, or determinants of health
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