Biopsychosocial determinants of wellbeing – a blueprint for tackling well-being inequalities?

Volume 5, Issue 3, June 2021     |     PP. 134-154      |     PDF (576 K)    |     Pub. Date: May 31, 2021
DOI: 10.54647/sociology84565    88 Downloads     4987 Views  


Kaz Stuart, Director of the Centre for Research in Health and Society, University of Cumbria. United Kingdom

This paper argues for the ‘social determinants of health’ (SDoH) discourse to be extended in three respects. Firstly, the case is made for the ‘social’ aspect of SDoH to be extended to include biological, psychosocial and social determinants, leading to a new framing of the ‘biopsychosocial’ determinants of health. Secondly, the paper proposes the focus on health outcomes is extended to include all aspects of well-being, otherwise important interrelationships are overlooked, a shift to biopsychosocial determinants of well-being. The final proposal is to view the path of determinants as multi-directional rather than purely toward outcomes, as outcomes then become determinants themselves in complex cycles, rather than simple linearity. This leads to the final modelling of biopsychosocial cycles of well-being. The paper presents secondary data related to a fictional character to underpin the theoretical developments proposed, and concludes that these three extensions enable an expanded awareness of determinants of wellbeing, with promising implications for practice.

Biopsychosocial, determinants, wellbeing, equity, social justice.

Cite this paper
Kaz Stuart, Biopsychosocial determinants of wellbeing – a blueprint for tackling well-being inequalities? , SCIREA Journal of Sociology. Volume 5, Issue 3, June 2021 | PP. 134-154. 10.54647/sociology84565


[ 1 ] Aked, J., Marks, N., Cordon, C., Thompson, S. (2008). Five Ways to Wellbeing: The Evidence. London: nef
[ 2 ] Alonso Y. (2004). The biopsychosocial model in medical research: The evolution of the health concept over the last two decades, Patient Education and Counseling 53: 239–244.
[ 3 ] Alvarez A.S., Pagani M., Meucci P. (2012). The clinical application of the biopsychosocial model in mental health: a research critique, American Journal Physical Medical Rehabilitation, 2012; 91(suppl):173-180.
[ 4 ] Archer, M. (1995). Being Human. Oxford: Oxford University Press.
[ 5 ] Benning, T. (2015). Limitations of the biopsychosocial model in psychiatry, Advances in Medical Education and Practice, 2015 (6): 347-352.
[ 6 ] Bloodworth, J. (2016). The Myth of Meritocracy. Cambridge: Biteback Publications.
[ 7 ] Bolton, D., Gillet, G. (2019). The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments. Cham (CH): Palgrave Pivot.
[ 8 ] Braithwaite, J., Churruca, K., Long, J.C., Ellis, L.A., Herkes, J. (2018). When complexity science meets implementation science: a theoretical and empirical analysis of systems change, BMC Medicine, 16(63).
[ 9 ] Brannen, J. (2005). Mixed Methods Research a Discussion Paper, NCRM Methods Review Papers, London: NCRM.
[ 10 ] Carr, A.J., Gibson, B., Robinson, P.G. (2001). Measuring quality of life: Is quality of life determined by expectations or experience? British Medical Journal. 322(7296):1240-1243. doi:10.1136/bmj.322.7296.1240
[ 11 ] CSDH (2008). Closing the Gap in a Generation. Health equity through action on the social determinants of health. Final Report on Social Determinants of Health. Geneva: World Health Organisation.
[ 12 ] Currie, C., Zanotti, C., Morgan, A., Currie, D., de Looze, M., Roberts, C., Samdal, O., Smith, O.R.F., Barnekow, V. (2012). Social Determinants of Health and Well-Being Among Young People. Health Behaviour in School-Aged Children Study. International Report from the 2009/2010 Survey. Copenhagen: World Health Organisation.
[ 13 ] Deeming, C. (2013). Addressing the Social Determinants of Subjective Wellbeing: The Latest Challenge for Social Policy, Journal of Social Policy, 42(3): 541-565.
[ 14 ] Deleuze, G., Guattari, F. (1987). A Thousand Plateaus. Capitalism and Schizophrenia. Minessota: Minessota Press.
[ 15 ] Diener, E. (2009). Assessing Well-Being. The Collected Works of Ed Diener. Dordrecht: Springer.
[ 16 ] Dolan, P., Metcalfe, R. (2012). Measuring subjective wellbeing: recommendations on measures for use by national governments, Journal of Social Policy, 41(2): 409:407.
[ 17 ] Dorling, D. (2010). Injustice. Why social inequality persists. Bristol: Policy Press.
[ 18 ] Elwell-Sutton, T., Marshall, L., Bibby, J., Volmert, A. (2019). Briefing: Reframing the Conversation on the Social Determinants of Health. London: The Health Foundation.
[ 19 ] Engel, G.L. (1960). A unified concept of health and disease, Perspect. Biol. Med. 1960, 3, 459–485.
[ 20 ] Engel, G.L. (1977). The need for a new medical model: a challenge for biomedicine, Science, 196: 129-136.
[ 21 ] Evans, R.W. (1991). Quality of Life, Lancet, pp.338-363.
[ 22 ] Farre, A., Rapley, T. (2017). The New Old (and Old New) Medical Model: Four Decades Navigating the Biomedical and Psychosocial Understandings of Health and Illness, Healthcare, 5(88): pp.1-9.
[ 23 ] Frederickson, B.L., Levenson, R.W. (1998). Positive emotions speed recovery from the cardiovascular sequelae of negative emotions. Cognition and Emotion, 12:191–220.
[ 24 ] Gagliese, L., Gauther, L.R., Narain, N., Freedman, T. (2018). Pain, aging and dementia: towards a biopsychosocial model, Progress in Neuropsychopharmacology, (2018), pp.207-215.
[ 25 ] Ghaemi, S.N. (2009). The rise and fall of the biopsychosocial model, The British Journal of Psychiatry, 195(1):3-4.
[ 26 ] Gilbert, P. (2019) Psychotherapy for the 21st Century: An integrative, evolutionary, contextual, biopsychosocial approach, Psychology and Psychotherapy: Theory, Research and Practice, 92:164-189.
[ 27 ] Graham, H. (2009). Understanding Health Inequalities, 2nd Edition. Maidenhead: Open University Press.
[ 28 ] Gunnars, K. (2019). The Harmful Effects of Fat Shaming, Healthline, February 27th 2019. Accessed 16/5/20 at
[ 29 ] Hargarten, S.W., Lemer, E.B., Gorelick, M., Brasel, K., deRoon-Cassini, T., Kohlbeck, S. (2018). Gun Violence: A biopsychosocial Disease, Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 19(6): 1024-1043.
[ 30 ] Health Foundation (2019). Public Perceptions of Health and Social Care. London: The Health Foundation.
[ 31 ] Heliwell J.F. (2019). Determinants of Well-Being and Their Implications for Health Care, Annals of Nutrition and Metabolism, 74(2):8-14.
[ 32 ] Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T., Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review, Perspectives on Psychological Science, 10(2), pp.227-37.
[ 33 ] House of Commons Library (2018). NEET: Young People Not in Education, Employment or Training. Accessed 23/4/19 at
[ 34 ] Jenson, C., Kersbergen, C.J. (2017). The Politics of Inequality. London: Palgrave Macmillan.
[ 35 ] Kontos, N. (2011). Biomedicine - Menace or Straw Man? Re-examining the Biopsychosocial Argument, Academic Medicine, 86: 509-515.
[ 36 ] Lyubomirsky, S., King, L., Diener, E. (2005). The benefits of frequent positive affect: does happiness lead to success? Psychol Bulletin, 131(6):803–855.
[ 37 ] Marmot, M. (2005) Remediable or preventable social factors in the aetiology and prognosis of medical disorder. In P.D. White (Ed.) Biospsychosocial Medicine: An Integrated Approach to Understanding Illness. New York: Oxford University Press, pp.39-58.
[ 38 ] Marmot, M., Allen, J., Goldblatt, P., Boyce, T., McNeish, D., Grady, M., & Geddes, I. (2010). Fair society, healthy lives: Strategic review of health inequalities in England post 2010. Accessed 24.12.19 at
[ 39 ] Marmot, M., Allen, J., Boyce, T., Goldblatt, P., Morrison, J. (2020). Health Equity in England: the Marmot Review 10 Years On. Accessed 31.3.20 at
[ 40 ] AUTHORS, 2018
[ 41 ] McManus, C. (2005). Engel, Engels, and the side of the angels, The Lancet, 395(9478): 2169-2170.
[ 42 ] Morrison, K. (2002). School Leadership and Complexity Theory. London: Routledge.
[ 43 ] LCOB (2020). The London Childhood Obesity Strategy. London’s Child Obesity Taskforce: London.
[ 44 ] Niglas, K. (2000). Combining quantitative and qualitative approaches, Paper presented at the European Conference on Educational Research, 20.
[ 45 ] OECD (2005). Beyond GDP. World Forum Statistics, Knowledge and Policy Proceedings. Paris: OECD.
[ 46 ] Office for National Statistics (2019). Measures of National Well-Being Dashboard. London: ONS. Accessed 24.12.19 at
[ 47 ] Office for National Statistics (2020). Covid-19 and Deprivation in the UK. London: ONS.
[ 48 ] Ostir, G.V., Markides, K.S., Black, S.A. (2000). Emotional well-being predicts subsequent functional independence and survival. J Am Geriatr Soc , 48:473–478.
[ 49 ] Sapolsky, R. (2005). Sick of Poverty, Scientific American, 293(6):92-99.
[ 50 ] Social Media Research Group (2016). Using Social Media for Social Research: An Introduction. London: Government Social Research Unit.
[ 51 ] Solwar, O., Irwin, A. (2007). A Conceptual Framework for Action on the Social Determinants of Health. Discussion Paper for the Commission on Social Determinants of Health. Geneva, World Health Organisation.
[ 52 ] Smith, R.C.; Fortin, A.H.; Dwamena, F.; Frankel, R.M. (2013). An evidence-based patient-centered method makes the biopsychosocial model scientific. Patient Educ. Couns. 2013, 91, 265–270.
[ 53 ] Strother Ratcliff, K. (2017). The Social Determinants of Health: Looking Upstream. Cambridge: Polity Press.
[ 54 ] Tavory, I., Timmermans, S. (2014). Abductive Analysis: Theorising Qualitative Research. Chicago: University of Chicago Press.
[ 55 ] Tov, W., Diener, E. (2008). The well-being of nations: Linking together trust, cooperation, and democracy. In: BA Sullivan, M Snyder, JL Sullivan (Eds.) Cooperation: The psychology of effective human interaction. Malden, M.A.: Blackwell Publishing; 323–342.
[ 56 ] Wade, D.T., Halligan, P.T. (2017). The biopsychosocial model of illness: a model whose time has come, Clinical Rehabilitation, 31(8): 995-1004.
[ 57 ] Ward, P., Mamerow, L., Meyer, S.B. (2013). Identifying Vulnerable Populations Using a Social Determinants of Health Framework: Analysis of National Survey Data across Six Asia-Pacific Countries, PLoS ONE, 8(12): e83000.
[ 58 ] Wojatzki, M., Mohammad, S.,  Zesch, T.,  Kiritchenko, S. (2018). Quantifying Qualitative Data for Understanding Controversial Issues, Proceedings of the Eleventh International Conference on Language Resources and Evaluation (LREC 2018), May 2018; Miyazaki, Japan, European Language Resources Association (ELRA).
[ 59 ] World Health Organisation (2002). Towards a Common Language for Functioning, Disability and Health. Brussels: WHO.