Conceptual
Framework -
Evans and Stoddart
Our
conceptual framework for this text is adapted in part from one developed by Evans
and Stoddart (1994) and extended by Roos, et al. (1996) to describe the relationships
between social and individual factors and health. This comprehensive model and
its extensions specify important variables that influence the relationships between
the health care system on the one hand and disease and injury and health and function
on the other hand. Specifically, the structural variables of economic environment,
social environment, physical environment, and genetic endowment have direct effects
on disease and injury and indirect effects mediated through individual response.
The health care system,
a process variable in this model, treats the disease and injury to produce well-being
and prosperity, the outcome variables. The economic environment includes such
factors as income and employment. The social environment includes social status,
social capital, and socioeconomic status. The physical environment includes exposure
to physical, biological, and chemical agents as well as impact of the work environment,
i.e., social structure, level of job demand and discretion. Genetic endowment
includes not only specific genetic diseases, e.g., sickle cell anemia, but a range
of predispositions to and protection against disease. Individual response expands
upon the epidemiological concept of host response to include lifestyle behaviors
and use of medical care
Prepared by
Carl
H. Slater, M.D., Associate Professor, Health Services Organization University
of Texas School of Public Health Houston, TX Phone:(713)500-9183FAX:(713)500-9171.
Email: [email protected]