Admin, Sorry for delayed posting…. 
I would like to share this, just as a compliment to what we have already learnt about determinants of health that you may also familiar with some models that pictured their relationships; for instance HL Blum models.
Similarly, The mandala of health is also one of the models that describe determinants factor of health which I think quite complete since it addressing some issue that were missed by other models.
The Mandala means the circular symbol of universe; meanwhile, the mandala of health is a bio-psycho-socio-environmental model of health (Hancock and Perkins, 1985) It’s pretty old model, isn’t it?
It describes both the relationships and the dynamics within the determinants factors; it looks at the individual as a part of bigger community and the environment (include physical and social environment), as well as two way influenced that could be come about between them. This model is quite flexible to implement in many health issues, and it has been extensively implemented for health promotion and education purposes.
[Click the picture for viewing the larger model !!]
Picture. The Mandala of Health [Hancock and Perkins, 1985]
I would like to highlight some distinction of this model, e.g.
It distinguishes personal behaviour and life style as a different thing; lifestyle is regarded as a result of personal behaviour and psycho-socio-economic environment composition. It actually give us a new sight that we could not always blame ones for their risky personal behaviour (victim blaming) without looking at their environment, community and others.
“How could we try to suggest people to stop smoking when their peer’s smoke, when they have high stress burden, when they live in deprived community?”
It also placed medical system only related to personal behavior and human biology. Unarguably, only these determinants could possibly be reached by medical system; unless, they reorient their service. Hence, it consistent with the fact that curative approach only, could not alleviate our health problems.
Many issues are beyond health capabilities that really need contribution and coordination from other sectors
Hope this will be useful!!
Regards
Ayu
Dear mbo Ayu,
thanks for the interesting posting. I agree with you that this a a more comprehensive model for explaining human behaviour.
However, I’m a bit confused about the difference between “behaviour” and “lifestyle”.I was wondering if you could provide me with further explanations and concrete examples of the differences between the two?? Or , in other words, can you give me an example of human behaviour which is not considered as lifestyle?
>Wulan, I can not give you the example..he..he..
Actually we could not distinguish personal behaviour and lifestyle, since lifestyle itself is personal behaviour that lifelong influenced by environment. Moreover,my personal thaught there is no pure personal behaviour.
The point in this model is how we viewed the problem and how we should approach it. If we viewed it only in the individu itself it is personal behaviour (without influenced by other factors which is I think non sense); however, when we prone to upstream problem we may realise this actually their lifestyle. For instance; patient with myocardial infarct, he might be smoking, never exercise, eat fastfood (personal behaviour); when we investigate we found he has stressful work, poor, could not afford healthy food, low supply of healthy food in the area, no facilities for exercise, no sidewalk, neighbourhood is not safe for walking etc…(Those personal behaviour should be consider as lifestyle).
The model just give us an insight to viewed the problem more comprehensively, do not always blame the individual without addressing social/broader determinant of health and that we need to go beyond health system.
Nice posting, the model’s name sounds familiar, just like sansekerta language isn’t it?
It’s also similar to the bio-psycho-socio-spiritual model that we’ve learnt from psychiatric subjects. So where is the place of spiritual factors on the model? Or the spiritual factors just the part of cultural determinants??
It is sansekerta language. We could see the spiritual factor in the individu in the centre of the model that comprise body, mind and spirit. And I think implicitly in the cultural determinant as well.
Based on this model, what is the best approach to help teenagers quiet smooking then??
Hehe sorry, gangguin orang bikin assignment
He..he..sorry lg due date. There isn’t any single best approach. Similar to Bio-psycho-socio-spiritual in psychiatry, this model provide a comprehensive view regarding factors that influence health & wellbeing. Based on those determinants, than we choose appropriate strategies. In health promotion field, best strategy should be integrating all aspect of the Ottawa charter (healthy public policy, supportive env,strengthen community action,personal skill and reorient health service. Hence, for adolescence smoking there should be integration between school-based and community based program, health education, capacity building,media campaign, policy and law enforcement, cessation program etc… To date, no evidence of any single intervention brings a sustainable results
I think Wulan knows better..he..