Causes of change in the health of populations: A biopsychosocial viewpoint

In the current review, a biopsychosocial perspective is applied to current changes in the health of populations. It is proposed that the psychosocial environments either promote health or precipitate disease. Changes in the types of stress that people experience as well as its prevalence over time are discussed. In addition, possible biological mechanisms linking the psychosocial environments to health are presented. "Food for thought" is the possible interaction between the physical/chemical and the psychosocial environments and changes in health of individuals. Clearly, our traditional view of disease mechanisms is not sufficient to understand recent phenomena, such as environmental illness and chronic fatigue syndrome. Issues worthy of further discussions are the role of the "just-in-time" society, where individuals increasingly have to change jobs, cope with reorganizations and increased production pressure, and its impact on health and well-being. Further, in what way can we develop better models to truly assess the impact of an increasingly complex interaction between individual and environmental factors on health? A major obstacle to enhancing our understanding of causes of change in the health of populations is the use of inappropriate or outdated statistical analytical models. Finally, it is suggested that prospectively controlled studies of the impact on health of changes in the health and welfare systems are carried out. This would further add to our understanding of factors contributing to changes in the health of population.