Dahlgren-Whitehead Model (1991)

Explanation of what The Dahlgren-Whitehead Model (1991) is

The Dahlgren-Whitehead is a model which explains the social determinants of health

What are the different levels of the Dahlgren-Whitehead model, and label whether these levels are proximal, intermediary, or distal

Age, sex & constitutional factors - Proximal

Individual lifestyle factors - Proximal

Social and community networks - Intermediary

Living and working conditions - Distal

General socio-economic, cultural and environmental conditions - Distal

What is the age, sex & constitutional factors ‘level’ in the Dahlgren & Whitehead 1991 model?

This part of the model is proximal and upstream, and refers to the biological make-up and how our bodies are made

What is the Individual lifestyle factors ‘level’ in the Dahlgren & Whitehead 1991 model?

This level is proximal and downstream; these are factors that relate to individual lifestyle or behaviours/ have agency over. Such as smoking, drinking, eating choices, physical activity, vaccine uptake, etc. Can be ‘risky’ or health-promoting behaviours

What is the social and community networks ‘level’ in the Dahlgren & Whitehead 1991 model?

This is the intermediary and midstream part of the model and talks about the social networks that surround communities or individuals and are the connections we have with each other, with the degree of social support people feel they have.

What is the living & working conditions ‘level’ in the Dahlgren & Whitehead 1991 model

This is the distal and upstream part of the model and includes the environments we live, work and grow in. This includes the idea of structure vs. agency

General socio-economic, cultural & environmental conditions

This is the distal and upstream part of the model and includes things like policies & legislations which can influence our living and working conditions, also includes global influences and cultural beliefs, norms, and values.

what is meant by structure vs agency

Structure refers to the external forces that shape what is possible, whereas agency is the individual ability to make choices and act. An example of this is higher rates of fast food chains in lower socioeconomic areas. The high presence of these food places is an example of structure, and the agency would be buying food from these places due to their high availability.