The multilevel model of health is described as an approach of understanding the various levels in which an individual’s risk factors influence the health of populations (Galea, 2015). It explores how social, biological, geographical, political and temporal factors shape the health of populations (Galea, 2015). A form of the multilevel model of understanding health is the ecological model. Health from an ecological perspective is a measure of the wellness of the individual dependent on the wellness of the community and vice versa (Dustin, Bricker, & Schwab, 2009). The ecological model is rooted from the ecological theory which argues that human development is influenced by a set of common interactions that may support or undermine it (Tehrani, Majlessi, Shojaeizadeh, Sadeghi, & Hasani, 2016).
The ecological model explores the complex links and relationships between health and its factors or determinants (The Women and Children Health Policy Center, 2013). This ecological model depicts a vivid image of the interaction between factors at the four levels; which are individual, interpersonal, social environment, physical environment and public policies (Tehrani et al., 2016). The ecological model treats the interaction among the factors at each different level with equal importance to that of the influencing factors within a single level (World Health Organization, 2018). The individual level examines how personal characteristics such as age, gender, knowledge and attitude can cause changes in one’s behaviours. The social environment examines how interpersonal and cultural interactions can affect the performance of an individual (Tehrani et al., 2016). The physical environment involves natural or man-made environments and involves the availability and accessibility of facilities that motivates the individual to take part in the physical environment (Tehrani et al., 2016). Last, public policies involve the rules, regulations and policies that affect health (Tehrani et al., 2016).
The ecological model is used to examine the health of immigrant women. Culture, gender and the migration experience are viewed as determinants of health for immigrant women (Thurston & Vissandjée, 2005). The ecological model effectively depicts how individual behaviors, social environments, and physical environments of immigrant women influence their health and well-being (Thurston & Vissandjée, 2005). Factors such as language barriers, culture shock, social isolation and loneliness, feelings of loss of socioeconomic status, finding employment and establishing a source of income, working in unsafe or unhealthy work environments, discrimination, barriers in accessing healthcare services, and establishing a new home; can potentially result in negative outcomes in the health of immigrant women (Thurston & Vissandjée, 2005). It is evident that the interactions among the determinants of health for immigrant women can be quite complex. Therefore interventions in eliminating these negative outcomes for the immigrant women should not only focus on the individual level but also at the organizational levels in the form of institutional changes in polices and services (Thurston & Vissandjée, 2005).
References
Dustin, D. L., Bricker, K. S., & Schwab, K. A. (2009). People and Nature: Toward an Ecological Model of Health Promotion. Leisure Sciences, 32(1), 3-14. Retrieved from http://0-eds.a.ebscohost.com.aupac.lib.athabascau.ca/eds/pdfviewer/pdfviewer?vid=1&sid=060bf01f-8148-4085-bae6-9515dcc44c89%40sessionmgr4010
Galea, S. (2015, May 31). The Determination of Health Across the Life Course and Across Levels of Influence. Boston University School of Public Health. Retrieved from https://www.bu.edu/sph/2015/05/31/the-determination-of-health-across-the-life-course-and-across-levels-of-influence-2/
Tehrani, H., Majlessi, F., Shojaeizadeh, D., Sadeghi, R., & Hasani, K. M. (2016). Applying Socioecological Model to Improve Women’s Physical Activity: A Randomized Control Trial. Iranian Red Crescent Medical Journal, 18(3). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884614/
The Women and Children Health Policy Center (WCHPC). (2013). The Ecological Model in Public Health [Video File]. Retrieved from https://www.youtube.com/watch?v=Rm00AzC-gEU
Thurston, W. E., & Vissandjée, B. (2005). An ecological model for understanding culture as a determinant of women's health. Critical Public Health, 15(3), 229-242. Retrieved from http://0-eds.a.ebscohost.com.aupac.lib.athabascau.ca/eds/pdfviewer/pdfviewer?vid=1&sid=a5ed6718-3df4-4b63-84c4-307431f86441%40sessionmgr4010
World Health Organization (WHO). (2018). The Ecological Framework. Retrieved from http://www.who.int/violenceprevention/approach/ecology/en/