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Menurut Louis Warwick-Booth dibukunya yang berjudul Contemporary

Health Studies An Introduction menjelaskan bahwa “Strategies to improve
neighbourhood health Biomedical strategies we can see using a settings approach
that the major determinants of neighbourhood health cannot be adequately
addressed by drawing on biomedical strategies such as screening or vaccination.
That is not to downplay the role that screening or vaccination can play in health
protection and prevention for spe- cific diseases but are unlikely to address the
health concerns of the neighbourhood. Individual lifestyle l behavioural change
strategies The strategy of indi- vidual behaviour change is also less applicable to
addressing neigh- bourhood determinants of health. Concepts such as social
support and social capital imply a connectedness between people that can
influence individual choice and action. However, it is possible to con- sider how
educational approaches can be used to foster participation in neighbourhood life.
Indeed, citizenship within the UK national curriculum for school-aged children
has, at its heart, participation in neighbourhoods, communities and civic activities
(Qualifications and Curriculum Development Agency, no date). changing the
social and economicenvironment If health is to be addressed at the level of the
neighbourhood then strategies that are implemented” (Louis, 284, 2012)

Berikut model rainbow menurut Louis Warwick-Booth :

Keterangan model rainbow di atas :

 Lapisan pertama
Mendeskripsikan ciri dan lifestyle individu, meliputi :
a) Umur
b) Jenis kelamin
c) Faktor konstitusional
 Lapisan kedua
Mendeskripsikan jaringan sosial dan komunitas, meliputi :
a) Kebutuhan untuk berinteraksi
b) Kebutuhan akan informasi
c) Komunikasi
 Lapisan ketiga
Mendeskripsikan tentang lingkungan tempat beraktivitas, meliputi :
a) Perumahan
b) Layanan kesehatan
c) Hygiene dan sanitasi
d) Lingkungan kerja
e) Fasilitas pendidikan
f) Pertanian dan
g) Produksi pangan
 Lapisan keempat
Mendeskripsikan mengenai faktor yang paling luar yang
mempengaruhi kesehatan, meliputi faktor :
a) Sosial ekonomi
b) Budaya
c) Lingkungan secara umum

Berdasarkan penjelasan diatas, dijelaskan bahwa kesehatan lingkungan

tidak dapat diselesaikan jika hanya menggunakan pendekatan atau strategi
biomedikal saja. Lebih lanjut dijelaskan bahwa gaya hidup perorang dan strategi
perubahan perilaku individu juga kurang berlaku untuk mempengaruhi faktor
penentu lingkungan tersebut. Namun yang mempengaruhi secara signisikan faktor
ini adalah perilaku masyarakat secara keseluruhan.
Lebih lanjut Louis Warwick-Booth di dalam bukunya menjelaskan bahwa ” How
the rainbow model might be improved ?
Refer back to the things you considered in learningtask 13.3. As part of
this task you were asked to think about how the rainbow model might be improved upon.
This section will consider this in more depth. The model has proved invaluable in a wide
variety of situations for assess- ing and conceptualizing factors influencing health;
however, no single framework can capture everything. The model, although widely used,
has been subject to some criticism. The framework tends to be more descriptive rather
than analytical or critical, demonstrating the relationships between different influ- ences
on health but not really going into any depth about what the nature of these are and how
they interact or co-exist to influence health outcomes. Therefore, although the model
shows many of the deter- minants of health, it cannot demonstrate the complexities of
causes. Dahlgren and Whitehead (20o6b) themselves argue that the analysis of causal
factor reeds further development. There is a lack of detail in relation to describing the
extent to which the identified determinants influence health overall. So, for example, are
socialand community networksa more significant determinantthan health care services?
Dahlgren and Whitehead (20o6b: 22) recognize this when stating "in practice, making
the distinction between these categories ofd eterminants may be difficult at times The
model, as it stands, neglects global, political and historical determinants of health.”
(Louis, 289, 2012)

Berdasarkan penjelasan di atas disebutkan bahwa model rainbow

menunjukan bahwa banyak dari aspek masyarakat global bertindak sebagai determinan
fator kesehatan. Model ini tidak menjelaskan kelayakan untuk mengubah faktor-faktor
spesifik, serta tindakan apa yang diperlukan dalam kaitannya dengan masing-masing
lapisan atau bagaimana lapisan dalam model ini mempengaruhi lapisan yang lain.

KONKLUSI

Faktor-faktor penyebab penyakit dapat diminimalisir dengan

pengembangan pemahaman tentang faktor penentu yang lebih luas melalui
pengkajian model rainbow ini, sehingga membantu untuk merancang strategi
untuk upaya promosi kesehatan di berbagai sektor yang ada dalam kehidupan
masyarakat secara holistis.

DAFTAR PUSTAKA

Warwick-Booth, Louis et All. 2012. Contemporary Health Studies An

Introduction. Cambridge : Politity Press. Halaman 284

Warwick-Booth, Louis et All. 2012. Contemporary Health Studies An

Introduction. Cambridge : Politity Press. Halaman 289
 BUKTI PUSTAKA

Bukti Pustaka 1: Halaman Sampul Buku Karya Louis Warwick-Booth

Bukti Pustaka 2: Halaman Penerbit dan Tahun Terbit
Bukti Pustaka 3: Halaman yang Dikutip pada Halaman Nomor 284
Bukti Pustaka 4: Halaman yang Dikutip Pada Halaman Nomor 294