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Introduction to the socio-ecological model

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This social ecological model of health by Dahlgren and Whitehead (1991) describes how each layer has certain influence on health. They use the model to establish a relationship between the individual or groups to their environment and illnesses. Individuals are at the center with a set of fixed genes. With the subjects being in the middle of the rainbow, influences on health surrounding them can be modified.

The first layer can be classified as individual lifestyle factors which promotes or damages health. An example would be how the influence of friendships on the choice of smoking. The next layer describes the social and communal influences which provides support for community members, sometimes in unfavorable conditions too. The community can choose to not support or even promote negatively.

The third layer contains the broader aspect of influence on the individual which encapsulates their food supply, access to essential goods and services, living and working conditions. Lastly, the overall society also influences the individual in terms of population health, economic, cultural and environmental situation. This model shows how health determinants are deeply related to social norms and networks, living or working conditions and general socioeconomic cultural environment.


“Health” can be define as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2003). In terms of mental and physical health, a key method of maintaining both would be sleep behavior. The recommended hours of sleep for adults is seven to eight hours and nine to eleven hours for children around fourteen. Many suffer from insufficient sleep and it has become a public health epidemic (CDC, 2015). Having sufficient sleep would provide the individual with enough energy and mental clarity to process information efficiently and participate actively in daily tasks.

Sleep aids memory retainment, learning and warding off diseases. (National Sleep Foundation, 2011) The long-term effect of sleep deprivation may include high blood pressure, heart failure, attention related disorders, depression and obesity. (Breus, 2006)


On an individual level, individual may not get enough sleep due to a belief that sleep is not important. They underestimate the problems which sleep deprivation entails. According to a Journal of School Health in 2009, students are aware about the benefits and need to practice good sleeping habits, but they still engage in poor practices. The study showed that the students know that taking naps could help them catch up on sleep but amongst all the participants only 38.6% of them reported taking naps.

The data tells us that sleep deprivation in this age group stems from the lack of willingness to correct the problem. The student’s attitudes and beliefs must be changed first. Demographics also affect sleeping habits. Races, ethnicities and social classes. According to a lecture by Michael Grandner who is a member of the Center for Sleep and Circadian Neurobiology, as compared to whites, other ethnicities has a higher percentage of sleep. Education levels and gender also affects the individuals and their sleep patterns. Educated females generally experience more sleep disturbances than males across all levels of education. (Grandner, 2012)


Social interactions include relationships with members of the family, friends and the immediate community around the individual. Positive interactions which promotes a sense of security can improve sleep behaviors in a person (Umberson, Crosnoe, and Reczek, 2010). By establishing a strong bond with these groups, sleep habits will be less disruptive. If the community provides a negative influence in the sense of increasing stress and conflict will result in sleep problems (Umberson and Montez, 2010). Among all the social interactions, generally a parent child relationship is the most important. However, factors like reduced interactions with parents due to packed college schedules or being a child in a family with parents undergoing divorce, such circumstances will experience more stress and sleep issues.


Homelessness or inadequate housing quality coupled with unemployment and geographic isolation is also a prominent issue when dealing with health issues. Without proper shelter to protect oneself against the elements will result in a lack of sleep. In urbanized areas, quality of sleep can also be affected by the temperature, ambient noise and lighting. Having a device near you also can affect how the individual sleep. Such situations will generate unnecessary stress to the person. People who live in urban areas will experience more problems sleeping than those not. Communities were created to help tackle unhealthy sleep behaviors. In America, the National Sleep Foundation and American Sleep Association created the National Sleep Awareness Roundtable to improve collaboration and interaction between the public and their organization. To engage the community and create a culture of proper sleep behavior, they use social media to connect. Facebook and Twitter were used to upload photos and increase awareness of Campaigns to encourage sleeping (National Sleep Foundation).


Under this layer, usually public policies or regulations are imposed to tackle the problem however since sleep depravation is a health behavior, it cannot be solved using such a method. What could be done would be to change the societal and cultural norms and values to encourage the community to learn how healthy and beneficial it is to have healthy sleep habits. Hopefully by encourage more people to agree and be convinced, reinforcing factors would result in a spread off intrapersonal and interpersonal interactions which will motivate individuals to have healthy sleeping habits.


Sleep deprivation is a real health issue and we need to correct this behavior. This epidemic can be seen mostly among college students or fresh graduates working whilst adjusting to the demands of their jobs. Sleep is essential for maintaining physical and mental health. Lack of sleep would result in a lack in quality of work and decrease the safety of individuals as well. To correct this issue, efforts should be made to correct the attitudes and beliefs of the individuals with organizations working with universities to target at changing social norms and perhaps introduce sleep therapies. Medically, pills could help with sleeping or dealing with insomnia, but the risk of side effects should be considered and thus refrained from long term usage. As such sleep depravation is a behavioral problem stemmed from a poor work-rest cycle lifestyle.


WHO (2003). Who Definition of Health. from http://www.who.int/about/definition/en/print.html
National Sleep Foundation (2011). Why Sleep Awareness Is Important. from http://www.nsart.org/why-sleep-awareness-is-important
Breus, M.J. (2006). Sleep Habits: More Important Than you Think. from
CDC (2015). Insufficient Sleep Is a Public Health Epidemic. from http://www.cdc.gov/features/dssleep/
Grandner, M.A. Racial/Ethnic and Socioeconomic Sleep Disparities: A key factor in health disparities? [PDF document]. Retrieved from University of California, San Francisco Center for Health and Community Online Web Site: http://chc.us.sf.edu/coast/pdfs/2012%20Symposium/Grandner_presentations.pdf
Umberson. D.,Crosnoe R., ReczekC. (2010). Social Relationships and Health Behavior across the Life Course. Annual Review of Sociology , 36, 139-57 doi: 10.1146/annurev-soc-070308-120011
Umberson D.,Montez, J.K. (2010). Social Relationships and Health: A Flashpoint for Health Pollicy. Journal of Health and Social Behavior ,51,54-66. Doi:10.1177/0022146510383501
National Sleep Foundation. (n.d.). In Facebook (Organization). from https://www.facebook.com/nationalsleepfoundation

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