Social Medicine

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???? Social Medicine
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??? ? ?Chapter one Introduction

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• concept, nature, contents and tasks
• Development
• Basic thinking
• Relation with other subjects

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What is social medicine?????????
Medicine
sociology

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What is medicine??????

• The science related to the
• diagnosis
• understanding
• prevention
• treatment of illness.

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What is social medicine?
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1. Interactions and law between the social
factors and health disease 2. Stipulate
social health strategy and measures 3. Protect
health improve life quality, give the full
display of the social function of health.
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Why we need to look at the social factors?

• Human being is more of
• the social creature than the animal.
• its social attribute is the fundamental nature.
• New concept of Health by WHO 1948
• Health is a state of complete physical,
  mental and social well-being and not merely the
  absence of disease or infirmity.

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• WHO 1948??????
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???????The dual nature of human beings

• Aristotle human
• beings are, by nature,
• social animals
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• Social nature
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• Biological nature
• Does it matter to health?

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Whats Relationship between social factors and
health?WHO put forward Social determinants for
Health

• Politics
• Economy
• Culture
• Environment
• Social security system
• Life style and behaviors
• Health care system

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• 911?????3000?????,??????????????
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Rudolf Virchow German pathologist

• 1. Social and economic conditions profoundly
  impact health, disease and the practice of
  medicine.
• 2. The health of the population is a matter of
  social concern.
• 3. Society should promote health through both
  individual and social means.

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????????? Contents of social medicine

• Social health status, mainly population health
  status
• Influence factors
• especially social factors
• Social health strategies and measures

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????????? Core Contents

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• Identify social health problems diagnosis of
  problems
• Analysis of social causes of diseases social
  etiology
• Social medicine prescription--
• social strategy

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????????????

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• social medicine mainly target at population
  level
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• Identify social problemsocial diagnosis
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• Social medical analysisfind out social
  causes
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• Social comprehensive therapy

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• Clinical medicine mainly target at individual
  level
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• Identify individual health problem---medical
  diagnosis
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• Etiological analysis biological
• causes analysis
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• Provide medical prescription

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??????? The Nature of
Social Medicine

• Interdisciplinary subjectsocial science and
  medicine
• Synthetic research methods
• Practicality of social medicine

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???????The tasks of social medicine

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• Advocate positive concept of health
• To improve social health status, enhance
  population health and quality of life
• To formulate health policy strategies
• To conduct preventive care services for special
  population and specific disease

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Basic thinking of social medicine

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• II.???????

• Harmonious relationship between health and
  social development
• Two way interaction between health and social
  economic development

• ????Mushkin???????19001960?????????????????8200?
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• (Death, Disability, Debility)

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Basic thinking of social medicine

• Positive concept of healthBio-psycho-social
  medical model

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USA 19000?
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IV.??????????
High risk factors population
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Basic thinking of social medicine
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Basic thinking of social medicine

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• VI.?????

• Important role of social factors in prevention
  and treatment of diseases
• Multisector participation

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???????The history of social medicine

• Embryonic stage of social medicine
• Establishment development of social medicine
• Development of social medicine in China

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Embryonic stage of social medicine
Hippocrates

• Air, Water and Places
• stress on the impacts of environment,
• wind direction, sunlight, water quality
• and citizens life style on peoples
• health.
• -- It is more important to know what sort of
  person has a disease than to know what sort of
  disease a person has.

Hippocrates, born in 460 bc , father of modern
medicine.
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Pathogenesis of disease and the role of doctors

• The external influences of food and drink and
  climatic factors of excessive heat and cold
  influence internal mechanisms.
• The role of the physician was to restore the
  equilibrium of health.
• The Humoural theory was a holistic view.

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Embryonic stage of social medicine

• 1. Galen focus on psychological factors upon
  health
• 2.Peter Frank miserable life is the hotbed of
  diseases
• the National Supervision Systemsupervision
  plangovernment measures to protect public health
• First person put forward adopt social health
  measures to control disease

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??????????Establishment and development of
Social Medicine

• Frenchman Jules Guerin first person Social
  medicine
• Scattered medical supervision public health and
  forensic medicine should be integrated into
  Social medicine divided into 4 parts
• Social physiology
• Social pathology
• Social hygiene
• Social therapeutics

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?????? ???German Pathologist Rudolf Virchow

• The kernel of medical science is social science
• Medicine is a social science
• Politics is nothing more than medicine in broad
  sense
• Best method of medicine is to combine medicine
  with social life and political activities

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??????German A.Grotjahn

• Put forward theory of
• social pathology
• Write social Pathology
• suggests that disease should be studied from
  the standpoint of social view
• Is a first person given lecture on social hygiene

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Germany Birthplace of social medicine

• Before WWII
• Social hygiene
• Social medicine
• Later--become social medicine

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??????????Development of Social Medicine in
different countries

• In UK, course of social medicine is offered,
  social medicine research institute was
  established in Oxford University
• Professor John Ryle
• all public health, industrial health, social
  health and medical care belong to social medicine
• In 1960s, social medicine was changed into
  community medicine

• ?? 40s ??????, ??????????????
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• 60s???????????

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??????????In United States

• Medical sociology and family medicine developed
• Emphasis on sociology, management and economics
• Social medicine was included in the course of
  health management and health policy

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??????????Social medicine in China

• In 50s, course of Health Care Organization is a
  compulsory course for medical student,
• In 80s, Ministry of Health set up 6 training
  centre of health administration, social medicine
  was the main course
• 90 of medical college offered course in social
  medicine.

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• 80???????6???????????,??????????
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??????????????The relationship between social
medicine and other related subjects

• Preventive medicine
• Community medicine
• Medical sociology
• Health management
• Medical psychology

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Preventive Medicine

• Preventive medicine studies how natural and
  social factors affect peoples health
• ?? How Disease occurred and spread
• ?? put prevention fist
• ?? Three-stage preventive measures
• ?? focus on medical prevention
• ?? Bio-preventive strategy mainly
• ?? Social medicine grow out of
• preventive medicine

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Social Medicine Vs Community Medicine

• Community medicine
• More practical
• Operational
• Both target at population level
• Intermediate level
• Share same origin with social medicine
• The Practice of social medicine facilitate the
  development of theory of social medicine

• Social medicine
• More theoretical
• Macro mainly at policy level
• Offer guiding principle
• Theory of social medicine be practiced in
  community medicine
• More theoretical, offer principle and guidance to
  CM

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Medical Sociology

• Medical sociology belong to the disciplinary
  group of sociology
• Concerned with social causes and consequences of
  health and illness
• Social aspects of health and illness
• Social functions of health organizations
  institutions
• Healthcare systems vs. social systems
• Social behavior of health workers and users
• patterns of health services patterns of health
  services

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Question??? why we should learn social
medicine?

• What is the nature of this subject?
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• why it is necessary and important for medical
• students ?
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???? references

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• WHOsocial determinants of health
• World BankMacro economy and health
• WHO 2002 world health reportReducing risks,and
  Promoting Healthy Life Style
• WBI Getting Health Reform Right? World Bank 2002