Chapter1 Introduction to Social Medicine Section 1 The object, Content, Nature and Task of Social Medicine 1、 concept sociology medicine Social medicine socialhehehehehehehe heheheeheheheh • sociology Social statics Social dynamics Chinese 1、 what’s the merits and the medicine Traditional demerits of the medicine Other Folk folk medicine ? medicine 2、what’s your idea about the development of medicine folk medicine? basic medicine Modern Application medicine medicine Theoretical medicine • Social medicine is a newly developed overlapping course of study composed of sociology and medical science. • Though the basis is medical science and sociology, the nature of social medicine makes it inclined to medical science. The introduction in the textbook Internal Medicine (third edition), tells us that the three pillars of modern medical science are clinical medicine, preventive medicine and social medicine. 2.The objectives and contents of social medicine In clinical study when you are faced with a patient, what kinds of knowledge do you individual must have ? groups social medicine is a subject about people’s social physiological phenomenon, social pathological phenomenon, and undertakes diagnoses of social medical problems of people in order to prescribe for them. 2.1 Social physiological phenomenon: to study mutual actions and its laws between social factors and people’s health, social hygienic situations, and the tactics of social hygiene. 2.2 Social pathological phenomenon Sociology and medicine overlap, because man has sociality as well as biotic properties. “Childbearing is for the continuity of society”. It is man’s sociality that makes the biological properties of human beings to be under the control of certain regulations, which harmonize society. Biotic medicine model emphasizes the study of man’s biotic properties, but often overlook man’s psychological needs socially. At present, medicine is becoming more and 2.3 Social diagnosis To research into the interaction between social factors and state of health. Study social hygienic conditions. 2.4 Social prescription The social health strategy The health services research Community health services The social security system The education of health for example kick network addiction 3.The nature of social medicine Overlapping of the social medicine Synthetic research method The practicality of social medicine ①Overlapping of the social medicine. Sociology and medicine overlap, because man has sociality as well as biotic properties. “Childbearing is for the continuity of society”. It is man’s sociality that makes the biological properties of human beings to be under the control of certain regulations, which harmonize society. Biotic medicine model emphasizes the study of man’s biotic properties, but often overlook man’s psychological needs socially. At present, medicine is becoming more and more socialized. ② Synthetic Research Method • Being an overlapped subject between sociology and medicine, it needs to use the methods of physical science and social science which include making social investigation, psychology method, anthropology method, epidemiological method, statistics method, economics method and management method. • For example, when we study patients’ behavior, and people’s life style quality, we prefer to use social investigation and psychology methods. But when our goal is to study health service efficiency we always choose economic and management methods. In some synthetic research work, many kinds of methods are used together. ③The Practicality of Social • Medicine Solving actual problems that emerged from health practice enlightens he practice of social medicine research. • Other basic features of social medicine are there are no regular patterns of research, which gives an even wider scope to our study, and it does not easily degenerate into dogmatism. Of course, social medicine needs to take further steps to be specialized and theorized, which is also the only road to the development of social medicine. 4.The principal tasks of social medicine • Providing social health information for policy makers. • Raise people’s health level and life quality. • The education propagation of social medicine. ① Providing Social Health Information for Policy Makers The most important tasks of social medicine is to get a clear understanding of the social health situation, find out major problems through social investigation, and provide information for the Chinese government’s health programs. In the early 1980’s, many Health Care Management Departments were established in some medical colleges in China. Since then China’s social medicine has developed rapidly. ②Raise People’s Health Level and Life Quality After evaluating people’s health status, health risk factors, life quality and investigations of people’s behaviors, a complete diagnosis of people’s health problems will be made and a recipe for efficient health care will also be given. Our goal is to make people change unhealthy behavior and harmful life-styles, to improve the social environment, and to raise people’s health level and life quality. ③The Education and Propagation Knowledge of social medicine is infiltrated into clinical medicine, preventive medicine, rehabilitation medicine, health education, and community medicine and health care management. It is quite clear that a modern medical model should assist health practice and management. Trained health and management personnel who will be able to keep abreast of the modern medical model are needed. Social medicine is playing an increasingly important role in modern society. Section 2 Using the Experience of Other Major Subjects for Reference 1、Preventive medicine • Prevention focus research on bio- factor ,the factors of physics and chemistry • Need to support each other ,learn from each other 2. Sociology • Sociology( 1838 ) and social medicine(1848) emerged almost from the same time and in the same place. • Sociology is a basic subject of social medicine • Medical sociology and social medicine are sisters of subject. 3. Community medicine • Community medicine provides basic health care services,which include medical treatment, prevention, health care, rehabilitation, health education and birth control for people who live in community . • Social medicine is macroscopically Community medicine . • Social medicine focused on theories; Community medicine focused on practice. 4.Medicine ethics • The concrete application of general ethics in medical practice. • Ethics relates to “value”, “right”, “Responsibility”、 “conscience” “welfare” etc. • what do doctors do for patients? • Commonweal view: How do we distribute resource? (priority) • It’s a doctrine of study of the origin and the development of morals, standards of behavior and obligations among humans. Now medical ethics has develops into bioethics. • Social medicine inevitably will be influenced by theories in both values and public benefits. • Ex. Which area or target population should have priority for health resources over others? • Social medicine involves the “value” when studying health policy. • Social medicine also involves the “justice” that how the resources were distributed. Section 3 The History and the Trend of Social Medicine 1.The development western social medicine (1)The embryonic stage of social medicine Famous character 1： Hippocrates(450-377B.C.) Book: Air ,Water and Region Famous Italian Ramazzini2 ： The character (A.D.1669～1714) in his famous book Disease in Handicraft Industry described the health status of workers from 52 different occupations and the effects these (about A.D pay attention to he city’s Galen:Doctors should130-200,health;the is called the factors have on people’s an ancient doctor natural environment, such as in Romefather of Labor medicine wind direction, ) by posterity. sunlight, and water quality, local plants’ growth Paracelsus: (A.D 1493-1541) He thought that it and to the citizen’s life-style. was more important <mercury disease>to understand patients than patients’ disease during medical practice. Ramazzini: (A.D 1669-1741) <disease in handicraft industry> New social health problems arose along with industrialization and urbanization, such as urban During Industrial Revolutionworking environment, workers’ adverse conditions and food hygiene problems. “miserable life was a hotbed of diseases” “a medical supervision plan could be used to Johann Peter Frank: German social make hygienist the government take measures to protect public health” Friedrichwas the firsthis book British social 《the national medicalwho usedWorkinghealth He Engel’s in man supervision Class Situation said : measures system》 to control disease,from the a and made British industry had been the development of great contribution to built up public Engels: Friedrich health andin health. And the workers’ workers’ break down social medicine. movement promoted the establishment of the 《British Working Class Situation》 social health organization and social health measures were improved step by step. 2. The forming and development period Background: 1784 steam engine 1789 French revolution Jules Guerin (1801-1886)French doctor Social physiology Social Pathology Social Hygiene Social therapeutics • Social physiology researching the relationship between people,s health status and social system;law,customs and habits。 • Social pathology researching the relationship between diseases and social problems。 • social hygiene researching how to promote health and protect disease。 • Social therapeutics researching how to cure disease when there was an abnormal social situation。 Rudolf Virchow (German pathologist) “the kernel of medical science is social science, while politics is just medicine in a broad sense ” How to understand the sentence? Social medicine as a course 1920, the social hygiene course was given in Berlin University 1940s a social medicine research institute was established in Oxford University Social medicine in Britain and America In Britain, in 1960s social medicine has been changed into community medicine. In America, social medicine was included and taught in the course of health management and health policy. 2.The development of social medicine in China ancient time : forming nature philosophy medical model , there are Many Concepts of “heaven and man”, “correspondence between man and universe”. 1949-1978 With the spread of venereal disease and snail fever controlled, the mass health conditions have been changed greatly. A public health college was set up in the China medical university in 1949. In Modern time since 1980s Academy: social medicine and health care management become independent subject in many academies; social medicine emerged as a main course in teaching. Journals: Medicine and philosophy Social Medicine of China Medical ethics of China Education Degree of Social Medicine Bachelor Master Doctor Research ： Health services research Sociopath( suicide , traffic accidents,Addictive Sociopath) The evaluation of quality of life 4. A comparison between China and western countries gap Reason: economic; government; and society Current situation question for review 1.What’s the objectives of social medicine? 2. what’s the nature of social medicine? 3. what’s the related subjects to social medicine?
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