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What is Social Medicine? Meaning and scope

This history dates back (at least) to the early nineteenth century when the systematic study of the relationships between society, disease, and medicine began in earnest.

What is Social Medicine? Meaning and scope:


This history dates back (at least) to the early nineteenth century when the systematic study of the relationships between society, disease, and medicine began in earnest. This study—and the forms of medical practice derived from it—became known as “social medicine.” Over time the term “social medicine” took on varied meanings as it was adapted to differing societies and diverse social conditions. Nonetheless, certain common principles underlie the term:

·              Social and economic conditions profoundly impact health, disease, and the practice of medicine.


·              The health of the population is a matter of social concern.


·              Society should promote health through both individual and social means.


Social conditions contribute to ill health. This was described as early as the 19th century by Rudolf Virchow, generally considered the founder of social medicine.

Social medicine, an approach to the prevention and treatment of disease that is based on the study of human heredity, environment, social structures, and cultural values.


It is the field of medicine that studies the impact of the collective behavior of organized society on individuals belonging to various, often disadvantaged, subgroups within the society. This is found in Engel’s phenomenon of Homelessness, Latchkey children, Supermom. Socialized medicine.


It is a specialized field of medical knowledge concentrating on the social, cultural, and economic impact of medical phenomena. The field of social medicine seeks to: understand how social and economic conditions impact health, disease and the practice of medicine and foster conditions in which this understanding can lead to a healthier society.


This type of study began formally in the early 19th century. The Industrial Revolution and the subsequent increase in poverty and disease among workers raised concerns about the effect of social processes on the health of the poor.


Prominent figures in the history of social medicine include Rudolf Virchow, Salvador Allende, and more recently Paul Farmer and Jim Yong Kim.


More specifically, Farmer et al. (2006) state that "Biosocial understandings of medical phenomena [such as the social determinants of health] are urgently needed". Paul Farmer's view is that modern medicine is focused at the molecular level, and there is a "gap" between social analysis and everyday clinical practices

Moreover, Farmer, Nizeye, Stulac and Keshavjee (2006) view social medicine with increasing importance as scientific inquiry is increasingly "desocialized". The latter refers to "...a tendency to ask only biological question about what are in fact biosocial phenomena.


The field of social medicine is most commonly addressed today by public health efforts to understand what are known as social determinants of health.


Social medicine is distinguished from medico biological and clinical disciplines that study healthy and diseased states of the body.

Social medicine is closely related to the social sciences, including political economy, sociology, demography, and the general theory of administration. It concentrates primarily on social conditions and studies the interrelationships between social and biological factors in medicine. Evaluations are made primarily on the basis of statistics.

Social medicine also utilizes evaluations made by specialists in various fields, experiments, models, questionnaires, and the historical method.


The bases of social medicine are associated with the study of occupational diseases, medico topographical data, and publichealth statistics. In the late 18th century the use of J. P. Frank’s system of medical police promoted the state regulation of public health. In the 19th century the development of social medicine was associated with the rise of capitalism and with bourgeoisdemocratic revolutions. In Great Britain, France, Germany, and other countries data were gathered on how working and living conditions affected the health of workers. Statistical methods were used in making evaluations, and attempts were made to substantiate scientifically publichealth measures. The term “social medicine” was introduced at this time.


From the late 18th century until the 1870’s specific issues were presented in medical police and socialmedicine courses in various countries. At the turn of the 20th century chairs of social medicine were established, and independent courses in social medicine and social hygiene were given by A. V. KorchakChepurkovskii in Kiev (from 1906), A. I. Shingarev in St. Petersburg (from 1908), L. Teleky in Vienna (from 1909), and A. Grotjahn in Berlin (from 1912). The subsequent development of social medicine proceeded under the influence of social democratic ideas and the class struggle of the proletariat in capitalist countries.


The organizational basis of social medicine is the Soviet system of public health, which is directed toward the socioeconomic transformation of society and the elimination of social roots generating diseases and which makes available state measures for the protection of the health of citizens. It is under socialist conditions that social medicine is best able to elaborate the scientific bases for therapeutic preventive measures fostering the harmonious physical and spiritual development of man and promoting maximum life expectancy. The development of social medicine and the introduction of preventive medicine into medical practice and into the system of medical education were promoted by the activities of the sub departments of social medicine created in the First Moscow State University (N. A. Semashko, 1922), the Second Moscow State University (Z. P. Solov’ev, 1923), and the State Institute of Social Medicine (A. V. Mol’kov, 1923). Sub departments of social medicine were later created in all higher medical institutions.


The leading scientific center on social medicine and publichealth administration is the N. A. Semashko AllUnion Scientific Research Institute of Social Medicine and the Organization of Public Health of the Ministry of Public Health of the USSR (Moscow). Research is being conducted in the USSR on theoretical issues of social medicine and the organization of public health, on social conditions and the health of the population, and on the scientific foundations of the economics and planning of public health. An automated publichealth planning and administration system is being developed, and the scientific foundations of the organization of medical care and the training and education of the population in social medicine are under study. Social medicine is part

of the curriculum at several institutions outside the USSR, including the Institute of Social Hygiene and Health Organization of the People’s Republic of Bulgaria, the Academy for Advanced Training of Physicians in the German Democratic Republic, and the Institute of Social Medicine and Organization of Public Health of the Czechoslovak Socialist Republic. AllUnion, republic, and local societies of hygienists and publichealth physicians have groups specializing in social medicine. International organizations that function in the area of social medicine include the World Health Organization (founded 1948), the International Medical Association for the Study of Living Conditions and Health (founded 1951), and the European Association of Social Medicine (founded 1955).


In the USSR, social medicine is taught at medical institutes by departments of therapeutics, pediatrics, and public health and hygiene under the control of sub departments of social medicine and publichealth organizations (from 1941 to 1966— subdepartments of publichealth organizations). Outside the USSR it is controlled by sub departments of social medicine, publichealth organizations, and community health protection.


The most important domain of social medicine is the culture itself. Health professionals and institutions have their own cultures that also go beyond clinical interactions. Health systems and health research both contain agendas, prejudices, and beliefs that can lead to certain perspectives being favored as the most legitimate. Understanding the culture of medicine is essential to understanding health professionals' attitudes toward illness, patients, and treatments.

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