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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.
In 1976, the British public health scientist and health care critic, Thomas McKeown, MD, published the The role of medicine: Dream, mirage or nemesis?, wherein he summarized facts and arguments that supported what became known as the McKeown's thesis, i.e. that the growth of population can be attributed to a decline in mortality from infectious diseases, primarily thanks to better nutrition, later also to better hygiene, and only marginally and late to medical interventions such as antibiotics and vaccins. McKeown was heavily criticized for his controversial ideas, but is nowadays remembered as 'the founder of social medicine'.
The major emphasis on biomedical science in health care and medical research has resulted into a gap with our understanding and acknowledgement of far more important social determinants of public health and individual disease: social-economic inequalities, war, illiteracy, detrimental life-styles (smoking, obesity), discrimination because of race, gender and religion. Farmer et al. (2006) gave the following explanation for this gap:
'One reason for this gap is that the holy grail of modern medicine remains the search for a molecular basis of disease. While the practical yield of such circumscribed inquiry has been enormous, exclusive focus on molecular-level phenomena has contributed to the increasing "desocialization" of scientific inquiry: a tendency to ask only biological questions about what are in fact biosocial phenomena.'
They further concluded that 'Biosocial understandings of medical phenomena are urgently needed'.
- social epidemiology
- social psychology
- socialized medicine
- Society for Social Medicine
- medical anthropology
- medical sociology
- Social determinants of health in poverty
- McKeown, Thomas and Lowe, C.R. (1966). An Introduction to Social Medicine. Oxford and Edinburgh: Blackwell Scientific Publications.
- Farmer, Paul (2002). Social medicine and the challenge of biosocial research. In: Opolka U, Schoop H (editors): Innovative Structures in Basic Research: Ringberg-Symposium, 4–7 October 2000. München: Max-Planck-Gesellschaft. pp. 55–73.
- McKeown, Thomas (1976). The Role of Medicine: Dream, Mirage or Nemesis? (The Rock Carlington Fellow, 1976). London, UK: Nuffield Provincial Hospital Trust. ISBN 0-900574-24-0.
- Deaton, Angus (2013). The Great Escape. Health, wealth, and the origins of inequality. Princeton and Oxford: Princeton University Press. pp. 91–93. ISBN 978 0 691 15354 4.
McKeown's views, updated to modern circumstances, are still important today in debates between those who think that health is primarily determined by medical discoveries and medical treatment and those who look to the background social conditions of life.
- Farmer, Paul, Bruce Nizeye, Sarah Stulac, and Salmaan Keshavjee (2006). "Structural violence and clinical medicine". PLoS Medicine. v.3(10): e449.
- Social Medicine: http://journals.sfu.ca/socialmedicine/index.php/socialmedicine/index
- Social Medicine Portal: http://www.socialmedicine.org/
- Porter D (2006). "How Did Social Medicine Evolve, and Where Is It Heading?". PLoS Med. 3 (10): e399. doi:10.1371/journal.pmed.0030399. PMC . PMID 17076552.
- Matthew R. Anderson, Lanny Smith, and Victor W. Sidel. What is Social Medicine? Monthly Review: 56(8). http://www.monthlyreview.org/0105anderson.htm
- King NMP, Strauss RP, Churchill LR, Estroff SE, Henderson GE, et al. editors (2005) Patients, doctors, and illness. Volume I: The social medicine reader 2nd edition Durham: Duke University Press.
- Henderson GE, Estroff SE, Churchill LR, King NMP, Oberlander J, et al. editors (2005) Social and cultural contributions to health, difference, and inequality. Volume II: The social medicine reader 2nd edition Durham: Duke University Press.
- Oberlander J, Churchill LR, Estroff SE, Henderson GE, King NMP, et al. editors (2005) Health policy, markets, and medicine. Volume III: The social medicine reader 2nd edition Durham: Duke University Press.
- Porter D, Porter R (1988). "What was social medicine? An historiographical essay". J Hist Sociol. 1: 90–106. doi:10.1111/j.1467-6443.1988.tb00005.x.
- Stonington S, Holmes SM (2006). "Social medicine in the twenty-first century". PLoS Med. 3 (10): e445. doi:10.1371/journal.pmed.0030445.