社会医学1课件

1、社会医学Social Medicine 社会医学教研室 第一章 概 论Chapter one Introduction社会医学的概念、性质、内容和任务社会医学的发展社会医学基本观点社会医学与其他学科的关系concept, nature, contents and tasksDevelopment Basic thinking Relation with other subjectsWhat is social medicine?什么是社会医学？Medicinesociology社会学政治学经济学伦理学管理学基础医学临床医学预防医学Human behavior Culture Value Str

2、ucture of society Social interaction Socialization Social institutions Dynamic of Society Social change Social life Sociology What is medicine?什么是医学The science related to the diagnosis understanding prevention treatment of illness. Human being is more of the social creature than the animal. its soci

3、al 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.Why we need to look at the social factors? 人的本质属性：在于其社会属性WHO： 1948新的健康定义: 健康是： 身体 心理 社会 的完好状态，而不仅是没有疾病或身体

4、虚弱而已。人类的双重属性The dual nature of human beings Aristotle : human beings are, by nature, social animals 社会属性 Social nature 生物属性 Biological natureDoes it matter to health?霍普金斯大学的研究小组通过对伊拉克全国47个区进行调查走访形成的报告认为，美国发动伊拉克战争造成了65.5万伊拉克人死亡，平均每天死亡500人 人口爆炸！非洲难民美国哥伦比亚大学教授、联合国前秘书长安南的特别顾问JEFFREY SACHS先生SACHS教授说：2003

5、年的发展议题被挤出了国际议程，战争与反恐取代了发展。 艾滋病每天夺去数以千计的生命，由于贫困买不起挽救生命的药品而死亡； “911”灾难夺走了3000多人的生命，从而主宰了两年多的世界议程。 世界上每天有20，000多人死于贫困、疾病、灾害 世界军费开支将达9000亿美元，而用于发展援助为500亿美元，用于艾滋病防治仅10亿美元。Rudolf Virchow: German pathologist1. Social and economic conditions profoundly impact health, disease and the practice of medicine. 2.

6、 The health of the population is a matter of social concern. 3. Society should promote health through both individual and social means. 1. 社会经济条件对健康、疾病和医学实践具有深刻的影响；2. 群体的健康应该成为社会关注的内容;3. 社会应该通过个人和社会的手段来改善人群健康。 社会医学的核心内容 Core Contents Identify social health problems diagnosis of problems Analysis of

7、social causes of diseases social etiologySocial medicine prescription- social strategy - 社会医学诊断- 社会病因分析- 社会医学处方 社会医学与临床医学的比较社会医学：群体 social medicine: mainly target at population level发现社会问题社会诊断 Identify social problemsocial diagnosis社会医学分析了解社会成因 Social medical analysisfind out social causes社会医学综合处方 S

8、ocial comprehensive therapy临床医学：主要针对个体 Clinical medicine: mainly target at individual level了解个体健康问题医学诊断 Identify individual health problem-medical diagnosis开展病因学分析: 主要是生物学病因分析 Etiological analysis: biological causes analysis制定医学处方 Provide medical prescription社会医学的任务The tasks of social medicineAdvoca

9、te positive concept of healthTo improve social health status, enhance population health and quality of life To formulate health policy & strategiesTo conduct preventive care services for special population and specific disease 倡导积极的健康观改善社会卫生状况;提高人群健康水平和生命质量;制定卫生政策和策略；开展特殊人群和特种疾病的预防保健工作; Basic thinki

10、ng of social medicineHarmonious relationship between health and social developmentTwo way interaction between health and social economic developmentI.协调发展的观念II.双向作用的观念美国学者Mushkin计算出了美国在19001960年人口死亡率下降带来的经济收益约为8200亿疾病对人力资本和劳动生产率造成损失的“3D”框架 (Death, Disability， Debility）Basic thinking of social medici

11、nePositive concept of healthBio-psycho-social medical modelIII. 现代医学模式下的积极健康观USA19000亿1%最不健康2020慢病病人70 70%健康人10%吸烟已成为全球第二号杀手IV.关注高危人群&高危因素High risk factors & populationBasic thinking of social medicineBasic thinking of social medicineImportant role of social factors in prevention and treatment of di

12、seasesMultisector participationV.社会因素在疾病防治中的重要作用VI.多部门参与人事人口&计划生育劳动&社会保障教育计划、财政药品监督管理卫生社会医学发展史The history of social medicineEmbryonic stage of social medicineEstablishment & development of social medicineDevelopment of social medicine in China社会医学的萌芽 社会医学的创立和发展我国社会医学的发展 Pathogenesis of disease and t

13、he role of doctorsThe 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.饮食和气候等外部因素可以通过影响人类的内在机制而起左右。医生的职责是恢复健康平衡;四体液学说体现了整体医学

14、观 Embryonic stage of social medicine1.Galen: focus on psychological factors upon health；2.Peter Frank: miserable life is the hotbed of diseases; “the National Supervision System”supervision plangovernment measures to protect public health First person put forward: adopt social health measures to con

15、trol disease古罗马医师盖伦：重视心理因素对健康的影响;德国社会卫生学家:弗兰克: 悲惨的生活是疾病的温床; : 用医学监督计划使政府采取措施保护公众的健康; 第一个提出社会卫生措施德国病理学家 魏尔啸German Pathologist: Rudolf VirchowThe kernel of medical science is social science“Medicine is a social sciencePolitics is nothing more than medicine in broad senseBest method of medicine is to c

16、ombine medicine with social life and political activities医学科学的核心是社会科学医学是一门社会科学；任何社会都应对居民的健康负责政治学是广义上的医学实现医学目标的最好的办法是将医学和社会生活和政治活动结合起来 德国：格罗蒂杨German A.GrotjahnPut forward theory of social pathologyWrite : “ social Pathology” suggests that disease should be studied from the standpoint of social view;I

17、s a first person given lecture on social hygiene 提出社会病理学的理论和概念;用社会观点研究人类疾病的原则首次在柏林大学开设社会卫生学讲座 Germany： Birthplace of social medicineBefore WWIISocial hygieneSocial medicineLaterbecome social medicine德国是社会医学的发源地二战前：使用社会卫生学和社会医学后改为社会医学 社会医学在各国的发展Development of Social Medicine in different countries In

18、 UK, course of social medicine is offered, social medicine research institute was established in Oxford UniversityProfessor John Ryle: all public health, industrial health, social health and medical care belong to social medicineIn 1960s, social medicine was changed into community medicine 英国: 40s 开

19、设社会医学, 在牛津大学成立社会医学研究院；牛津大学赖尔教授:公共卫生、工业卫生、社会卫生服务、公共医疗事业都属于社会医学的范畴；60s社会医学改成社区医学。 社会医学在美国的发展In United StatesMedical sociology and family medicine developedEmphasis on sociology, management and economicsSocial medicine was included in the course of health management and health policy医学社会学和家庭医学得到了发展强调社会

20、学、管理学和经济学社会医学包含在卫生管理学和卫生政策学的讲座内容中 社会医学在中国的发展Social medicine in ChinaIn 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

21、course in social medicine.50年代：保健组织学作为医学生的必修课，成立保健组织教研组80年代：卫生部成立6所卫生管理干部培训中心，社会医学成为主干课程90%以上的医学院开设了社会医学课程Preventive medicineCommunity medicineMedical sociologyHealth managementMedical psychology 社会医学与其他相关学科的关系The relationship between social medicine and other related subjects 预防医学社区医学医学社会学卫生管理学 医学心

22、理学Preventive MedicinePreventive 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 medicineSocial

23、Medicine Vs Community MedicineCommunity medicineMore practical OperationalBoth target at population levelIntermediate levelShare same origin with social medicineThe Practice of social medicine facilitate the development of theory of social medicine Social medicineMore theoretical Macro mainly at policy levelOffer guiding principleTheory of social medicine be practiced in community medicineMore theoretical, offer principle and guidance to CM Medical SociologyMedical sociology belong to the disciplinary group of sociology;C