第一章 社会医学概论1.ppt

1、,社会医学,Social Medcine,王志忠 Wang Zhi Zhong,宁夏医科大学公共卫生学院,Objects,1. Grasp the conception of social medicine 2. Understand the basic thinking of SM 3. Think about the relationship between SM and other courses,第一章 概 论,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 tasks Devel

2、opment Basic thinking Relation with other subjects,What is social medicine?什么是社会医学？,Medicine,sociology,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,What is medicine?,The science related to the diagnosis understanding prevention treatment of illness.,What is social medicine?,定义： 是一门交叉学科，研究： 1. 社会因素 健康和疾病 2. 制定

3、社会卫生策略和措施 3. 保护和促进健康,1. Interactions and law between the social factors and health 3. Protect health Influence factors ; especially social factors Social health strategies and measures;,研究社会卫生状况，主要 是人群健康状况; 研究影响人群健康的因素， 主要是社会因素; 研究社会卫生策略与措施。,社会医学的核心内容 Core Contents,Identify social health problems di

4、agnosis of problems Analysis of social causes of diseases social etiology Social 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 an

5、alysisfind out social causes 社会医学综合处方 Social 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 prescripti

6、on,社会医学的性质 The Nature of Social Medicine,Interdisciplinary subjectsocial science and medicine Synthetic research methods Practicality of social medicine,医学和社会学的交叉学科 采用综合的研究方法 社会医学的实践性,社会医学的任务The tasks of social medicine,Advocate positive concept of health To improve social health status, enhance pop

7、ulation health and quality of life To formulate health policy 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 thinking of social medicine,Harmonious relationship between health and social development Two way interaction between health and social economic development,美国学者Mushkin计算出了美国在19001960年人口

8、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 medicine,Positive concept of healthBio-psycho-social medical model,III. 现代医学模式下的积极健康观,USA 19000亿,1%最不健康,20,20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 四体液学说体现了整体医学观,Embryonic stage of social medicine,

9、1.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 control disease,古罗马医师盖伦：重视心理因素对健康的影响;

10、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,社会医学的建立和发展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

11、 parts: Social physiology Social pathology Social hygiene Social therapeutics,法国医生儒勒.盖林第一次提出社会医学; 建议将分散的医学监督、公共卫生、法医学构成一个整体：社会医学分为四个部分； 社会生理学； 社会病理学； 社会卫生学； 社会治疗学。,德国病理学家 魏尔啸German Pathologist: Rudolf Virchow,The kernel of medical science is social science “Medicine is a social science Politics is n

12、othing more than medicine in broad sense Best method of medicine is to combine 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.Grotjahn,Put forward theory of social pathology Write : “ social Pathology

13、” suggests that disease should be studied from the standpoint of social view; Is 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 medicine,Before WWII Social hygiene Social medicine Laterbecome social medicine,德国是社会医学的发源地 二战前

14、：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 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

15、to social medicine In 1960s, social medicine was changed into community medicine,英国: 40s 开设社会医学, 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 States,Medical sociology and family medicine developed Emphasis on sociology, management and economics Socia

16、l 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 China,In 50s, course of Health Care Organization is a compulsory course for medical student,； In 80s, Ministry of Health set up 6 training

17、centre of health administration, social medicine was the main course； 90% of medical college offered 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 medicine Community medicine Medical sociology Health management Medical psycho

18、logy,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 医学心理学,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

19、 focus on medical prevention Bio-preventive strategy mainly Social medicine grow out of preventive medicine,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 so

20、cial 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,Medical Sociology,Medical sociology belong to the disciplinary group of sociology; Concerned with socialcauses and consequences of health andillness; Social aspects of health and ill