第一章 社會醫(yī)學概論1.ppt

1、,社會醫(yī)學,Social Medcine,王志忠 Wang Zhi Zhong,寧夏醫(yī)科大學公共衛(wèi)生學院,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 論,社會醫(yī)學的概念、性質、內容和任務 社會醫(yī)學的發(fā)展 社會醫(yī)學基本觀點 社會醫(yī)學與其他學科的關系,concept, nature, contents and tasks Devel

2、opment Basic thinking Relation with other subjects,What is social medicine?什么是社會醫(yī)學？,Medicine,sociology,社會學 政治學 經濟學 倫理學 管理學,基礎醫(yī)學 臨床醫(yī)學 預防醫(yī)學,What is medicine?,The science related to the diagnosis understanding prevention treatment of illness.,What is social medicine?,定義： 是一門交叉學科，研究： 1. 社會因素 健康和疾病 2. 制定

3、社會衛(wèi)生策略和措施 3. 保護和促進健康,1. Interactions and law between the social factors and health 3. Protect health Influence factors ; especially social factors Social health strategies and measures;,研究社會衛(wèi)生狀況，主要 是人群健康狀況; 研究影響人群健康的因素， 主要是社會因素; 研究社會衛(wèi)生策略與措施。,社會醫(yī)學的核心內容 Core Contents,Identify social health problems di

4、agnosis of problems Analysis of social causes of diseases social etiology Social medicine prescription- social strategy,- 社會醫(yī)學診斷 - 社會病因分析 - 社會醫(yī)學處方,社會醫(yī)學與臨床醫(yī)學的比較,社會醫(yī)學：群體 social medicine: mainly target at population level 發(fā)現社會問題社會診斷 Identify social problemsocial diagnosis 社會醫(yī)學分析了解社會成因 Social medical an

5、alysisfind out social causes 社會醫(yī)學綜合處方 Social comprehensive therapy,臨床醫(yī)學：主要針對個體 Clinical medicine: mainly target at individual level 了解個體健康問題醫(yī)學診斷 Identify individual health problem-medical diagnosis 開展病因學分析: 主要是生物學病因分析 Etiological analysis: biological causes analysis 制定醫(yī)學處方 Provide medical prescripti

6、on,社會醫(yī)學的性質 The Nature of Social Medicine,Interdisciplinary subjectsocial science and medicine Synthetic research methods Practicality of social medicine,醫(yī)學和社會學的交叉學科 采用綜合的研究方法 社會醫(yī)學的實踐性,社會醫(yī)學的任務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質量; 制定衛(wèi)生政策和策略； 開展特殊人群和特種疾病的預防保健工作;,Basic thinking of social medicine,Harmonious relationship between health and social development Two way interaction between health and social economic development,美國學者Mushkin計算出了美國在19001960年人口

8、死亡率下降帶來的經濟收益約為8200億 疾病對人力資本和勞動生產率造成損失的“3D”框架 (Death, Disability， Debility）,Basic thinking of social medicine,Positive concept of healthBio-psycho-social medical model,III. 現代醫(yī)學模式下的積極健康觀,USA 19000億,1%最不健康,20,20慢病病人,70,70%健康人,10%,吸煙已成為全球第二號殺手,IV.關注高危人群 四體液學說體現了整體醫(yī)學觀,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,古羅馬醫(yī)師蓋倫：重視心理因素對健康的影響;

10、德國社會衛(wèi)生學家:弗蘭克: 悲慘的生活是疾病的溫床; : 用醫(yī)學監(jiān)督計劃使政府采取措施保護公眾的健康; 第一個提出社會衛(wèi)生措施,社會醫(yī)學的建立和發(fā)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,法國醫(yī)生儒勒.蓋林第一次提出社會醫(yī)學; 建議將分散的醫(yī)學監(jiān)督、公共衛(wèi)生、法醫(yī)學構成一個整體：社會醫(yī)學分為四個部分； 社會生理學； 社會病理學； 社會衛(wèi)生學； 社會治療學。,德國病理學家 魏爾嘯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,醫(yī)學科學的核心是社會科學 醫(yī)學是一門社會科學；任何社會都應對居民的健康負責 政治學是廣義上的醫(yī)學 實現醫(yī)學目標的最好的辦法是將醫(yī)學和社會生活和政治活動結合起來,德國：格羅蒂楊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,提出社會病理學的理論和概念; 用社會觀點研究人類疾病的原則 首次在柏林大學開設社會衛(wèi)生學講座,Germany： Birthplace of social medicine,Before WWII Social hygiene Social medicine Laterbecome social medicine,德國是社會醫(yī)學的發(fā)源地 二戰(zhàn)前

14、：使用社會衛(wèi)生學和社會醫(yī)學 后改為社會醫(yī)學,社會醫(yī)學在各國的發(fā)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,英國: 40s 開設社會醫(yī)學, 在牛津大學成立社會醫(yī)學研究院； 牛津大學賴爾教授:公共衛(wèi)生、工業(yè)衛(wèi)生、社會衛(wèi)生服務、公共醫(yī)療事業(yè)都屬于社會醫(yī)學的范疇； 60s社會醫(yī)學改成社區(qū)醫(yī)學。,社會醫(yī)學在美國的發(fā)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,醫(yī)學社會學和家庭醫(yī)學得到了發(fā)展 強調社會學、管理學和經濟學 社會醫(yī)學包含在衛(wèi)生管理學和衛(wèi)生政策學的講座內容中,社會醫(yī)學在中國的發(fā)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：保健組織學作為醫(yī)學生的必修課，成立保健組織教研組 80年代：衛(wèi)生部成立6所衛(wèi)生管理干部培訓中心，社會醫(yī)學成為主干課程 90%以上的醫(yī)學院開設了社會醫(yī)學課程,Preventive medicine Community medicine Medical sociology Health management Medical psycho

18、logy,社會醫(yī)學與其他相關學科的關系The relationship between social medicine and other related subjects,預防醫(yī)學 社區(qū)醫(yī)學 醫(yī)學社會學 衛(wèi)生管理學 醫(yī)學心理學,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