第一章 社會(huì)醫(yī)學(xué)概論1.ppt

1、,社會(huì)醫(yī)學(xué),Social Medcine,王志忠 Wang Zhi Zhong,寧夏醫(yī)科大學(xué)公共衛(wèi)生學(xué)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(huì)醫(yī)學(xué)的概念、性質(zhì)、內(nèi)容和任務(wù) 社會(huì)醫(yī)學(xué)的發(fā)展 社會(huì)醫(yī)學(xué)基本觀點(diǎn) 社會(huì)醫(yī)學(xué)與其他學(xué)科的關(guān)系,concept, nature, contents and tasks Devel

2、opment Basic thinking Relation with other subjects,What is social medicine?什么是社會(huì)醫(yī)學(xué)？,Medicine,sociology,社會(huì)學(xué) 政治學(xué) 經(jīng)濟(jì)學(xué) 倫理學(xué) 管理學(xué),基礎(chǔ)醫(yī)學(xué) 臨床醫(yī)學(xué) 預(yù)防醫(yī)學(xué),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(xué)科，研究： 1. 社會(huì)因素 健康和疾病 2. 制定

3、社會(huì)衛(wèi)生策略和措施 3. 保護(hù)和促進(jìn)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(huì)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(huì)因素; 研究社會(huì)衛(wèi)生策略與措施。,社會(huì)醫(yī)學(xué)的核心內(nèi)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(huì)醫(yī)學(xué)診斷 - 社會(huì)病因分析 - 社會(huì)醫(yī)學(xué)處方,社會(huì)醫(yī)學(xué)與臨床醫(yī)學(xué)的比較,社會(huì)醫(yī)學(xué)：群體 social medicine: mainly target at population level 發(fā)現(xiàn)社會(huì)問題社會(huì)診斷 Identify social problemsocial diagnosis 社會(huì)醫(yī)學(xué)分析了解社會(huì)成因 Social medical an

5、alysisfind out social causes 社會(huì)醫(yī)學(xué)綜合處方 Social comprehensive therapy,臨床醫(yī)學(xué)：主要針對個(gè)體 Clinical medicine: mainly target at individual level 了解個(gè)體健康問題醫(yī)學(xué)診斷 Identify individual health problem-medical diagnosis 開展病因?qū)W分析: 主要是生物學(xué)病因分析 Etiological analysis: biological causes analysis 制定醫(yī)學(xué)處方 Provide medical prescripti

6、on,社會(huì)醫(yī)學(xué)的性質(zhì) The Nature of Social Medicine,Interdisciplinary subjectsocial science and medicine Synthetic research methods Practicality of social medicine,醫(yī)學(xué)和社會(huì)學(xué)的交叉學(xué)科 采用綜合的研究方法 社會(huì)醫(yī)學(xué)的實(shí)踐性,社會(huì)醫(yī)學(xué)的任務(wù)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(zhì)量; 制定衛(wèi)生政策和策略； 開展特殊人群和特種疾病的預(yù)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(xué)者M(jìn)ushkin計(jì)算出了美國在19001960年人口

8、死亡率下降帶來的經(jīng)濟(jì)收益約為8200億 疾病對人力資本和勞動(dòng)生產(chǎn)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(xiàn)代醫(yī)學(xué)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(hào)殺手,IV.關(guān)注高危人群 四體液學(xué)說體現(xiàn)了整體醫(yī)學(xué)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(huì)衛(wèi)生學(xué)家:弗蘭克: 悲慘的生活是疾病的溫床; : 用醫(yī)學(xué)監(jiān)督計(jì)劃使政府采取措施保護(hù)公眾的健康; 第一個(gè)提出社會(huì)衛(wèi)生措施,社會(huì)醫(yī)學(xué)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(huì)醫(yī)學(xué); 建議將分散的醫(yī)學(xué)監(jiān)督、公共衛(wèi)生、法醫(yī)學(xué)構(gòu)成一個(gè)整體：社會(huì)醫(yī)學(xué)分為四個(gè)部分； 社會(huì)生理學(xué)； 社會(huì)病理學(xué)； 社會(huì)衛(wèi)生學(xué)； 社會(huì)治療學(xué)。,德國病理學(xué)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(xué)科學(xué)的核心是社會(huì)科學(xué) 醫(yī)學(xué)是一門社會(huì)科學(xué)；任何社會(huì)都應(yīng)對居民的健康負(fù)責(zé) 政治學(xué)是廣義上的醫(yī)學(xué) 實(shí)現(xiàn)醫(yī)學(xué)目標(biāo)的最好的辦法是將醫(yī)學(xué)和社會(huì)生活和政治活動(dòng)結(jié)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(huì)病理學(xué)的理論和概念; 用社會(huì)觀點(diǎn)研究人類疾病的原則 首次在柏林大學(xué)開設(shè)社會(huì)衛(wèi)生學(xué)講座,Germany： Birthplace of social medicine,Before WWII Social hygiene Social medicine Laterbecome social medicine,德國是社會(huì)醫(yī)學(xué)的發(fā)源地 二戰(zhàn)前

14、：使用社會(huì)衛(wèi)生學(xué)和社會(huì)醫(yī)學(xué) 后改為社會(huì)醫(yī)學(xué),社會(huì)醫(yī)學(xué)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(shè)社會(huì)醫(yī)學(xué), 在牛津大學(xué)成立社會(huì)醫(yī)學(xué)研究院； 牛津大學(xué)賴爾教授:公共衛(wèi)生、工業(yè)衛(wèi)生、社會(huì)衛(wèi)生服務(wù)、公共醫(yī)療事業(yè)都屬于社會(huì)醫(yī)學(xué)的范疇； 60s社會(huì)醫(yī)學(xué)改成社區(qū)醫(yī)學(xué)。,社會(huì)醫(yī)學(xué)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(xué)社會(huì)學(xué)和家庭醫(yī)學(xué)得到了發(fā)展 強(qiáng)調(diào)社會(huì)學(xué)、管理學(xué)和經(jīng)濟(jì)學(xué) 社會(huì)醫(yī)學(xué)包含在衛(wèi)生管理學(xué)和衛(wèi)生政策學(xué)的講座內(nèi)容中,社會(huì)醫(yī)學(xué)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(xué)作為醫(yī)學(xué)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(xùn)中心，社會(huì)醫(yī)學(xué)成為主干課程 90%以上的醫(yī)學(xué)院開設(shè)了社會(huì)醫(yī)學(xué)課程,Preventive medicine Community medicine Medical sociology Health management Medical psycho

18、logy,社會(huì)醫(yī)學(xué)與其他相關(guān)學(xué)科的關(guān)系The relationship between social medicine and other related subjects,預(yù)防醫(yī)學(xué) 社區(qū)醫(yī)學(xué) 醫(yī)學(xué)社會(huì)學(xué) 衛(wèi)生管理學(xué) 醫(yī)學(xué)心理學(xué),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