第一章 社会医学概论1

,*,政策：政策是指政党和国家,(,或者政府,),在一 定历史时期为实现某种政策目标或完 成某项任务而制定的行为规范和活动 指南，是进行政治决策的一种成果形式。,WHO,卫生政策定义：“改善卫生状况的目标，这些目标中的重点，以及实现这些重点目标的主要途径。,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,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,Development,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,2.Stipulate social health strategy and measures;,3.Protect health&improve life quality,give the full display of the social function of health.,Human being is more of,the social creature than the animal.,its social attribute is the fundamental nature.,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,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 nature,Does it matter to health?,Whats Relationship between social factors and health?WHO put forward:Social determinants for Health,Politics,Economy,Culture,Environment,Social security system,Life style and behaviors,Health care system,政治,经济,文化,环境,社会保障制度,生活方式和行为,卫生保健体制,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,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 pathologist,1.Social and economic conditions profoundly impact health,disease and the practice of medicine.,2.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,社会医学的研究内容,Contents of social medicine:,Social health status,mainly population health status;,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,diagnosis of problems,A,nalysis 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 analysisfind 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 prescription,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 population health and quality of life,To,formulate health policy&strategies,To 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 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,1900,1960,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 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,&,高危因素,High risk factors&,population,Basic thinking of social medicine,Basic thinking of social medicine,Important role of social factors in prevention and treatment of diseases,Multisector participation,V.,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 medicine,Embryonic stage of social medicine,Establishment&development of social medicine,Development 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,Embryonic stage of social medicine:Hippocrates,“,Air,Water and Places,”,stress on the impacts of environment,wind direction,sunlight,water quality,and citizen,s life style on people,s,health.,-,“,It is more important to know what sort of person has a disease th