DOCSLIB.ORG

Community Mental Health, Primary Health Care, and Health-Promoting Universities in Ecuador*

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Community Mental Health, Primary Health Care, and Health-Promoting Universities in Ecuador* Pan American Journal Special report of Public Health Community mental health, primary health care, and health-promoting universities in Ecuador* Victoriano Camas Baena1 Suggested citation (original manuscript) Camas Baena V. Salud mental comunitaria, atención primaria de salud y universidades promotoras de salud en Ecuador. Rev Panam Salud Publica. 2018;42:e162. https://doi.org/10.26633/RPSP.2018.162 ABSTRACT The objective of this paper is to describe the current situation of mental health in Ecuador. In Ecuador, although the model of community mental health has been integrated into primary health care services for a decade, its implementation does not seem to have achieved the expected results. It is pertinent to explore the causes of this situation and to propose alterna- tives, taking into account the contributions of social medicine, collective health, and partici- patory action research as emblematic models in Latin America in the field of mental health. For an effective implementation of community mental health in primary care in Ecuador, the role of universities is central, specifically in projects linked to the community and in pre- professional practices in health science careers. These projects allow the promotion of commu- nity mental health at the first level of health care from a critical perspective, open to complex- ity and based on the principle that the community is the main active subject of social transformation. Key words Mental health; primary health care; community participation; universities; Ecuador The mental health system in Ecuador conditions. Furthermore, it recognizes the promotion, care, and recovery of in- has evolved over the past decade and the role of users, families, and social or- dividual, family, and community health is hailed as one of the main achieve- ganizations, as well as the central as a human right (2). ments of the country’s integrated fam- role of health professionals, especially Other significant steps forward in ily, collective, and intercultural health those who work in the primary care this process have been the Strategic care model (modelo de atención integral services (1). National Plan and the Mental Health de salud familiar, colectivo e intercultural – Since 2007, the national government Care Model 2015–2017, which have MAIS-FCI). In this model, mental health has sought to follow the principles sought to replace the curative/hospital- is considered to depend not only on agreed upon by the member states of the focused model with a community biological factors but also on living World Health Organization (WHO) at care model. For this purpose, they have Alma-Ata 40 years ago—namely: to pro- promoted the development of PHC * Official English translation from the original tect and promote the health of all the services and coordination between Spanish manuscript made by the Pan American people of the world, with primary health these centers and the second level of Health Organization. In case of discrepancy, the original version (Spanish) shall prevail. care (PHC) as the guiding principle of an care, facilitating the process of deinstitu- 1 Facultad de Psicología, Universidad Laica Eloy integrated health system. This model tionalization (3). Alfaro de Manabí, Manta, Ecuador. Send corre- spondence to Victoriano Camas Baena, vcamas. seeks to replace the medical-biologistic- Despite the foregoing achievements, [email protected] curative approach with one focused on the mental health system in Ecuador has This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. No modifications or commercial use of this article are permitted. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article’s original URL. Rev Panam Salud Publica 42, 2018 1 Special report Camas Baena • Community mental health and health-promoting universities in Ecuador limitations that make it difficult to imple- effective implementation. And there is approach proposed by public agencies— ment this new legislation. They include: still another highly important drawback: comes up short. From the perspective the existing academic and professional being proposed here, CMH is an innova- 1. Insufficient funding in a budget that training programs are unable to prepare tive proposal within the panorama of the gives priority to supporting the sec- the human resources needed to meet the social and health sciences. Unlike the ond and third levels of care. In 2012, legal requirements for offering CMH prevailing traditional models in psychia- the total allocation for health was US$ within PHC. Even though recent years try and clinical psychology, which prefer 1,881,061,107, of which only 0.44% have seen progress in the development to focus on the study and treatment of (US$ 8,308,210) was designated for of higher education in this area, many disease, the integrated CMH proposal mental health, and of this amount, health professionals in Ecuador do not approaches its task from the perspective 98.57% was for psychiatric hospitals. have specific training in mental health at of health promotion and protection us- This trend continued in 2014, when the undergraduate or graduate level. To ing an investigative methodology that only 1.46% of the health budget was compound the problem, pre-professional includes community participation (9). set aside for mental health, and al- practices in the health science programs The increase in psychopathologies and most half was for investments in psy- are based on the hospital-focused model psychosocial problems is all the more chiatric hospitals (4). (7). Furthermore, few academic or health reason to seek an integrative approach 2. The primary mental health care ser- institutions offer community-oriented that is not limited to working with vices do not have enough profession- in-service practicums in mental health, individuals and their particular set of als or PHC centers to meet the needs nor do university-level teachers have problems/psychopathology, but rather of users. This situation often leads specific competency in health promo- extends attention, evaluation, and pre- them to “self-refer” to institutions at tion. The exception is the graduate pro- vention to the family and community the second and third levels of care (5). gram in family medicine, which includes level. The integrated CMH model en- 3. Most of the professionals who work training in mental health, capacity- compasses problems in the community, in the PHC centers lack resources, building to handle mental health prob- including active engagement in social competencies, and expertise in the lems, management of psychotherapeutic participation and the incorporation of area of mental health––much less in agents, and systemic psychotherapy, but mental health in PHC, with priority on community mental health. It is there- the depth of the training varies among the prevention of psychopathologies/ fore quite challenging for them to universities (8). Against this background, psychosocial problems and the promo- meet the needs of users and comply the specific objectives of this manuscript tion of mental health (10). with the terms in the Integrated are to reflect on some ideas for integrat- Bearing in mind the above, we now Family Health Care Model (MAIS). ing CMH into PHC; discuss the complex- turn to the proposals offered by the As a result, they tend to refer users ity of the issue from a critical perspective; Latin American social medicine/collec- to facilities at the second and third and suggest the fundamental role that tive health movement, especially its main levels of care. universities can play in improving health authors in Ecuador, as basic theoretical, 4. At the same time, the mental health care in the context of pre-professional methodological, praxeological, and above system in Ecuador continues to favor practices and outreach to the collectivity. all ethical and political references for re- the biomedical model for evaluation, In addressing social and community thinking and reformulating the country’s diagnosis, and interventions, omit- practices in health from this perspective, current model and the community mental ting the family and community com- we rely on the rich theoretical output of health policies, particularly within the ponent. Because of this limitation, the Latin American social medicine/col- context of primary health care. The Ecua- mental health care tends to focus on lective health movement. dorian authors of this school of social reducing symptoms in the individual medicine emphasize the importance of without considering the family and Community mental health and expanding the country’s current vision of community context. This is one of the primary health care: a critical health. They point to the deterioration of reasons why the numbers of cases overview services provided under the logic of the continues to rise in the health centers, unicausal biomedical paradigm, which along with psychosocial problems in As indicated above, CMH requires a has clearly failed to solve growing health the community. The current public detailed, substantive, and well-inten- problems (11). health scenario is governed by a pa- tioned policy along with legal
Load more

Recommended publications
  • Why Do We Need a Social Psychiatry? Antonio Ventriglio, Susham Gupta and Dinesh Bhugra
    The British Journal of Psychiatry (2016) 209, 1–2. doi: 10.1192/bjp.bp.115.175349 Editorial Why do we need a social psychiatry? Antonio Ventriglio, Susham Gupta and Dinesh Bhugra Summary interventions in psychiatry should be considered in the Human beings are social animals, and familial or social framework of social context where patients live and factors relationships can cause a variety of difficulties as well as they face on a daily basis. providing support in our social functioning. The traditional way of looking at mental illness has focused on abnormal Declaration of interest thoughts, actions and behaviours in response to internal D.B. is President of the World Psychiatric Association. causes (such as biological factors) as well as external ones such as social determinants and social stressors. We Copyright and usage contend that psychiatry is social. Mental illness and B The Royal College of Psychiatrists 2016. and difficulties at these levels can lead to psychopathological Antonio Ventriglio (pictured) is an honorary researcher at the Department of and behavioural dysfunctions. Social stressors can lead to changes Clinical and Experimental Medicine at the University of Foggia, Italy. Susham 5 Gupta is a consultant psychiatrist at the East London Mental Health in the cerebral structure and affect neuro-hormonal pathways. Foundation NHS Trust. Dinesh Bhugra is Emeritus Professor of Mental Health Even organic conditions such as dementia are said to be related to & Cultural Diversity at the Institute of Psychiatry, Psychology & Neuroscience, life events and social factors such as economic and educational status.5 King’s College London and is President of the World Psychiatric Association.
    [Show full text]
  • The Public’S Role in COVID-19 Vaccination
    Vaccine xxx (xxxx) xxx Contents lists available at ScienceDirect Vaccine journal homepage: www.elsevier.com/locate/vaccine The public’s role in COVID-19 vaccination: Human-centered recommendations to enhance pandemic vaccine awareness, access, and acceptance in the United States ⇑ Monica Schoch-Spana a,c, , Emily K. Brunson b, Rex Long b, Alexandra Ruth c,f, Sanjana J. Ravi a,c, Marc Trotochaud a,c, Luciana Borio d, Janesse Brewer c, Joseph Buccina d, Nancy Connell a,c, Laura Lee Hall e, Nancy Kass c,f, Anna Kirkland g, Lisa Koonin h, Heidi Larson i, Brooke Fisher Lu j, Saad B. Omer k,l,m, Walter A. Orenstein n,o,p, Gregory A. Poland q, Lois Privor-Dumm r, Sandra Crouse Quinn s, Daniel Salmon c,t, Alexandre White u,v a Johns Hopkins Center for Health Security, Baltimore, MD, USA b Department of Anthropology, Texas State University, San Marcos, TX, USA c Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA d In-Q-Tel, Arlington, VA, USA e Center for Sustainable Health Care Quality and Equity, Washington, DC, USA f Johns Hopkins Berman Institute of Bioethics, Baltimore, MD, USA g Department of Women’s and Gender Studies, University of Michigan, Ann Arbor, MI, USA h Health Preparedness Partners, Atlanta, GA, USA i Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK j Department of Communication, University of Maryland, College Park, MD, USA k Yale Institute for Global Health, New Haven, CT, USA l Yale School of Medicine, New Haven, CT, USA m Yale School of Public Health,
    [Show full text]
  • The Culture of Medicine and Racial, Ethnic, and Class Disparities in Healthcare Mary-Jo Delvecchio Good, Ph.D., Professor of Social Medicine Cara James, B.A
    RUSSELL SAGE FOUNDATION Working Paper #199 The Culture of Medicine and Racial, Ethnic, and Class Disparities in Healthcare Mary-Jo DelVecchio Good, Ph.D., Professor of Social Medicine Cara James, B.A. Byron J. Good, Ph.D., Professor of Medical Anthropology Anne E. Becker, M.D, Ph.D., Assistant Professor of Medical Anthropology Department of Social Medicine, Harvard Medical School December 2002 Russell Sage Working Papers have not been reviewed by the Foundation. Copies of working papers are available from the author, and may not be reproduced without permission. This has been reproduced from the IOM Unequal Treatment CDROM 2002. The Culture of Medicine and Racial, Ethnic, and Class Disparities in Healthcare Mary-Jo DelVecchio Good, Ph.D., Professor of Social Medicine Cara James, B.A. Byron J. Good, Ph.D., Professor of Medical Anthropology Anne E. Becker, M.D, Ph.D., Assistant Professor of Medical Anthropology Department of Social Medicine, Harvard Medical School INTRODUCTION Racial disparities in medical treatments and in health status have been documented in numerous studies over the past two decades. In a recent editorial in the New England Journal of Medicine, Epstein and Ayanian (2001) noted that “there is little evidence that racial disparities in medical care or in measures of health have substantially diminished.” Gary King (1996), in an insightful theoretical analysis of this research, argues that explanations of racial differences in medical care and of participation rates in medical research are grounded in institutional racism and in the pro- fessional ideologies of medicine and healthcare systems that lead to power imbalances between minorities and medicine’s elite professionals.
    [Show full text]
  • Ministry of Health of Ukraine Ukrainian Medical Stomatological Academy
    MINISTRY OF HEALTH OF UKRAINE UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY "Approved" at a meeting of the department of social medicine, public health organizations health economics with medical and labor expertise Head of Department Protocol No13 from 08.01.2020 Professor______________Golovanova I.A. Methodical recommendations for independent work of studets during preparation of practical (seminar) classes Educational discipline Social medicine, public health Module № 1 Topic Social medicine and public health as a science. Evidence-based medicine, its importance for health care practice Study level III Faculty Foreign Students Training Department 1. Relevance of the topic: The nature of the health care system in each country is determined by the position and development of public health as a scientific discipline. The specific content of any course on public health varies depending on national circumstances and needs, as well as the differentiation achieved by various medical sciences. 1 Methodological basis of public health as a science is to study and correct interpretation of the causes, connections and interdependence between health and social relations, ie, the correct solution of the problem of social and biological relationships in society. Discipline "social medicine" refers to the number of specialized in the preparation of social work on the basis of university education, general professional disciplines studied in the unit. 2. Specific objectives: To interpret theoretical bases, modern principles and legal health framework; Identify and analyze key indicators of public health in relationship with the factors that affect it; Develop measures to improve the health of the population and the individual his troops; Assess the organization, quality and efficiency of different types of therapeutic and preventive care for the urban and rural population in terms of health care reform.
    [Show full text]
  • PREVENTING DISEASE THROUGH HEALTHY ENVIRONMENTS This Report Summarizes the Results Globally, by 14 Regions Worldwide, and Separately for Children
    How much disease could be prevented through better management of our environment? The environment influences our health in many ways — through exposures to physical, chemical and biological risk factors, and through related changes in our behaviour in response to those factors. To answer this question, the available scientific evidence was summarized and more than 100 experts were consulted for their estimates of how much environmental risk factors contribute to the disease burden of 85 diseases. PREVENTING DISEASE THROUGH HEALTHY ENVIRONMENTS This report summarizes the results globally, by 14 regions worldwide, and separately for children. Towards an estimate of the environmental burden of disease The evidence shows that environmental risk factors play a role in more than 80% of the diseases regularly reported by the World Health Organization. Globally, nearly one quarter of all deaths and of the total disease burden can be attributed to the environment. In children, however, environmental risk factors can account for slightly more than one-third of the disease burden. These findings have important policy implications, because the environmental risk factors that were studied largely can be modified by established, cost-effective interventions. The interventions promote equity by benefiting everyone in the society, while addressing the needs of those most at risk. ISBN 92 4 159382 2 PREVENTING DISEASE THROUGH HEALTHY ENVIRONMENTS - Towards an estimate of the environmental burden of disease ENVIRONMENTS - Towards PREVENTING DISEASE THROUGH HEALTHY WHO PREVENTING DISEASE THROUGH HEALTHY ENVIRONMENTS Towards an estimate of the environmental burden of disease A. Prüss-Üstün and C. Corvalán WHO Library Cataloguing-in-Publication Data Prüss-Üstün, Annette.
    [Show full text]
  • The Cuba - Timor-Leste Health Program
    The Role of Social Medicine in Filling the Gap in Human Resources in Health: The Cuba - Timor-Leste Health Program Casey Lucas Hastings A thesis submitted in partial fulfillment of the requirements for the degree of Master of Public Health University of Washington 2012 Committee: Mary Anne Mercer James Pfeiffer Program Authorized to Offer Degree: Department of Global Health School of Public Health Abstract Objectives The developing world is faced with a high burden of infectious disease and insufficient physicians to address these problems. The alternative model of medical training that characterizes Cuban social medicine has been credited with the major successes of Cuba’s health system, but the possibility of applying this model to other developing countries has not been well studied. In Timor-Leste, physicians newly trained in Cuba in social medicine are returning to practice in the individual patient-focused health care system of Timor-Leste. Although the 1,000 newly graduated physicians expected to enter the Timorese national health system in the coming few years will help fill the current gap in human resources in health, the different approach to health problems afforded by their social medicine training may also present novel challenges. Methods The study design employed mixed methods, administering a quantitative questionnaire and performing qualitative semi-structured interviews with all 18 members of the first class of Timorese graduates of the Latin America School of Medicine in Cuba as well as with key informants in the Timorese medical community. Results Recent graduates demonstrated a social medicine directed approach to conceptualizing and addressing health issues, including strong public health skills with an emphasis on societal-level determinants of health.
    [Show full text]
  • The English Revolution in Social Medicine, 1889-1911
    THE ENGLISH REVOLUTION IN SOCIAL MEDICINE, 1889-1911 UNIVERSITY OF LONDON PhD THESIS DOROTHY E. WATKINS 1984 To J.D.M.W. and E.C.W. 2 ABSTRACT The dissertation examines the development of preventive medicine between 1889-1911. It discusses the rise of expertise in prevention during this period and the consolidation of experts into a professional body. In this context the career histories of medical officers of health in London have been analysed to provide a basis for insight into the social structure of the profession. The prosopog- raphy of metropolitan officers demonstrated a broad spectrum of recruitment from the medical profession and the way in which patterns of recruitment changed over time. The level of specialisation in preventive medicine has been examined through a history of the development of the Diploma in Public Health. The courses and qualifying examinations undertaken by medical officers of health revealed the way in which training was linked to professionalisation through occupational monopoly. The association representing the interests of medical officers of health, their own Society, was Investigated through its recorded minutes of Council and Committees from the year it was first amalgamated into a national body, 1889, up to the date of the National Insur- ance Act in 1911. Here the aims and goals of the profession were set against their achievements and failures with regard to the new patterns of health care provision emerging during this period. This context of achievement and failure has been contrasted with an examination of the 'preventive ideal', as it was generated from within the community of preventive medical associations, of which the Society of Medical Officers of Health was one member.
    [Show full text]
  • The Case for Social Medicine a Consensus Statement by the Social Medicine Consortium
    Achieving Health Equity This Generation: The Case for Social Medicine A Consensus Statement by the Social Medicine Consortium Why Raise Our Voices? We have participated in and been complicit with broken health systems whose principles and systems don’t lead to healthier communities. We have heard the voices of patients throughout the world whose tragic stories of sickness plead for more just, equitable health systems and care. We have witnessed politics that tolerate xenophobia, racism, sexism, and unregulated capitalism without any accountability. We have observed economic and social systems that routinely fail to affirm the dignity of all humans and ignore the tremendous assets of all communities. We have trained in educational systems that acknowledge very little or none of this. We refuse to stand by and let this happen. Social Medicine is our response. What Change Do We Seek? Social and economic inequities are a root cause of health disparities throughout the world. These inequities drive morbidity and mortality in tragically predictable ways that preferentially afflict the poor and marginalized. They are perpetuated by factors including racism, sexism, economic policy prioritizing productivity and profit, and disregard for historical injustices. We can and must take action to address these root causes of ill health that we as a society have created and sustained. Social medicine is the practice of seeking to understand the social context of patients and communities and working to remediate the impact of these grossly unequal contexts on the life and death of the poor and marginalized. Not to be confused with socialized medicine, a political policy that involves centralized management of a health system by the state, social medicine aspires to ensure health by drawing on social analysis and community strengths to change the structural forces that determine health disparities.
    [Show full text]
  • Social Medicine
    SOCIAL MEDICINE Edited by MICHAELA KOSTIČOVÁ First Edition Comenius University in Bratislava Slovakia 2015 Moderné vzdelávanie pre vedomostnú spoločnosť/Projekt je spolufinancovaný zo zdrojov EÚ KOSTIČOVÁ, M. (ED.) SOCIAL MEDICINE First Edition Comenius University in Bratislava, Slovakia, 2015, 181 pages. © Michaela Kostičová, MD, PhD, MPH Silvia Capíková, LLM et MA, PhD Leonard Levy, DPM, MPH Cecilia Rokusek, EdD, MSc, RD Darina Sedláková, MD, MPH Anthony Silvagni, DO, PharmD, MSc, FACOFP, FAFPE Assoc. prof. Ivan Solovič, MD, PhD 2015 Reviewers Prof. Jan Holčík, MD, DrSc Prof. Jozef Matulník, MA, PhD Proofreaders Mgr. Martin Gazdík ISBN 978-80-223-3935-3 Printed by KO& KA in Bratislava 2015 This textbook was prepared and published within the project “MPH curriculum development at Comenius University in Bratislava in English language”, ITMS code: 26140230009, funded by European Social Fund - Operational Programme Education (ESF – OPE). Recipient of the ESF: Comenius University in Bratislava, Faculty of Medicine. Head of the project: Prof. Ľudmila Ševčíková, MD, PhD This textbook is from the series of textbooks listed below. The aim of the textbooks, funded by ESF-OPE, is to provide students of the study program Master of Public Health (MPH) at Comenius University in Bratislava with information and knowledge of public health issues. Biology and Genetics for Public Health, Pharmacology in Public Health Basics of Clinical Microbiology and Immunology for MPH Students Environmental Health - Hygiene Occupational Health and Toxicology Epidemiology
    [Show full text]
  • Dangerous Secrets—Sars and China's Healthcare
    DANGEROUS SECRETS—SARS AND CHINA’S HEALTHCARE SYSTEM ROUNDTABLE BEFORE THE CONGRESSIONAL-EXECUTIVE COMMISSION ON CHINA ONE HUNDRED EIGHTH CONGRESS FIRST SESSION MAY 12, 2003 Printed for the use of the Congressional-Executive Commission on China ( Available via the World Wide Web: http://www.cecc.gov U.S. GOVERNMENT PRINTING OFFICE 88–399 PDF WASHINGTON : 2003 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 VerDate 11-MAY-2000 16:20 Jul 22, 2003 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 88399.TXT China1 PsN: China1 CONGRESSIONAL-EXECUTIVE COMMISSION ON CHINA LEGISLATIVE BRANCH COMMISSIONERS House Senate JIM LEACH, Iowa, Chairman CHUCK HAGEL, Nebraska, Co-Chairman DOUG BEREUTER, Nebraska CRAIG THOMAS, Wyoming DAVID DREIER, California SAM BROWNBACK, Kansas FRANK WOLF, Virginia PAT ROBERTS, Kansas JOE PITTS, Pennsylvania GORDON SMITH, Oregon SANDER LEVIN, Michigan MAX BAUCUS, Montana MARCY KAPTUR, Ohio CARL LEVIN, Michigan SHERROD BROWN, Ohio DIANNE FEINSTEIN, California BYRON DORGAN, North Dakota EXECUTIVE BRANCH COMMISSIONERS PAULA DOBRIANSKY, Department of State* GRANT ALDONAS, Department of Commerce* D. CAMERON FINDLAY, Department of Labor* LORNE CRANER, Department of State* JAMES KELLY, Department of State* JOHN FOARDE, Staff Director DAVID DORMAN, Deputy Staff Director * Appointed in the 107th Congress; not yet formally appointed in the 108th Congress. (II) VerDate 11-MAY-2000 16:20 Jul 22, 2003 Jkt 000000 PO 00000 Frm 00002 Fmt 0486 Sfmt 0486 88399.TXT China1 PsN: China1 C O N T E N T S Page STATEMENTS Henderson, Gail E., professor of social medicine, University of North Carolina School of Medicine, Chapel Hill, NC .................................................................
    [Show full text]
  • Differences and Inequalities
    The Social Medicine reader Volume 3rd2 Edition Differences and Inequalities Jonathan oberlander / Mara buchbinder / larry r. churchill Sue e. eStroff / nancy M. P. King / b arry f. SaunderS ronald P. StrauSS / rebecca l. WalKer • e ditorS the social medicine reader Volume 2, Third Edition the social medicine reader volume 2 third edition Differences and Inequalities Jonathan Oberlander, Mara Buchbinder, Larry R. Churchill, Sue E. Estroff, Nancy M. P. King, Barry F. Saunders, Ronald P. Strauss, and Rebecca L. Walker, eds. Duke university Press · Durham anD LonDon · 2019 © 2019 Duke University Press All rights reserved Printed in the United States of Amer i ca on acid- free paper ∞ Designed by Matthew Tauch Typeset in Minion Pro by Westchester Publishing Ser vices Library of Congress Cataloging- in- Publication Data Names: Oberlander, Jonathan, editor. Title: The social medicine reader / Jonathan Oberlander, Mara Buchbinder, Larry R. Churchill, Sue E. Estroff, Nancy M. P. King, Barry F. Saunders, Ronald P. Strauss, Rebecca L. Walker, editors. Description: Third edition. | Durham : Duke University Press, 2019– | Includes bibliographical references and index. Identifiers: lccn 2018044276 (print) lccn 2019000395 (ebook) isbn 9781478004356 (ebook) isbn 9781478001737 isbn 9781478001737 (v. 1 ; hardcover ; alk. paper) isbn 9781478002819 (v. 1 ; pbk. ; alk. paper) Subjects: lcsh: Social medicine. Classification: lcc ra418 (ebook) | lcc ra418 .s6424 2019 (print) | ddc 362.1—dc23 lc record available at https://lccn.loc.gov/2018044276 Contents ix
    [Show full text]
  • Introducing Social Medicine the Editors
    EDITORIAL Introducing Social Medicine The Editors If a reader picked up a journal entitled By the end of the 19 th century pathology and Cardiology or Dermatology s/he would have a microbiology seemed to provide definitive answers fairly clear idea about the types of articles likely to to the questions of how and why people got sick. be found inside. It is less clear exactly what might Social explanations fell from favor. Since social be the content of a journal entitled Social Medicine . explanations raised politically “difficult” questions As a discipline, Social Medicine has many roots they were best left out of the education of a and many branches. Social Medicine has taken on profession that sought to create a monopoly on a variety of meanings as diverse schools of social health care. medicine (or its offspring community medicine) The resultant form of medicine, baptising itself have grown up in different parts of the world. “biomedicine”, proclaimed that it was grounded in What, then, is a reader to expect of this journal biology and highly scientific. Yet with time we Social Medicine ? have grown to appreciate that the program of biomedicine is quite restricted. We can, for The nature of Social Medicine instance, understand in great molecular detail the Despite the diversity in its expression certain hows and whys of the HIV virus. This fundamental ideas lie behind the concept of social understanding does little to explain the patterns of medicine. The most important is that the structure spread of the virus. More importantly, although we of a society profoundly influences who will be may develop the technical means to treat the virus healthy and who will be well.
    [Show full text]