Dr. Matiur Rahman & Shishir Reza :
Social Medicine means an organized investigation of social, genetic, and environmental factors influencing human disease and disability and promotion of methods of prevention of disease and health measures protective of individual and community. The term ‘Social Medicine’ is first used in 1848 by a French doctor Jules Guérin. In the same year, Rudolf Virchow and his colleagues introduced social medicine in Germany. Social medicine is concerned over the relation between the individual and his environment. Social medicine is also considered as community medicine, public health, social determents of health etc.
The core principles of social medicine are: 1) that social and economic conditions have an important effect on health, disease and the practice of medicine, and these relations must be subjected to scientific investigation; and 2) that the measures to promote health and combat disease must be social as well as medical.
Global research clarifies that social medicine extends the interest and alters the emphasis of the older public health, just as social pathology extends the interest and alters the emphasis of earlier epidemiological study. In general, social medicine unites the clinical with the public and embraces the organization of after care, and the readjustment of the lives of individuals and families disturbed or broken by illness. When confronted with public health, which is primarily intended to focus on the environment (housing, safe water, and sanitation), social medicine differs by encompassing “the whole of the economic, nutritional, occupational, educational, and psychological opportunity or experience of the individual or the community”.
People are all together biological and social organisms, and thus human health and disease are affected by social and biological factors. The interdisciplinary program between medicine and social science would provide the former with knowledge and skills needed to analyze the social causes of health and illness in the same way as the alliance between medicine and laboratory sciences. Social medicine explicitly investigates social determinants of health and disease, rather than treating such determinants as mere background to biomedical phenomena. The proposition of social medicine deserves emphasis, and especially so today – its intellectual breadth, its political and economic depth, its essential humanism.
In an article of journal of global health it has mentioned that Covid-19 is a social disease due to its widespread diffusion in the general population, the serious harm it causes on affected patients and its impact on the economy and social life. While socialization is a risk factor for the spread of Covid-19, health protection measures such as isolation and lockdown further aggravated the “social” burden of it. Diseases with social impact require a management approach based on social medicine, integrating health, social and economic responses.
There is evidence that a low socio-economic status is strongly associated with higher rates of both incidence and mortality attributable to Covid-19. In particular, housing conditions, over-crowding and other aspects that hinder social distancing can greatly influence the risk of Covid-19 transmission. In addition, individuals of lower socio-economic status are more likely to rely on public transport to reach their respective workplace, thereby increasing the risk of Covid-19 through inter-personal contact.
Socio-economic status also affects the living environment, the eating habits, the occupational status and the access to health care services. Most determinants of health are social by nature and the most effective public health interventions to tackle them frequently require a social component in their design and implementation. Given the current scenario caused by the Covid-19 pandemic, interventions to tackle socio-economic disparities should be considered as priorities like the search for effective curative and preventative treatments. Indeed, existing inequities worsened during the pandemic and aspects like access to food, education, and psycho-social support must be carefully weighed in a holistic approach.
Contemporary social medicine is critical to understand and prevent diseases, improving healthy life conditions in the general population and the efficiency of health systems. Now a days, health challenges require novel approaches involving the implementation of new technologies and advanced methodologies such as tele-medicine, tele-rehabilitation, tele-consultation and new digital infrastructures for modern data communication 5G technology, Big Data and their management through artificial intelligence algorithms will define an epochal change in health care delivery, processing huge amounts of health data in real time.
These technologies will allow clinical research to identify new models of diagnostic, therapeutic and preventative interventions, optimizing health care expenditures yet supporting the most fragile population. Recent studies suggest that countries implementing an integrated health, social and economic public policy response will be able to outdo the current pandemic not only healthier, but also economically and socially stronger.
Social diseases require social remedies. As an index for formulating, evaluating, and implementing health policy and care delivery, social medicine recommends at least three things: integrating health, social, and economic responses; bringing care to the points of greatest need; and focusing on broad equity-driven reforms in the pandemic’s wake.
Covid-19 is a social disease requires an integrated, caring, and equity-focused response. Social medicine brings with it a set of tools for responding to the waves of suffering that have already arrived-in the form of disease and its attendant social fractures and economic wreckage-as well as others still to come.
(Dr. Matiur Rahman is Research Consultant, Human Development Research Centre and Shishir Reza is Environmental Analyst & Associate Member, Bangladesh Economic Association).
