社会医学专题知识讲座.pptx

,#,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,#,社会医学专题知识讲座,社会医学专题知识讲座,第1页,第一章 概 论,Chapter one Introduction,社会医学概念、性质、内容和任务,社会医学发展,社会医学基础观点,社会医学与其它学科关系,concept,nature,contents and tasks,Development,Basic thinking,Relation with other subjects,社会医学专题知识讲座,第2页,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,社会医学专题知识讲座,第3页,Human behavior,Culture,Value,Structure of,society,Social,interaction,Socialization,Social,institutions,Dynamic of,Society,Social change,Social life,Sociology,社会医学专题知识讲座,第4页,What is medicine?,什么是医学,The science related to the,diagnosis,understanding,prevention,treatment of illness.,社会医学专题知识讲座,第5页,What is social medicine?,定义：,是一门交叉学科，研究：,1.,社会原因 健康和疾病,2.,制订社会卫生策略和办法,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.,社会医学专题知识讲座,第6页,Human being is more of,the social creature than the animal.,its social attribute is the fundamental nature.,New concept of Health by 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?,人本质属性：在于其社会属性,WHO,：,1948新健康定义:,健康是：,身体,心理,社会,完好状态，而不但是没有疾病或身体虚弱而已。,社会医学专题知识讲座,第7页,人类双重属性,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?,社会医学专题知识讲座,第8页,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,社会医学专题知识讲座,第9页,霍普金斯大学研究小组经过对伊拉克全国,47,个区进行调查走访形成汇报认为，美国发动伊拉克战争造成了,65.5,万伊拉克人死亡,，平均天天死亡,500,人,人口爆炸！,非洲难民,社会医学专题知识讲座,第10页,美国哥伦比亚大学教授、联合国前秘书长安南尤其顾问,JEFFREY SACHS,先生,SACHS,教授说：,年发展议题被挤出了国际议程，战争与反恐取代了发展。,艾滋病天天夺去数以千计生命，因为贫困买不起挽救生命药品而死亡；,“,911”,灾难夺走了,3000,多人生命，从而主宰了两年多世界议程。,世界上天天有,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。,社会医学专题知识讲座,第11页,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、疾病和医学实践含有深刻影响；,2.,群体健康应该成为社会关注内容,;,3.,社会应该经过个人和社会伎俩来改进人群健康。,社会医学专题知识讲座,第12页,社会医学研究内容,Contents of social medicine:,Social health status,mainly population health status;,Influence factors;,especially social factors,Social health strategies and measures;,研究社会卫生情况，主要 是人群健康情况,;,研究影响人群健康原因，主要是社会原因,;,研究社会卫生策略与办法。,社会医学专题知识讲座,第13页,社会医学关键内容,Core Contents,Identify social health problems diagnosis of problems,A,nalysis of social causes of diseases social etiology,Social medicine prescription-,social strategy,-,社会医学诊疗,-,社会病因分析,-,社会医学处方,社会医学专题知识讲座,第14页,社会医学与临床医学比较,社会医学：群体,social medicine:mainly target at population level,发觉社会问题社会诊疗,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疗,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,制订医学处方,Provide medical prescription,社会医学专题知识讲座,第15页,社会医学性质,The Nature of Social Medicine,Interdisciplinary subjectsocial science and medicine,Synthetic research methods,Practicality of social medicine,医学和社会学交叉学科,采取综合研究方法,社会医学实践性,社会医学专题知识讲座,第16页,社会医学任务,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,提倡主动健康观,改进社会卫生情况,;,提升人群健康水平和生命质量,;,制订卫生政策和策略；,开展特殊人群和特种疾病预防保健工作,;,社会医学专题知识讲座,第17页,Basic thinking of social medicine,Harmonious relationship between health and social development,Two way interaction between health and social economic development,I.,协调发展观念,II.,双向作用观念,美国学者,Mushkin,计算出了美国在,19001960,年人口死亡率下降带来经济收益约为,8200,亿,疾病对人力资本和劳动生产率造成损失“,3D”,框架,(Death,Disability,，,Debility,）,社会医学专题知识讲座,第18页,Basic thinking of social medicine,Positive concept of healthBio-psycho-social medical model,III.,当代医学模式下主动健康观,USA,19000,亿,1%,最不健康,20,20,慢病病人,70,70%,健康人,10%,社会医学专题知识讲座,第19页,吸烟已成为全球第二号杀手,IV.,关注高危人群,&,高危原因,High risk factors&,population,Basic thinking of social medicine,社会医学专题知识讲座,第20页,Basic thinking of social medicine,Important role of social factors in prevention and treatment of diseases,Multisector participation,V.,社会原因在疾病防治中主要作用,VI.,多部门参加,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,社会医学专题知识讲座,第21页,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,社会医学萌芽,社会医学创建和发展,我国社会医学发展,社会医学专题知识讲座,第22页,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 than to know what sort of disease a person has.”,Hippocrates,born in 460 bc,father of modern medicine.,社会医学专题知识讲座,第23页,Pathogenesis of disease and the role of doctors,The external influences of food and drink and climatic factors of excessive heat and cold influence internal mechanisms.,The role of the physician was to restore the equilibrium of health.,The Humoural theory was a holistic view.,饮食和气候等外部原因能够经过影响人类内在机制而起左右。,医生职责是恢复健康平衡,;,四体液学说表达了整体医学观,社会医学专题知识讲座,第24页,Embryonic stage of social medicine,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,古罗马医师盖伦：,重视心理原因对健康影响,;,德国社会卫生学家,:,弗兰克,:,悲惨生活是疾病温床,;,:,用医学监督计划使政府采取办法保护公众健康,;,第一个提出社会卫生办法,社会医学专题知识讲座,第25页,社会医学建立和发展,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 parts:,Social physiology,Social pathology,Social hygiene,Social therapeutics,法国医生儒勒,.,盖林,第一次提出社会医学,;,提议将分散医学监督、公共卫生、法医学组成一个整体：社会医学,分为四个个别；,社会生理学；,社会病理学；,社会卫生学；,社会治疗学。,社会医学专题知识讲座,第26页,德国病理学家 魏尔啸,G,erman Pathologist:Rudolf Virchow,The kernel of medical science is social science,“Medicine is a social science,Politics is nothing more than medicine in broad sense,Best method of medicine is to combine medicine with social life and political activities,医学科学关键是社会科学,医学是一门社会科学；任何社会都应对居民健康负责,政治学是广义上医学,实现医学目标最好方法是将医学和社会生活和政治活动结合起来,社会医学专题知识讲座,第27页,德国：格罗蒂杨,German A.Grotjahn,Put forward theory of,social pathology,Write:,“social Pathology”,suggests that disease should be studied from the standpoint of social view;,Is a first person given lecture on social hygiene,提出社会病理学理论和概念,;,用社会观点研究人类疾病标准,首次在柏林大学开设社会卫生学讲座,社会医学专题知识讲座,第28页,Germany,：,Birthplace of social medicine,Before WWII,Social hygiene,Social medicine,Later,become social medicine,德国是社会医学发源地,二战前：使用社会卫生学和社会医学,后改为社会医学,社会医学专题知识讲座,第29页,社会医学在各国发展,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 to social medicine,In 1960s,social medicine was changed into community medicine,英国,:40s,开设社会医学,在牛津大学成立社会医学研究院；,牛津大学赖尔教授,:,公共卫生、工业卫生、社会卫生服务、公共医疗事业都属于社会医学范围；,60s,社会医学改成小区医学。,社会医学专题知识讲座,第30页,社会医学在美国发展,In United States,Medical sociology and family medicine developed,Emphasis on sociology,management and economics,Social medicine was included in the course of health management and health policy,医学社会学和家庭医学得到了发展,强调社会学、管理学和经济学,社会医学包含在卫生管理学和卫生政策学讲座内容中,社会医学专题知识讲座,第31页,社会医学在中国发展,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 centre of health administration,social medicine was the main course,；,90%of medical college offered course in social medicine.,50,年代：,保健组织学,作为医学生必修课，成立保健组织教研组,80,年代：卫生部成立,6,所卫生管理干部培训中心，社会医学成为主干课程,90%,以上医学院开设了社会医学课程,社会医学专题知识讲座,第32页,Preventive medicine,Community medicine,Medical sociology,Health management,Medical psychology,社会医学与其它相关学科关系,The relationship between social medicine and other related subjects,预防医学,小区医学,医学社会学,卫生管理学,医学心理学,社会医学专题知识讲座,第33页,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,focus on medical prevention,Bio-preventive strategy mainly,Social medicine grow out of,preventive medicine,社会医学专题知识讲座,第34页,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 social 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,社会医学专题知识讲座,第35页,Medical Sociology,Medical sociology belong to the disciplinary group of sociology;,C,oncerned with socialcauses and consequences of health andillness;,Social aspects of health and illness;,Social functions of health organizations&institutions,Healthcare systems vs.social systems,Social behavior of health workers and users,patterns of health services patterns of health services,属于社会学分支,关注健康和疾病社会原因和结果,从社会角度研究健康和疾病,研究卫生组织和机构社会职能,卫生系统和社会系统关系,医生和患者社会行为,利用卫生服务格局,社会医学专题知识讲座,第36页,Question:,思索题：,why we should learn social medicine?,What is the nature of this subject?,社会医学学科性质是什么？,why it is necessary and important for medical,students?,医学院校学生学习社会医学必要性和主要性,?,社会医学专题知识讲座,第37页,