Medicine and Social Sciences

Lecture 1Dr Shyam Ashtekar,

Community Medicine dept SMBT, Igatpuri Nashik

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A woman with Falciparum Malaria in Orissa-the SE context

A woman with F-malaria in KBK-Odisha The social context!

Backward districts of Orissa Tribal area, small hamlets High parasite density,

hyperendemic Rice fields, small streams Poor health care system,

long distances Anopheles-Fluvialtis stubborn

vector which survives even in flowing water

Open sleeping, poor housing

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So combating malaria is a socio-medical project

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Social Context of Health & Medicine

Doctor-patient in clinical setting

Socio-economic, psychological etc factors

Political factors

Clinical medicine Community

Medicine Epidemiology

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An example of socio-political context of medicine

Most health problems have a socio-political context Pellet gun injuries in J&K

Political situation in J&K, militants, AFSPA

Economic deprivation due to development gap..jobs..

Unrest, demonstrations Security response Pellet gun injuries-

blindness, deaths etc Schools closed-social

unrest cycle.

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Political Science-laws and governance institutions

Economics-production, distribution, consumption, ownership of resources, demand supply

Sociology-science of Human Relations & Behavior

Psychology- perception, thought, opinion, attitude, response, motivation, learning etc

Anthropology: physical, social, cultural history of man

History & Geography

Social Sciences

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Society-vast network of relationships/constraints affecting individuals

Community-locality defined group with common interests. Urban or Rural community! (urban means >5000 pop and with >75% non-farm employment in males, >400/sq km pop density)

Social structure-specific to state/nation/region Social institutions-family, caste, clan, religion, clubs,

schools, political party, associations etc Individual Role- as ascribed (through age/sex/clan) or

achieved (like a film star, sports icon) Socialism-state control of society/ownership

Sociology-some concepts

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Socialization-the process of individual acquiring various social norms, culture.

Social control mechanisms-formal (laws) & Informal (unwritten rules)

Customs-folkways-acceptable behavior (like respecting elders) & mores(more stringent)..like purdah in North India

Taboos: Donts’ (nishidhha) eg breastfeeding after birth was a taboo till recent times.

Norms and values

Sociology-concepts-cont.

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Culture-Socially acquired and learned behavior, customs, laws, beliefs, religion, arts, skills, moral values and subject to change.

Acculturation-Culture contact & spread—change process (due to trade, commerce, migration, education, technology etc)

Standard of living-income, possession, consumption, education, better public services

Social change-last 2 centuries have seen rapid change in lives..esp the last 2 decades. The change could be demographic, behavior, culture etc)

Sociology - concepts-cont.

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Social stress & coping Social stratification-income, occupation,

education Social problems-e.g. girl-child-abortion,

gender violence etc Social pathology-used in 2 ways (crime,

violence etc) and (disease link to social condition-like CHD in upper-middle class)

Social groups-primary, secondary, Crowd-temporary gathering

Sociology-some more concepts

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Social survey Case study-Case is person/family/group etc Field study Communication-effective passing of

information Social defense -defending society against

prevalent problems like drug abuse.

Sociology-some more concepts

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Psychology –Study of human behavior-

Scope of PsychologySeveral Factors affecting behavior

Abnormal/normal psychology

Educational Psychology Social Psychology Child Psychology Applied Psychology Medical Psychology Psychoanalysis

Knowledge Beliefs-attitudes Values Skills Gender roles, Opportunity Economy Peer pressure, Family influence Opinion leaders Material conditions

(shortage, oversupply) More…

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Self-actualization

Esteem-Recognition

Social (sense of belonging)

Safety

Physiological needs-hunger, sleep etc

Maslow’s hierarchy of needs

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Psychology-BehaviorCauses of Behavior Responses

Environmental stimuli Emotions and feelings Needs (Maslow’s

hierarchy-next slide) Motivation Intellectual perception

Physical responses-habits, skills

Emotional Responses: emotions, feelings, tension

Intellectual Response: Perception, thinking, reasoning

ADJUSTMENTS

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Emotions, motivation, attitudes

Emotions Motivation & attitudes

Jealousy, hate, anger Love, lust, pity, Joy, sorrow, grief Sympathy, Fear Moodiness

EMOTIONS alter/condition our response. Can be a barrier.

Control of emotions is essential to healthy life

Motives, needs, wants, desires, urges are a continuum

Biologic needs, social needs, economic needs, ego-integrative needs (recognition)

ATTITUDEs involve components of knowledge, feeling and tendency to act.

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LearningFactors affecting learning Types & ways of

Learning Intelligence Learning situation Motivation Age Physical health Mental Health

Cognitive, affective, Psychomotor

Learning by doing, trial& error, observation, imitation, memorizing, experience, problem solving

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Rationalization-justify Projection-blaming others Compensation- by some other means

like fashions, extravagant clothing, other activities

Escape!-addictions Displacement-taking it out on others Regression-immature forms of

response-crying, weeping, suicide

Defence mechanisms when one is faced with problems

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Extrovert-Introvert (Carl Jung) Traits-cheerful, honest, loyal, serious,

sporty, tactful, reliable, kind, helping, thoughtful, ethical, serene etc..

Personality development: through life cycle-childhood to old age

Personality-physical, emotional, intellectual& behavioral components

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Ability to see meaningful relations between things

IQ: Mental age/chronological age*100:Normal 90-109

Adult Intelligence: spatial, numbers, verbal comprehension, expression, memory, induction, deduction, flexibility

IQ tests-group tests, individual tests

Intelligence

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This is about Group Behavior Social Interaction-interpersonal or inter-

group Group morale- leadership is important for

this.

Social psychology

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Individual-Rights & ResponsibilitiesUniversal Human Rights (UN 1959) Individual Responsibilities

Livelihood and Standard of living attainable by him/family

Special rights for motherhood & childhood

Equality, justice Right to property Right to life, food, clothing,

housing Right to Health Freedom of speech Right to education

Personal health-diet, cleanliness

Healthful habits Safety of others (take

case of Dengue, chikengunya vector breeding)

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Understanding family, Cultural factors in Health & Disease Socio-economic classification Medical sociology Social problems

Next lecture..28th