On Epidemiological Significance of Social Enviroment: Contribution to Methodblogy of Investigation

Abstract

In his review of methods and present interpretations of the part played by social factors in the epidemiology of mass diseases, the author points out that the processes of social change going on in a given period have their influence on the state of health of the people concerned and, conversely, that the conditions and standard of health have repercussions throughout the social fabric of the period, conditioning a future pattern of the social scene.

For an effective investigation of the social factors bearing upon epidemiology, it is suggested that the following three aspects of social life should form 'the basis of studies: 1) the economic structure — more especially productivity of labour, technology, and ownership of means of production — ’in its influence on the health of a people, and, conversely, the

extent of influence of incidence-rates of morbidity, disability and mortality on the growth of economy and social processes, 2) public and social institutions — such as government, social and political organisations, character- of families and size of households — and their significance and influence on the general conditions of health of the community, 3) the part played by cultural factors — such as the systems of values and education, habits and customs, standard of morals — in conditioning the state and dynamics of health and in determining the setting-up or modifying of health programmes.

Dealing with the epidemiologic role of social factors in his medico-sociological studies, the author starts with an explanation of basic differences in social Life between human and animal societies, the subsequent chapters being concerned with the relevant social factors. The chapter about the role of economic factors provides Information regarding the influence of productivity of labour and ownership of the means of production on people’s health »in Yugoslavia and other countries. Furthermore, the »economic importance of health standards is pointed out, followed by an examination of diseases, short-term. and chronic disability, high death-rate as the underlying causes of a decline in the value of human labour force.

Consideration is given to technological development and its importance and influence on health. The importance to health of different systems of ownership of the means of production is presented in the light of unequal distribution of national resources and means of livelihood, of economic effects of class snuggles, strikes, national and racial oppressor, colonial exploitation and imperialistic wars.

Among social institutions that concern the health of a people most closely, 'the author speedily notes and deals with the roles of government, social organisations and the family. The significance of group membership in the system of social values and in its bearing upon physical and mental health is given due consideration.

In the chapter dealing with the important part played by culture in conditioning health standards, attention is drawn to influences of education, ideology, morals, the system of values and habits of life. The importance of cultural factors comes to the fore in the setting up and carrying out of various programmes of health education and in drives against mass diseases or for improvement of sanitation. Practical usefulness of a systematic investigation on »the epidemiologic role of social factors is summarised as follows:

1) Without a knowledge of the social factors involved it is impossible to obtain a complete picture of multiple causation of any mass disease; nor is it possible to find out what find of social action should be undertaken that would lead to a successful solution of a health problem;

2) In socialist countries, the research into social causation and the economic and social significance of a given health situation makes possible the dovetailing of national health service programmes into plans of general economic development, indicating as it does what proportion of national income should be allotted to health Services if diseases, disablement and mortality are not to act as a brake on activities directed towards economic and social advancement;

3) A study and ’investigations of the social causation of diseases provides a reliable means of finding out what is most urgently needed in the way of health improvement, and how to plan and organise programmes for the protection of health of people in undeveloped parts of a country;

4) The knowledge of social conditions, and particularly of culture, is a key to understanding the behaviour of a people; such knowledge is necessary in the planning of all health programmes; it is indispensable for health education.