Social Medicine: an Important Factor in Preventive Medicine
by Jordana Birck
September 4, 2019
The body is not only a physical and a biological entity. Our bodies are also social bodies composed of experiences, relationships, symbols, and social bonds. Modern medicine focuses on the physical and biological part of the body, looking for biological reasons to prevent and treat ailments. Although modern medicine is amazing because it has the best methods to prevent and treat diseases and illnesses, it lacks an important component when approaching health and healthcare. Modern medicine forgets one essential aspect: that we are human, social beings. We do not only look for medical treatment to cure our physical bodies but also to create social “bonds” with the individuals who we meet in the search for health and healthcare. It is my goal, in this essay to briefly explain preventive and social medicine. Although these two may seem to be completely different concepts, they actually can be considered interdependent when discussing health and healthcare.
The origins of healthcare
The idea of improving individuals’ health began in England in the 18th Century. The state believed that once they treated the poor – who were the individuals lacking health – they would protect the privileged classes (the wealthy ones) from diseases. Industrialization caused an increase in migration to the cities (and therefore an increase in the number of poor masses), these destitute people were a threat to the wealthy and healthy individuals. Thus, it was the role of the state to protect the healthy ones by curing, treating and proving health to the poor, unhealthy individuals. One of the ways of improving individuals’ health is by preventing ailments.
What is Preventive Medicine?
Preventive medicine, as its own name says, is how diseases are prevented. It includes all measures which limit the progression of disease at any stage of its course (CLARKE, 1974: 65) and it focuses on the biological aspects of diseases.
Types of Preventive Medicine:
Preventive Medicine splits into two other main branches: primary prevention and secondary prevention. While the former aims to prevent the occurrence of a disease, the latter focus on where a disease or its complications are halted or averted at any point after the onset of disease (CLARKE, 1974: 65). The main instruments used by preventive medicine in avoiding and treating diseases are biostatistics and epidemiology. However, it considers social, economic and behavioral sciences as important factors that may contribute to sickness, as well the role of legislation, health equity and social disparities between different populations and communities in accessing healthcare. However, these aspects are secondary, since disease – as a biological entity – prevails in preventive medicine. Even though it is important to consider all the biological aspects of our bodies when discussing health and healthcare, we should not forget that we are social beings.
The importance of Social Medicine
Social medicine should be taken into consideration by modern medicine when professionals discuss the best ways to prevent and treat diseases. Social medicine is a “systematic study of the relationships between society, disease, and medicine” (Anderson et al, 2005). Michael Foucault says that modern medicine (we may also refer to it as “biomedicine) is the medicine that mainly uses technology and scientific methods. However, modern medicine is not individualistic (as people might believe!), but it is actually social. According to Foucault “medicine is a social practice, and only one of its aspects is individualistic and valorizes the relations between the doctor and the patient” (Foucault, 1977: 144). So far, so good. But when does preventive medicine come in the story?
Social Medicine in Preventive Medicine
First of all, preventive medicine is important because it prevents and treats the ailments that incapacitate us of living a ‘normal’ life. However, we are humans and we interact with other people. Our social worlds directly influence how we deal with health and healthcare, as well as how we look for them. When we are sick, we look for feelings of listening and empathy in those to whom we are intimate. Although we want to be prevented and cured of all possible illnesses, we also want to be listened to and to be ‘taken care’. People not only consider a good doctor that one who can cure and give the best medical treatment, but also the one who listens, tries to understand, give some emotional support and try to create a trust-bond with the patient. Therefore, “satisfaction” with doctors’ services could indeed spring from indulging a desire for dependence upon a paternalistic doctor, even as this confounds expectations around “consumerism” (Williams in Lupton, 1997: 380). The expectation that people have when visiting a doctor is to have a prescription or a solution to their problem. However, people also want a ‘longer’ consultation and want to be heard by the health professional about their concerns, fears, and emotions.
It is possible to say that preventive medicine lacks what people most look for when visiting a doctor: someone who actually listens to them and cares for their social bodies. Even though we want to be free of the diseases and sickness that might burden us, we also want to feel cared for by the doctor. Thus, doctors – and other health professionals – should not only care about their patients but also care for them. Preventive medicine should walk hand in hand with social medicine since these two are complementary to each other. The biological aspects of health and healthcare, as well as of diseases are extremely important. However, we may not forget that these are directly influenced by our social worlds. We may use preventive medicine’s instruments to prevent and treat our ailments. However, we should also use our social ‘essence’ when approaching the best ways of preventing and treating diseases.
Foucault, Michel. 1977. Discipline and Punish: The Body of the Condemned. New York: Vintage Books: A Division Of Random House. Inc.
Lupton, Deborah. 1997. Consumerism, Reflexivity and the Medical Encounter. Soc. Sci. Med. Vol. 45, No. 3, pp. 373-381.
Clarke, E.A. 1974. What Is Preventive Medicine? Canadian Family Physician.
St. George’s University. What Is Preventive Medicine? A Look at What These Proactive Providers Do. 2018. Retrieved from https://www.sgu.edu/blog/medical/what-is-preventive-medicine/ (accessed in 08-25-2019)