Introduction
This note covers how social factors cause disease (social aetiology), how their effect is stopped (social prophylaxis), how disease is treated by social means (social therapy) and how people are returned to society (social rehabilitation).
Social aetiology
- Explains how far social factors have an impact on individual or public health.
- The impact may be of indirect or direct character, and positive, negative or both.
- Direct: congenital factors, weather, pathogen. Indirect: predisposition.
- Positive: good health promotion, education. Negative: problems with healthcare services, a bad work environment.
- Mechanisms by which social factors have a negative impact:
- direct cause of disease
- predisposition to a disease
- transport of the cause of the disease (transmission)
- influence on the flow of the disease
- Example: primary hypertension, with smoking, stress, dyslipidaemia, obesity and lack of exercise.
Social factors (mnemonic F PPP H)
- Personal
- Family
- Professional
- Public
- Related to the healthcare services
Social prophylaxis
- Analyses all the identified social factors and the ways to stop them by prevention. Once a social risk factor affecting health is identified, preventive programmes are developed to inhibit its influence on the health of individuals or the public.
- Exposure to these factors is reduced by primary, secondary and tertiary prevention.
- Primary prevention
- Intervention at the stage of susceptibility; reduction of exposure to noxious effectors; preventing the actual occurrence of a disease.
- Non-specific: health promotion by enhancing awareness, changing behaviours and supporting good health practices, e.g. sex education and AIDS awareness day.
- Specific: protective measures such as immunisation and vaccination, B12 and folic acid for pregnant women, iodisation of salt; health and safety measures such as seatbelts and helmets.
- Secondary prevention
- Early detection and treatment of disease at the pre-clinical and clinical stages to prevent progression and complications, reducing the impact of a disease that has already occurred by detecting and halting its progress.
- Examples: mammography, colonoscopy, general check-ups, modified (ergonomic) work conditions.
- Tertiary prevention
- The full picture of the disease is seen; the aim is to reduce the impact of ongoing injury or illness by managing it long term and improving quality of life and life expectancy.
- Main goal of social medicine here: limitation of disability and rehabilitation.