This is a question we hear all the time from students. This site has been created by faculty at the Department of Social and Family Medicine at AECOM to answer that question. The Social Medicine Portal will showcase the many aspects of social medicine and the incredible breadth of the movements inspired by it.
It is possible to argue that all medicine by its very nature is social. The way we define diseases and health, the methods we use for diagnosis and treatment, how we finance health care, all these cannot help but reflect the social environment in which medicine operates.
Social medicine, however, looks at these interactions in a systematic way and seeks to understand how health, disease and social conditions are interrelated. This type of study began in earnest in the early 1800’s. It was the time of the Industrial Revolution and it was impossible to ignore the extent to which the factory system impoverished the workers, thus creating poverty and disease.
The most famous representative of early social medicine is Rudolf Virchow, the distinguished German pathologist who developed the theory of cellular pathology. Virchow was also a social reformer who remarked that “politics is nothing more than medicine on a grand scale.” In the 20th century George Rosen would distill the Virchow’s principles into the following:
- Social and economic conditions profoundly impact health, disease and the practice of medicine.
- The health of the population is a matter of social concern.
- Society should promote health through both individual and social means.
As might be gathered from these ideas, social medicine was not simply an academic pursuit. Its practitioners were political reformers, radicals, activists. Virchow believed that the “physician was the natural advocate for the poor.” And this defense of social justice would stamp future generations of physicians and health care workers. Social medicine has grown and developed in many different ways in the past two centuries. At times it has seemed as if the “biomedical paradigm” would make social issues in medicine irrelevant. Yet we cannot escape the reality that we are social animals and our diseases occurs in “social animals” and not in test-tubes. The current debate over HIV treatment access illustrates both the astounding success and spectacular failure of modern biomedicine. Why is it that most AIDS patients will simply not get the medications that can save their lives?
You can read a fuller explanation of these ideas in our paper “What is Social Medicine?” that was published in Monthly Review.