social science and medicine

social science and medicine

The Intersection of Social Science and Medicine: Understanding the Impact on Health and Well-being

1. Introduction to the Interdisciplinary Field of Social Science and Medicine

The interdisciplinary field of social science and medicine is devoted to the analysis of the social determinants of health, health care, and health policy. The focus of the field is primarily mainstream interpretations of health and those interpretations that critique dominant perspectives. The field covers medical and political research, health care studies, health and welfare policies, social change, health behavior, professional work in the health services, health stratification and inequalities, quality and outcomes of health care, clinical work, administration, management, and planning of health services, managed care, holistic health, primary health care, and health economics. This field is not narrowly ‘behavioral’, ‘structural’, or ‘cultural’. However, critical perspectives are welcome, as are those that are concerned with positive interdisciplinary integration. Social science includes sociology, politics, geography, history, anthropology, political economy, and many other ‘overlapping’ areas of interest.

– Original research articles – 10/02/34, 10/02/66, 10/02/17, 10/02/24, 10/02/27, 10/02/53, 10/02/60, 10/09/66, 10/09/17, 10/09/24, 10/09/27, 10/09/53, 10/09/60, 20/01/02, C3

“SSM: Social Science & Medicine” is a leading interdisciplinary journal that addresses the important role of social science in understanding, influencing, and shaping health and illness. It publishes original research articles on a wide range of topics of major importance to social and health policy and organization, the individual, society, and health. It is an international, peer-reviewed, and interdisciplinary publication. SSM invites papers with policy implications from a broad range of disciplines including anthropology, criminology, economics, epidemiology, statistics, geography, gerontology, international relations, political science, psychology, social work, and sociology. SSM publishes the following types of papers:

2. The Influence of Social Determinants on Health Outcomes

What the health sector has historically largely ignored, however, is that placing more resources or simply providing better information has many fundamental limiters. A critical insight into when good nutrition will translate into health is what laboratory and clinical measures of health and their interaction with the broader documents can best teach. Conversely, the ability to enhance broader societal conditions could potentially provide a way out of what appears to be a low return to health spending in so many populations. Implicit in my own work is the growing realization that improving health is likely to be much more demanding a task than the idea that simply knowing more and doing more on the delivery side. Central to this relationship is the potentially large and even dominant demographic at what has historically been defined as the demand-side of economic research, but which in the context of health may also be a critical part of aggregate supply-side policy.

The world of health policy has been shaped for decades by a growing recognition of the influence of social determinants on health outcomes. The WHO (2008) classifies determinants into five categories: (1) socio-economic context, (2) age, gender, and hereditary factors, (3) individual behavior, (4) social and community networks, and (5) health services. Implicit in this classification is the fact that two domains – social determinants and health outcomes – rest at the center of a larger, overarching framework. Nonetheless, public and private health spending have focused primarily on the right-hand side of the diagram. Typically, providers and policymakers have worked at the patient or community level, focusing on how to facilitate the embodiment of new clinical knowledge or services through such tools as payments or education and trusting that these elements of supply-side health economics will execute their mission effectively. The currency of the supply-side delivery enterprise remains a dialogue that more typically sees health downplayed in a patient’s larger life instead of recognizing the critical role this broader world plays.

3. The Role of Cultural Competence in Healthcare Delivery

Cultural and linguistic competence means the capacity to possess cultural and linguistic predispositions to healthcare access and delivery that allow individuals to include the terms of the culture, values, beliefs, and behaviors of those who make tools for healthcare. It is the potential of being known culturally and linguistically for tools that are accessible, user-friendly, and alternatives that are equal and trusted in health literacy. The objective would be to avoid health discrepancies that result from cultural recognition, cultural implementation, cultural treatment decision-making, and social transformation operations. Addressing health insurance disparities in our attempts to establish a healthcare system that emphasizes a public health preventive model requires cultural competence. These issues are translated by cultural expertise through the identification and the end of racial, ethnic, and culturally-based health disparities.

In order to better integrate social science and medical practices and enhance health outcomes, the impact of social determinants of health and cultural competence has been increasingly emphasized. Most individuals are aware that access to health insurance and medical care can only go so far. Healthy eating and exercise benefit more than medicine, and cultural beliefs can affect health behaviors differently. Unfortunately, the conversation about what to do about these social issues in a clinical setting is happening more slowly, leaving a gap between understanding the role of social determinants of health and the effort to address them. More succinctly, no one is clear on who is responsible for acting on reported social data in the same integrated way that other clinical data is managed to be responsible for health, because no one is responsible.

4. Innovations in Integrating Social Science into Medical Practice

To discover and address the social determinants of health, scholars and providers will need to develop increased research literacy so that they are able to be partners, and not just consumers, of health research. This includes a deeper understanding that the patterns of poor health are due to social conditions and not only individual failures. To spearhead the movement to integrate social science research into medical practice, we feel that medical schools are the key. This issue of IJERPH highlights a number of innovative approaches that can be taught at the medical school level and then incorporated into practice. Our society would benefit from it.

This special issue has featured research that demonstrates the importance of incorporating social science into medical research and practice. As our understanding of the social determinants of health has increased, medical practice has not adapted as quickly as it should. Our hope is that the current research that is being featured continues to push the boundaries of integrating social science into medical research and identifies how providers can use their research in clinical practice. A number of articles suggest that sociological issues need to be integrated into the curriculum. In particular, poverty and racial disparities are often not addressed in medical training and how this gap influences the ability of physicians to empathize with and care for their patients who suffer the consequences of poverty and disparities.

5. Future Directions and Implications for Research and Policy

While these examples provide preliminary evidence of the potential for these two bodies of knowledge to inform each other, the work still needs to be done. There is also a large body of health outcomes research that will require input from social scientists. Given the complexity of the determinants of health care utilization, the varied nature of the factors contributing to individual health outcomes, and the growing statistical sophistication of social science researchers, it is likely that these contributions will come soon. What will be the implications for future health outcomes research and health policy?

While a great many factors have been linked to health and well-being status, our understanding of the biological, psychological, and sociological mechanisms by which these variables impact health is nascent at best. This chapter has presented a set of conceptual frameworks that help elucidate the mechanisms through which social science can impact health research. Examples involving specific patient populations (such as elderly patients, critically ill patients) and health care delivery (the hospital environment, levels of medical services, the insurance principal, the country in which medical services are delivered) were used.