Public Health Sociology

Unit I
Meena Kumari Shrestha
Public Health Sociology
Unit I
Introduction to Public Health Sociology
and
Its Application in Public Health Practice
4 hours
Objectives
•Review of concept of public health including its three domains to
understand application of sociology and social psychology principles in
public health practice
•Thematic domain, such as nutrition, environmental health, life-style,
reproductive health, MCH, communicable and non-communicable
diseases
•Public health core action domain, such as health promoting action,
health risk factors, injuries and disease prevention actions, health
protecting actions, epidemic control actions, and actions leading to
early detection, treatment and compliance to treatment resume
Objectives
•- Public health intervention domain, such as health
education, health promotion strategies, policy and legal
intervention, community organization and participation
• Meaning and definitions of public health sociology as part of
behavioral sciences
• Distinction between public health sociology and medical
sociology
• Importance of public health sociology in the context of three
domains of public health
Concept of public health including its three domains

• Thematic domain, such as nutrition, environmental health,

life-style, reproductive health, MCH, communicable and non-
communicable diseases
Public Health Sociology
Definition of Public health 
The Milbank Memorial Fund Commission (1976) wrote:
• "Public health is the combination of sciences, skills,
and beliefs that is directed towards the maintenance
and improvement of the health of all people through
collective or social actions. 

“Public health is thus a social institution, a discipline,

and a practice."
Public Health Sociology
Definition of Public health 
U.S. Institute of Medicine (The Future of Public Health,
Washington, 1988):
• [The mission of public health lies in] fulfilling society’s
interest in assuring conditions in which people can be
healthy. Its aim is to generate organized community effort
to address the public interest in health by applying scientific
and technical knowledge to prevent disease and promote
health. The mission of public health is addressed by private
organizations and individuals as well as by public agencies.
The committee finds that the core functions of public
health agencies at all levels of government are assessment,
policy, and assurance.
Public Health Sociology
Definition of Public health 
The WHO (1978):
• "Public health is the science and art of preventing disease,
prolonging life and promoting mental and physical health
and efficiency through organized community efforts for
the sanitation of the environment, the control of
communicable infections, the education of the individual
in personal hygiene, the organization of medical and
nursing services for the early diagnosis and preventive
treatment of disease, and the development of social
machinery to ensure to every individual a standard of
living adequate for the maintenance of health, so
organizing these benefits as to enable every citizen to
realize his birthright of health and longevity."
Public Health Sociology
Definition of Public health 
John Last, in the Dictionary of Epidemiology (1999):

• "one of the organized efforts of society to protect,

promote and restore the people's health".  More
recently, Last has noted that public health "can describe
a concept, a social institution, a set of scientific
disciplines and technologies, and a form of practice.
 Public health is an organized activity of society to
promote, protect, improve, and when necessary restore,
the health of individuals, specified groups or the entire
population."
Public Health Sociology
Definition of Public health 
• In 1920, C-E.A. Winslow defined public health as “the
science and art of preventing disease, prolonging life
and promoting health through the organized efforts and
informed choices of society, organizations, public and
private, communities and individuals.” 
Public Health Sociology
Definition of Public health 
• In 1920, C-E.A. Winslow defined public health as “the
science and art of preventing disease, prolonging life
and promoting health through the organized efforts and
informed choices of society, organizations, public and
private, communities and individuals.” 
Thematic domain

Thematic domain,such as:

• Nutrition
• Environmental health,
• Life-style,
• Reproductive health,
• MCH,
• Communicable and non-communicable diseases
Thematic domain

Nutrition: Science of food and its relationship to health

Environmental health,:
Thematic domain

Environmental health: The environment implies all the external factors-

living and non living , material and non material-which surround human. In
its modern concept, environment includes not only the water, air and soil
that form our environment but also the social and economic conditions
under which we live
Components of
• Physical
• Biological
• Social
Purpose is to create and maintain ecological conditions that will promote
health and thus prevent disease
Thematic domain

Life-style: The way of passing the days in life is life style. Life –style is
usually depend upon the community where he lives.
Reproductive health: People have the ability to reproduce and regulate
their fertility , women are able to go through pregnancy and child birth
safely, the outcome of pregnancies is successful in terms of maternal
and infant survival and well being and couples are able to have sexual
relations, free of fear of pregnancy and of contacting disease
Thematic domain

• MCH, Maternal and child health

• Communicable and non-communicable diseases

An illness due to a specific infectious agent on its toxic products
capable of being directedly or indirectly transmitted from human to
human, animal to animal or from the environment through air, dust, soil,
water ,food, etc to man or animal
Concept of public health including its three domains

• Public health core action domain, such as health

promoting action, health risk factors, injuries and
disease prevention actions, health protecting actions,
epidemic control actions, and actions leading to early
detection, treatment and compliance to treatment resume
Concept of public health including its three domains

• Public health intervention domain, such as health education,

health promotion strategies, policy and legal intervention,
community organization and participation.
 Public Health Intervention Domain :
•  health improvement, which draws heavily on the local government
roots of the profession, socio-economic influences and health
promotion, tackling the underlying determinants of health;
• health protection, which incorporates communicable disease control;
environmental, chemical, radiation and nuclear threats; and
occupational health; and
• health service quality improvement, which incorporates healthcare
systems, service quality, evidence-based practice, clinical effectiveness
and health economics.
Operational framework the core skills, knowledge
and competencies needed for services delivery
Meaning and definitions of public health sociology as part of
behavioral sciences
• It provides broad public health perspectives and skills
necessary to assume effective leadership in public health
practice, reflecting the three domains of health improvement,
health protection and health service quality.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•The medical sociology helps to identify and study social groups in their
activities of maintaining and preserving health , alleviating or curing diseases.
•The social group is a social system whose components are interdependent.
• Medical sociology is concerned with the social facets of health and illness,
social function of health institutions and organizations,the relationship of health
care delivery to other social systems and social behavior of health personnel
and consumers ofhealth care.
•In brief, it's the study of relationships between health phenomena and social
factors.
•Thus, in medical sociology health, illness and medical care are studied from
sociological perspectives.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•The units of analysis in medical sociology are;the smallest
social unit of relationships between doctor and patient,
doctor and nurse and others,
• organizational unit includes hospitals, medical associations
etc., social status which refers to occupational categories like
doctor, nurse etc. andcommunity and society where
neighborhood health centre,public health centre and
accessibility of primary health carecan be studied.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•Every society has its own definition of health, illness and
•disease. The medical sociology helps in understanding
•distribution and aetiology of disease in the society, the social
•and cultural perspective on disease, roles and attitude
•towards treatment. Medical sociology contributes to social
•aspects of medicine, for e.g. social factors involved in illness,
•the behavior of patients, medical professionals and other
•health workers as well as different types of medical
•organizations. Social science is concerned with human
•relationships either interpersonal relationships, individual
•personality or in context with its external milieu. Social science
•concerns with the people, who are either healthy or ill, but
•not with the disease itself. In more precise terms, it deals with
•the society in which people live in groups and thus deals
• with its structure, function, change and action.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•The contribution of medical sociology is in two spheres:1
•I. Sociology in medicine
•II. Sociology of medicine
•The sociology in medicine deals with analysis of aetiology of
•health disorders, differences in social attitude towards health
•and the recognition of relation of social variables like sex and
•age to the incidence of a specific health disorder. So, this is a
•type of applied research motivated by a medical problem rather
•than a sociological problem.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•The contribution of medical sociology is in two spheres:1
•I. Sociology in medicine
•II. Sociology of medicine
•The sociology in medicine deals with analysis of aetiology of
•health disorders, differences in social attitude towards health
•and the recognition of relation of social variables like sex and
•age to the incidence of a specific health disorder. So, this is a
•type of applied research motivated by a medical problem rather
•than a sociological problem.
•The sociology of medicine deals with organization's role,
•relationships, norms, values and beliefs of medical practice
•as a form of human behavior. Here, the social processes that
•occur in a medical setting are studied. Thus, sociology of
•medicine is research and analysis of medical environment
•from a sociological perspective. Thus, in short medical
•sociology covers the following aspects of public health:
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•i. Social determinants and distribution of disease
•ii. Attitudes and behavior of individuals and also
•individuals in group settings towards health and
•illness and this in turn decides their concept of
•health and illness, health seeking behavior and their
•level of acceptance towards modern form of
•medicine, their perceived health needs and their
•acceptance or rejection of various health programs.
•iii. It also studies the social environment of medicine
•and helps to design the curricula of trainings for
•health personnel.
•iv. It also studies the relationship between health
•provider and consumer, and thus decides the
•preference of consumer for a particular type of
•service as well as compliance of the consumer to
•the physician's advice.
•v. It studies the medical organizations in structural
•and functional manner.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•As we can see from above, medical sociology helps to
•understand the various factors related with a healthy or ill
•person and not the disease process itself and its specific
•aetiology. Thus, its contribution is more towards
•understanding the problem from a preventive and promotive
•aspect.
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•Role of Medical Anthropology in Public Health
•Medical anthropology is the cross cultural study of medical
•systems and the study of bio-ecological and socio-cultural
•factors that influence the incidence of health and disease
•now and throughout human history. The areas where the
• medical anthropologists do research are human evolution
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•Health Prospect 2012, Vol. 11 29
•anatomy, paediatrics, epidemiology, mental health, drug abuse,
•definition of health and disease, training of medical personnel,
•medical bureaucracies, hospital organization and operations,
•the doctor patient relationship and process of bringing
•scientific medicine to users of traditional medicine. (1,4)
•The medical anthropology can be studied as a bi-polar process
•whose one pole is biological in which one studies human
•growth and development, role of disease in human evolution
•and study of disease of ancient man. The second is sociocultural
•pole where one studies traditional medical systems,
Role of Medical Sociology and Anthropology in
Public Health and Health System Development
•illness behaviour, doctor patient relationship, introduction
•of western medicine to traditional societies and in between
•this there is epidemiology and cultural ecology. (5) So, medical
•anthropology encompasses the study of medical phenomena
•as they are influenced by social and cultural factors and social
•and cultural phenomena as they are influenced by these
•medical aspects. Another definition states that medical
•anthropology is concerned with the biocultural understanding
•of man and his works in relation to health and medicine. (6)
•Medical anthropology studies the relationship between
•human evolution and disease in the past, the biological and
•cultural determinants of disease, health and health care, the
•basis and effectiveness of traditional health care systems
•and suggests ways to integrate modern medicine into
•traditional societies.
•Hence, medical anthropology doesn't study the relationship
•of individual person to disease but studies the relationship
•between the biological and cultural characteristics of a
•group(ethnic or racial) and its resistance of susceptibility to
•various diseases in view of different genetic constitution. (7)
•It studies the traditional medical systems but not the modern
•systems of medicine.
•It helps to understand the disease prevalence and
•susceptibility to the genetic make-up of a man belonging to a
•particular race or ethnicity, impact of disease on human
•evolution and the impact of these inherent ethnic and racial
•differences on the functioning and acceptability of health
•care. (8)
Role of Medical Sociology and Anthropology
in Health System Development

•Public health as seen from the eyes of comprehensive primary

•health care mentioned in Alma Ata declaration covers the
•following aspects that can be analyzed from social and
•anthropological perspective. (9, 10)
•i. It sees health as a process in human development
•and states that it cannot be achieved in isolation
•without associated socio-economic development.
•ii. It strongly affirms that health which is the complete
•state of physical, social and mental well being and
•not merely the absence of disease and infirmity is
•the fundamental human right and to achieve the
•highest level of health should be a world-wide
•social goal.
Role of Medical Sociology and Anthropology
in Health System Development

•iii. For health it lays emphasis on all the aspects of

•health care that is, preventive, promotive, curative
•and rehabilitative.
•iv. Its shape is determined by social goals like quality
•of life and maximum health benefits to the greatest
•number of people and advises to attain these goals
•by social means like community participation.
•v. It lays emphasis on essential health care which is
•accessible, affordable and acceptable by the people
•and with their full participation. This health care
•has to be scientifically sound and socially
•acceptable. It requires co-ordinated efforts from all
•other related sectors.
•vi. It is based on the economic, socio-cultural and
•political conditions of a country and it promotes
•equity.
Role of Medical Sociology and Anthropology
in Health System Development

•Public health as seen from the eyes of comprehensive primary

•political conditions of a country and it promotes
•equity.
•Thus, primary health care as a means of public health looks
•after the health of the people not only by providing health
•services or taking the help of health personnel and health
•services. It lays stress in the overall development process as
•health, social and economic to desired results in the other
•sectors. (11) The benefit of overall development trickles down
•to societies, from there to individual families and lastly the
•individuals themselves. Hence, the name also benefits its
•description, the comprehensive primary health care. This care
•is more action oriented with input from various sectors like
•medical sociology and medical anthropology to meet the
•health needs of the public health system development in a
•better way
Public Health Sociology
Definition of Public health 
U.S. Institute of Medicine (The Future of Public Health,
Washington, 1988):
• [The mission of public health lies in] fulfilling society’s
interest in assuring conditions in which people can be
healthy. Its aim is to generate organized community effort
to address the public interest in health by applying scientific
and technical knowledge to prevent disease and promote
health. The mission of public health is addressed by private
organizations and individuals as well as by public agencies.
The committee finds that the core functions of public
health agencies at all levels of government are assessment,
policy, and assurance.
Public Health Sociology
Definition of Public health 
The WHO (1978):
• "Public health is the science and art of preventing disease,
prolonging life and promoting mental and physical health
and efficiency through organized community efforts for
the sanitation of the environment, the control of
communicable infections, the education of the individual
in personal hygiene, the organization of medical and
nursing services for the early diagnosis and preventive
treatment of disease, and the development of social
machinery to ensure to every individual a standard of
living adequate for the maintenance of health, so
organizing these benefits as to enable every citizen to
realize his birthright of health and longevity."
Public Health Sociology
Definition of Public health 
John Last, in the Dictionary of Epidemiology (1999):

• "one of the organized efforts of society to protect,

promote and restore the people's health".  More
recently, Last has noted that public health "can describe
a concept, a social institution, a set of scientific
disciplines and technologies, and a form of practice.
 Public health is an organized activity of society to
promote, protect, improve, and when necessary restore,
the health of individuals, specified groups or the entire
population."
Public Health Sociology
Definition of Public health 
• In 1920, C-E.A. Winslow defined public health as “the
science and art of preventing disease, prolonging life
and promoting health through the organized efforts and
informed choices of society, organizations, public and
private, communities and individuals.” 
Public Health Sociology
Definition of Public health 
• In 1920, C-E.A. Winslow defined public health as “the
science and art of preventing disease, prolonging life
and promoting health through the organized efforts and
informed choices of society, organizations, public and
private, communities and individuals.” 
Public Health Sociology
Definition of Sociology:
Sociology is the science of society