Social medicine as a theoretical basis of Health protection

1. Social medicineSocial medicine
as a theoretical basisas a theoretical basis
of health protectionof health protection

2. •“Civic medicine” studies laws of distribution
of diseases among people’s layers and searches
for causes of this distribution /commission of the
Pirogov association/.
•“Civic medicine” studies experience,
principles and forms of organization of medical
aid, its connection and interaction with civic life
and with local authorities. /A.Shyngarov/
•“Social medicine” studies state action mainly
in field of disease prophylactic /commission/.
•“Social medicine and civic medicine” study
laws of health protection of people
/V.Kanel/.

3. Studying of reasons of disease’s
spreading had begun long before
realizing of social conditionality of the
health. For a long time infectious
diseases with typical for them mass
epidemic spreading were the main
problem so the science, which studied
that, was named “epidemiology”.

4. The WHO conferencing gave the following
definition to civic health protection” – this is
the science and the art of preventing diseases,
prolongation of life and strengthening of
mental and physical health and capacity for
work by means of organization of social
efforts directed at making the environment
healthier, fight against infectious diseases,
train people’s skills of individual hygiene,
organize medical and nursing service for early
diagnostics and preventive treatment of
diseases.

5. Sponsored
Medical Lecture Notes – All Subjects
USMLE Exam (America) – Practice

6. Those measures can be
divided into 2 groups:
• -measures against the diseases;
• -measures aimed at improving
health.

7. Before the beginning of the 20th
century 3 ways of health protection
were formed:
• with help of state measures(the
promulgation of different medical and
social work);
• with help of social measures;
• with help of medical insurance.

8. “Civic health protection”
– this is a science and art of prevention from
diseases, prolongation of life and
strengthening of mental and physical health
and capacity for work by organization of
social efforts, which are directed to make the
environment healthier, to fight against
infectious diseases, to study people skills of
individual hygiene, to organize medical and
nursery service for early diagnostics and
preventive treatment for diseases.

9. Communal health protection
includes the problems of influence upon human
health, determination of its composition, the
environment hygiene, health protection services
and administrative management of medical-
sanitary aid services. But in some countries
“communal health protection” is used as a
synonym of “environment hygiene”; in other
countries it personifies medical-sanitary aid out
of hospital or medical-sanitary work among
people.

10. “Social hygiene” studies interaction of
social factors and human health including
changing of need in medical aid with the
purpose of making the rational economic
system of civic health protection measures
(K.Gargov, 1969).

11. Social hygiene and organization of health
protection studies the sanitative and negative
influence of social factors upon people’s
health and their separate layers, and work
out scientific substantiated recommendations
for realization of measures concerning
liquidation and prevention of unhealthy
influence of social factors on human health
to promote the protection and increasing the
level of civic health (Y. Lisicyn, 1987).

12. Social medicine and
organization of health protection
is a science about social
conformity with human health
and the ways of its improvement
by rational organization of health
protection.

13. The main tasks of social
medicine
• study of the state of human health and processes of
its reproduction;
• ensuring of thorough characteristic of movements
(dynamics), which take place in indices of human
health of the country on the whole and which take
place in regional levels, social-economic, ecologic-
geographic zones, settlements and separate
collectives;
• scientific exposition of conditions and factors which
reduce to positive and negative divergence
• in the state of health of different social, age-sexual
and other population groups

14. • elaboration of the directions of population’s
sanitation and determination of principles of health
protection system, its theoretical and organizing
bases;
• -analysis of health service organ’s activity and
establishments, creating their rational structures and
scientific substantiation of the most expedient forms
of work organization, reformation and
restructurization;
• creation of different-term prognoses and plans of the
development of health protection system with the
purpose of carrying out goal-directed measures
concerning maintaining the due level of human
health.

15. The World Assembly of Health
Protection (WAHP) in its resolution
number 23.61 considers that the optimum
development of health protection in any
country needs making use of generalized
experience of health protection
development in all the countries of the
world. The most effective principles
marked by experience of different
countries of building and development of
national health protection system are the
following:

16. • Proclamation of the responsibility of state and
society for health protection of the population,
which is to be incarnate on the basis of carrying out
the complex of economic and social measures which
promote directly or collaterally to reach the highest
health level of population by creating general
national system of health protection services on the
basis of the only national plan and local plans, and
also by goal-directed and effective use of all
resources, which society may apport on every stage
of its development for requirements of health
protection;

17. • Organization of rational training of national
specialists of all levels of health protection as the
basis for successful work of any health protection
system and realization by all medical specialists of
their high social responsibility to society;

18. • To ensure all population of the country the highest
possible level of qualified, generally accessible
prophylactic and medical aid, which is given
without financial or other restrictions by creating
suitable network of medical, prophylactic and
rehabilitation establishments;
• Wide use achievement of world medical science and
practice of health protection in every country with
the purpose of ensuring conditions for getting
maximum effectiveness of all taken measures in
health protection sphere;

19. • Sanitary education of citizens and drawing
into participation in conducting of all
programmers of health protection of wide
sphere of population are the argument of
personal and collective responsibility of all
members of society for health protection of
people.

20. The basic principles of the Public
Health service:
• The determination of the Public Health service with the
priority direction of the sasaity activities and government as
the one of the basic factors of the surviving and Ukrainian
nation development.
• The observance of the right and liberties of human and
citizen according to the Public Health service and securing
with the state guarantees.
• The human direction, securing with priority, common to all
mankind treasures in classical, national, grope or individual
interests, medical-social protection of the most vulnerable
part of the population.

21. • Of the citizens, democratism and opened to
general use of the medical aid and other
services in the Public Health service.
• Accordance to the task and social-
economical level and cultural development
of the sasaity, scientific explanation,
material and technical and financial
securing.
• Orientation to the modern health standards
and medical aid.
• The unit of the old traditions and
achievements in Public Health service.

22. • Preventive character, and composite. Social
ecological and medical approach to the
Public Health service.
• The unit state guarantees with
demonopolization and connecting of the
enterprises and competition.
• Decentralization of the state department,
development of the autocracy of the
institutions and Public health service staff
independence, based on low and contract.

23. Social medicine
– is a science that studies
social laws of peoples health
and characterizes the ways of
its improvement according to
rational organization of
public health services.

24. Health
is a condition of complete
social, mental and
biological well-being, and
not just the absence of
diseases or physical
defects

25. • 1. Historical, establishes historical regularities of
development of public health and its protection;
• 2. Sociological, that allows studying social
structure of a society and its influence on health;
• 3. Experimental, allows studying advantages
(lacks) of organizational forms of medical service;
• 4. Expertise, which help quality and efficiency of
medical service is studied;
• 5. Economical, that enable to determine economic
efficiency of systems of medical service.

26. Statistical totality
is the common number
of units of supervision,
taken in the set borders
of space and time.

27. Unit of supervision
is every special case of the phenomenon,
that is studied, that it is every primary
element of totality, which belongs to the
account (for example, every case of
disease, birth, deaths, hospitalizations and
others like that).
Such registration elements of totality
divide into attributive (expressed verbally)
and quantitative (expressed by a number).

28. • A general statistical totality is an
totality, which includes all units of
supervision. For example, all
morbidity on the earth.
• A selective statistical totality is an
totality, which includes the certain
part of units of supervision, but
this part is able to represent all
general totality.

29. Indexes of population’s health
The І group is morbidity and traumatism
The ІІ group is demographic indicators
(birth-rate, death rate, natural increase,
death rate of babies, average life duration )
The ІІІ group is disability (primary and
general)
The IV group is physical development
The V group is assignment of population
in health groups

30. Нealth groups
• 1 group are healthy – 20 %
• 2 group are practically healthy –
40 %
• 3 group – chronic patients in the
compensation phase – 35 %
• 4 group – chronic patients in the
subcompensation phase – 4 %
• 5 group – chronic patients in the
decompensation phase – 35 %

31. Group properties of statistical
totality:
• Distribution of characteristic (criterion – relative
sizes);
• Average level of index (criterions – Mo-mode, Me-
median, arithmetical mean);
• Variety of characteristic (criterions – lim- limit, am –
amplitude, σ – average quadratic deviation, Cv –
coefficient of variation );
• Representation (criterions – mM – mistake (error) of
average values, m% - mistake of relative values);
• Correlation between occurrences and features
(criterion – rxy - coefficient of correlation).

32. The stages of statistic
investigation
• 1st stage – composition of the program and
plan of investigation
• 2nd stage – collection of material
• 3ed stage – working up of material
• 4th stage – analysis of material, conclusions,
proposals
• 5th stage – putting into practice

33. The program of statistical research
shows the basic directions of
research and information, which it
is necessary to collect.
The programs are official (medical
statistical forms of document) and
special (which are folded by a
researcher).

34. The program of statistic
investigation consists of the
program of material
collection, the elaboration
program and the program of
analysis.

35. The collection program is the program of
statistic observation, the form with the list
of signs, that have to be registered
(registration’ signs) with an indication on
whom it will be filled in, that is with a
determination of the unit of observation.
There are the official programs of material
collection to study the health and activity
of medical establishments, and special
ones, composed by the investigater.

36. The material elaboration
program is the composition
of models of tables.

37. Types of tables
• simple (that give the material
bringing together only by one
sign);
• group (that give the material
bringing together only by two
sign);
• combinational (connection of three
or more signs).

38. The plan of statistic investigation
consists of:
• 1) the determination of the object of investigation;
• 2) the place of investigation;
• 3) the time of investigation;
• 4) the volume of investigation;
• 5) the method of material elaboration (manual, with the
help of ECM);
• 6) the terms of the carrying out of the work;
• 7) executors;
• 8) composition of the instructions of the methods of
work;
• 9) carrying out of the seminar for the executors.

39. The ways of formation of the object
of investigation:
• by the scope of observation are
continuous or selective;
• by the time of observation – flowing or
one-moment;
• by the way of obtaining the information –
direct observation, copying, filling in a
form.

40. • Complete or continuous research
covers all observation units.
• Selective research covers a
representative part of the
supervision units, which enables to
evaluate phenomenon in whole.

41. The ways of formation
of the statistic integrity
By the volume of observation
continuous
selective
volume
observation
select
ion
accidental
mechanic
typological
serial
regional
combinative
By the time of observation
By the type of observation
flowing
one-moment
direct
copying of the data
By anamnesis
questionnaire
interrogatory
2
22
t
n
∆
σ
=
2
2
∆
=
pqt
n

42. The stages of development of
statistical material are following:
• control /logical and technical/;
• enciphering /code/ of registered signs by
numbers, letters of alphabet;
• lay-out of cards on groups for the subaccount
or groupment;
• report of material;
• deduction of statistical criteria /indexes/, their
graphic image.

43. Thank you!Thank you!