Social medicine aims to understand how social and economic conditions impact health, disease and the practice of medicine. These are known as the wider determinants of health or 'upstream' factors and include housing, education, income, poverty, transport, health care organization and environmental and genetic influences. By targeting these factors we can prevent illness from happening and so save costs and lives.

A good way of illustrating how social medicine works is if you picture a health professional as a lifeguard on the bank of a river. Every now and then someone floats by and the health professional has to jump in and rescue them. Sometimes it's a body and other times there may be rapids or lots of people drowning. The health professional can only help one person at a time. It is tiring and costly. One day s/he may have a few moments to think about why so many people are falling into the river. What is happening upstream? If you can prevent people from falling into the river in the first place, fewer people will be at risk and the health professional's work would be easier.

So far social medicine sounds like public health but where it differs is in the emphasis on social approaches. Social medicine uses social science and humantities research to improve the practice of medicine, the delivery of treatment and development of healthcare policies. It is also made up of academics whereas public health consists of academics and health professionals.

If you wish to find out more about social medicine, see The Society for Social Medicine.

I came to public health from a sociological background. With all the changes around the white paper on public health and the proposed move into local authority, I'm more aware than ever of the important contribution an understanding of sociology can make to public health. Even if it is as basic as 'thinking sociologically', e.g. if someone wants to give up smoking but can't, what are the barriers stopping him/her? So I'm dedicating two pages to sociology - Medical Sociology and Sociology of Sexual Health.

Medical Sociology

Sociology of Sex, Relationships and Sexual Health