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in the USSR, a complex scientific discipline that aims to develop measures for protecting and improving the health of society by studying the state of health of the general population and specific population groups, the influence of socioeconomic factors on public health, and the forms and administration of public health. Social medicine is distinguished from medicobiological and clinical disciplines that study healthy and diseased states of the body.
Social medicine is closely related to the social sciences, including political economy, sociology, demography, and the general theory of administration. It concentrates primarily on social conditions and studies the interrelationships between social and biological factors in medicine. Evaluations are made primarily on the basis of statistics. Social medicine also utilizes evaluations made by specialists in various fields, experiments, models, questionnaires, and the historical method.
The bases of social medicine are associated with the study of occupational diseases, medicotopographical data, and public-health statistics. In the late 18th century the use of J. P. Frank’s system of medical police promoted the state regulation of public health. In the 19th century the development of social medicine was associated with the rise of capitalism and with bourgeois-democratic revolutions. In Great Britain, France, Germany, and other countries data were gathered on how working and living conditions affected the health of workers. Statistical methods were used in making evaluations, and attempts were made to substantiate scientifically public-health measures. The term “social medicine” was introduced at this time.
In Russia the development of research in social medicine was also associated with zemstvo medicine (the district form of rural medical service that arose in the late 19th century). A fundamental role in disseminating the views of social medicine was played by the journal Arkhiv sudebnoi meditsiny i obshchestvennoi gigieny (Archives of Forensic and Social Medicine) and by scientific medical societies, including the Society of Kazan Physicians. F. F. Erisman, E. A. Osipov, N. I. Teziakov, and A. I. Shingarev were among the physicians who gathered statistics on the health of various social groups in the population.
From the late 18th century until the 1870’s specific issues were presented in medical-police and social-medicine courses in various countries. At the turn of the 20th century chairs of social medicine were established, and independent courses in social medicine and social hygiene were given by A. V. Korchak-Chepurkovskii in Kiev (from 1906), A. I. Shingarev in St. Petersburg (from 1908), L. Teleky in Vienna (from 1909), and A. Grotjahn in Berlin (from 1912). The subsequent development of social medicine proceeded under the influence of social democratic ideas and the class struggle of the proletariat in capitalist countries.
In the USSR the basis of social medicine became the methodology of Marxism-Leninism. The principles of the radical solution of issues in social medicine were elaborated in the works of V. I. Lenin and were included in the programs of the RSDLP(B) and, later, of the RCP(B) and the CPSU. The organizational basis of social medicine is the Soviet system of public health, which is directed toward the socioeconomic transformation of society and the elimination of social roots generating diseases and which makes available state measures for the protection of the health of citizens. It is under socialist conditions that social medicine is best able to elaborate the scientific bases for therapeutic preventive measures fostering the harmonious physical and spiritual development of man and promoting maximum life expectancy. The development of social medicine and the introduction of preventive medicine into medical practice and into the system of medical education were promoted by the activities of the subdepartments of social medicine created in the First Moscow State University (N. A. Semashko, 1922), the Second Moscow State University (Z. P. Solov’ev, 1923), and the State Institute of Social Medicine (A. V. Mol’kov, 1923). Subdepartments of social medicine were later created in all higher medical institutions.
The leading scientific center on social medicine and public-health administration is the N. A. Semashko All-Union Scientific Research Institute of Social Medicine and the Organization of Public Health of the Ministry of Public Health of the USSR (Moscow). Research is being conducted in the USSR on theoretical issues of social medicine and the organization of public health, on social conditions and the health of the population, and on the scientific foundations of the economics and planning of public health. An automated public-health planning and administration system is being developed, and the scientific foundations of the organization of medical care and the training and education of the population in social medicine are under study. Social medicine is part of the curriculum at several institutions outside the USSR, including the Institute of Social Hygiene and Health Organization of the People’s Republic of Bulgaria, the Academy for Advanced Training of Physicians in the German Democratic Republic, and the Institute of Social Medicine and Organization of Public Health of the Czechoslovak Socialist Republic. All-Union, republic, and local societies of hygienists and public-health physicians have groups specializing in social medicine. International organizations that function in the area of social medicine include the World Health Organization (founded 1948), the International Medical Association for the Study of Living Conditions and Health (founded 1951), and the European Association of Social Medicine (founded 1955).
In the USSR, the principal journal that regularly publishes articles on social medicine is Sovetskoe zdravookhranenie (Soviet Public Health; Moscow, since 1942). Articles on the topic also appear in Gigiena i sanitariia (Hygiene and Sanitation; Moscow, since 1922) and republic journals, including Zdravookhranenie Rossiiskoi Federatsii (Public Health of the Russian Federation; Moscow, since 1957).
International journals on social health published outside the USSR include La sante publique (Public Health; Bucharest, since 1957) and Social Science and Medicine (Oxford, since 1967). National journals include British Journal of Preventive and Social Medicine (London, since 1947), Public Health Reports (Washington, since 1878), and Revue d’epidemiologic, medecine sociale et sante publique (Paris, since 1953). Leading journals of abstracts on social medicine are Meditsinskii referativnyi zhurnal, Razdel 16: Sotsial’naia gigiena i organizatsiia zdravookhraneniia (Medical Journal of Abstracts, Section 16: Social Medicine and Organization of Public Health; Moscow, since 1956) and Excerpta Medica, Section 17: Public Health, Social Medicine and Hygiene (Amsterdam, since 1955).
In the USSR, social medicine is taught at medical institutes by departments of therapeutics, pediatrics, and public health and hygiene under the control of subdepartments of social medicine and public-health organizations (from 1941 to 1966—sub-departments of public-health organizations). Outside the USSR it is controlled by subdepartments of social medicine, public-health organizations, and community health protection.
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IU. P. LISITSYN and lu. A. SHILINIS