第一章 09级社会医学绪论 PPT课件.ppt

社会医学
Social Medicine
社会医学与卫生事业管理教研室
高娉
第一章概论
1840
tubercle bacillus identified
1940
Death rate per million
Death rates from tuberculosis in England and Wales, 1840-1960
Case study 1
Cooper指出:
我们的同行发现了一个重大而严肃的事情,现代卫生保健对我们的影响可能低于经济状况、教育、住房和环境卫生的影响。我们的固有观念,即充足的、容易得到的高质量卫生保健包治百病,纯粹是一种虚构。
Case study 2
The experience of Eastern Europe
Countries such as Poland, Hungary, Bulgaria, and Russia experienced steady improvement in life expectancy after World War Ⅱ.
These increases ceased and life expectancy began to decline as the economies of these countries have faltered.
In Russia, life expectancy has fallen from 65 years in 1987 to 59 years in 1993.
Case study 3
Why is Japanese life expectancy so high?
For the past three decades, Japan has had the highest life expectancy in the world. This has been achieved while keeping health expenditures as a fraction of gross domestic product (GDP) under 8·5% in 2008, by contrast with 16·4% in the USA or 10·7% in Germany.
Excellent health es in Japan have been attributed to favorable risk factor profiles, health care system performance, and universal coverage.
Defining “social determinants for health”
Social and economic conditions that affect people’s health—对健康产生影响的社会因素
健康的社会决定因素是指在那些直接导致疾病的因素之外,由于人们居住和工作的环境中的社会分层的基本结构和社会决定性条件产生的影响健康的因素。
Why should we be concerned about the social determinants for health?
Health status
CIAR estimated health impact of determinants of health on population health status
The health gradient(健康梯度)