Health between medicine and society
Individual health is defined as much by the absence of disease or infirmity as the absence of risk factors. It is the purpose of the medicine, which, by a working laboratory and epidemiology seeks to discover the origin of diseases, in order to find the means of their prevention and their healing.
1.1. Of evolving diseases
The evolution of diseases due in part to advances in medical science: the discovery of new drugs and the huge improvements in the hygiene explain the discontinuation of certain threats epidemic, as in the case of the plague, and the World regression diseases transmitted by contaminated water. But habituation of the organism to medications (→ résitances) - or even changes to the agent responsible for the disease - causes the resurgence of certain infectious diseases.
Diseases contagious have their history: if some disappear, such as smallpox eradicated since 1978, new are emerging (the AIDS in the 1980s); others, after a temporary eclipse, tend to recur. Thus, tuberculosis, plague of xix th century and the first half of the XX th century seems once again become threatening in rich countries after being dammed for almost fifty years. Similarly, each mutation of one of the virus flu causes an epidemic or pandemic.
At the same time, we see exploding the frequency of diseases like obesity, the type 2 diabetes and cardiovascular diseases related to overeating, or the Alzheimer's disease linked to global aging population.
1.2. The social and political factors related to health
Advances in basic research are not enough to fully realize the causes of disease trends, and therefore the evolution of the concept of health. It also depends on social and political factors. Thus, health and social policy implementation at the country level by the state (creation of hospitals, free health care, prevention, etc.), or as part of an international cooperation, she plays an essential role in the improvement of health. Meanwhile, some economic changes also impact on the evolution of diseases and the development of the industry he has led both an urbanization accelerated and the emergence of new problems, including those related to work (occupational diseases ) or pollution.
Finally, the health desire - or the fear of disease - falls within the scope of collective mentalities. At each stage of its development, a company is characterized by a particular vision of the body and death; explicit part, partly unconscious, that vision affects people's behavior in everyday life and therefore influences their relation to disease. This subjective dimension of the problem is important. Work medicine Psychosomatic showed the psychic origin of many organic disorders; ethnopsychiatry studies the psychic disorders of a patient according to the cultural group norms which it belongs.
The concept of health therefore call, in addition to the views of scientific medicine, a historical, sociological and psycho-sociological.
2. Health: Object research and objective
2.1. The ratio of the population to the disease
Over the centuries, from antiquity to the late Middle Ages in particular, the same conceptions that inspired medical research could only help, eventually, to change mentalities. However, the evolution was slow, because subjected to contradictory influences. The economic development of Europe - that can be traced back to the xii th century - allowed, thanks to technical and scientific progress, a better knowledge of nature, both in its geographical variety (role of travel → great discoveries in From the end of the xv th century) and in the complexity of its structures (advances in science).
For more information, see the article History of Medicine.
But overall growth unequally benefits different social groups. Thus the improvement of hygiene is far from universal and continuous; it should be noted in particular that the extension of cities, where popular housing is often precarious, often creates unhealthy islands. The history of European companies is thus punctuated by the regular return of epidemics: the plague, with resurgences of xiv th to xviii th century, remains the most notorious of these; but the cholera again in 1832 killed over 18 000 people in Paris. The typhus, the smallpox, the flu virulent (like the "Spanish flu" that struck France in 1918) were also murderers.
The frequency and magnitude of these infectious diseases are explained by the conditions of existence (promiscuity promotes contagion) and inadequate therapeutic knowledge. But it should be emphasized especially their impact on the ratio of the population with the disease, and therefore on collective mentalities. Faced with a disease that can occur at any time, the feeling of insecurity is spreading. In what appears to the eyes of many, as inevitable, there are extranaturelles explanations: the epidemic would be a punishment of sins, or the result of plots hatched by evil forces (in the Middle Ages were accused Jews of poisoning wells and drinking fountains, and even a rumor in Paris during the 1832 cholera epidemic).
Epidemics were at the origin of collective fears, experienced by all classes of society, although qu'expliquées differently. Hence a conception of disease as an absolute anomaly. The most seriously ill were considered dangerous, and therefore affected by exclusion. The case of leprosy, stationed in reserved areas, forced to wear special clothing reflects this rejection. Other categories of patients - severely disabled in particular - suffer a similar fate. Patients are, to a large extent treated as scapegoats: they are punished because they are held accountable to the public misfortune. They join the category of those who are excluded for reasons unrelated to health: witches, heretics, Jews, etc.
This irrational attitude towards the disease diminishes with the progress of the prophylaxis and education, but it leaves in the collective imagination deep marks: the belief in the fatal inheritance, widespread at the end of xix th century (and as evidenced by the work of the writer Emile Zola), fear of the contagion of tuberculosis is clearly shown. The appearance of AIDS in the 1980s, and the persistence of misconceptions about its modes of contamination show that these obsessions are not totally overcome today.
2.2. The slow birth of a right to health
It is in the Renaissance that among the elite, attitude towards health is fundamentally changed. The Western world then accesses the so-called modernity. This is the culmination of a scientific nature reflections initiated since ancient Greco-Roman and whose development was possible due to the new social and cultural conditions.
Individualism gradually appears as the necessary condition for the proper functioning of society. And its development is done first at the expense of the hegemony of the Catholic Church: free examination of all that existed and exists becomes an intellectual behavior rule. This is the very idea of revealed truth which is implicitly called into question, and it will express the xviii th century by the philosophers of the Enlightenment. For progressive it is, this "cultural revolution" created a great void: we must find a new explanation of the world system as it is and the story as it is. Gradually emerged the idea of continuous progress of humanity. Belief in bliss reserved for the afterlife of life gives way to the affirmation of a possible happiness here and now. And science, continuous development, serves as collateral for this new vision. At the same time, the horizon of research expands focusing on the human being: all the activities of men and women deserve to be studied, those within the art or philosophy such as those ensure the daily well-being.
It is in this context that achieves the disruption of relationships with illness and health: the pain and evil are no longer perceived as inevitable that the most harmful consequences can only mitigate, the physical becomes a normal lens, and the body is restored. Medical research conquers a prominent place in all the sciences. Medicine is a profession (this is already expressed by Molière in the Malade Imaginaire, ridiculing late doctors on genuine knowledge of the body and its disorders). Progress does however benefit only a minority of society, one whose wealth allows access to culture. However, the momentum of the new spirit is to win sooner or later the whole public space of democratic movements xviii th and xix th centuries, with emphasis on human rights, will contribute; they will make the fight against the disease and the health guarantee a universal requirement.
3. The need for public health
The organization of care is long remained the responsibility of private initiative. The role of the Church was, in this respect, decisive: it is around religious institutions, often on the initiative of specialized orders, were born the first forms of hospitals. Later, the charity helped rich people poor access to care. It was generally even during epidemics, the task of the authorities confining itself mostly to the disposal of bodies of the victims to reduce the risk of contagion. The fight against the disease was within a spirit of charity, and was therefore linked to religious beliefs, as well as the assistance provided to the poor.
This is the nineteenth e century that the State was brought in most industrial countries, to support the community's health problems. This birth of Public Health has many causes, including changing attitudes, hastened by political transformations resulting from the democratic revolutions (the French Revolution in particular). When are proclaimed inviolable freedom and equality (Declaration of Human Rights and the Citizen of 26 August 1789) and that "the pursuit of happiness" (United States Declaration of Independence of July 4, 1776) is considered as an "inalienable right", it is normal that the poorest are trying to translate these general principles in concrete terms, daily. Modern politics, which will lead to the triumph of universal, leads to social application for accession to the greater well-being.
3.1. The role of the state facing industrialization
This requirement is made longer by the current development of the industry in xix th century. Especially if the workers are at that time stationed in neighborhoods located generally on the outskirts of cities, they are nonetheless present; and the spectacle of poverty that is often their lot is offered to all eyes. Sociological surveys (as in France, that of Louis-René Villermé on textile workers [1840]) also alert public opinion. A feeling of solidarity spreads, combined with a certain fear: the working classes are also, by their very misery of the "dangerous classes" (in the words of the historian Louis Chevalier) that must prevent violence.
There is yet another reason for the emergence of health problems in the public domain: the production requirements require contractors to ensure a certain standard of living labor. As we will be concerned to provide basic training to workers (in France, with the Jules Ferry laws on primary school), and we will care of the minimum needed to maintain health of the existence of employees - demanding that the unions.
The combination of political factors, the awakening of public opinion and economic imperatives led the government to implement a health policy that integrates the development of social protection. The State is only one with the means necessary to know all the problems and to implement solutions. In most countries, this new orientation is reflected in the establishment of specialized ministries. But it is the xx th century, after the economic crisis of the 1930s - and even more after the Second World War - that health will enroll at the forefront of government concerns. The establishment of various forms of social assistance - which will allow the access to medical care for all categories of the population - will strengthen the concept of the welfare state.
The modalities of state intervention vary by country. Four areas we can nevertheless distinguish: disease prevention, itself dependent upon the organization of research; the establishment of a network of health centers (hospitals, clinics); the accession of the population to routine care (which refers to the operation of Social Security).
3.2. WHO and international cooperation
By Piter
Individual health is defined as much by the absence of disease or infirmity as the absence of risk factors. It is the purpose of the medicine, which, by a working laboratory and epidemiology seeks to discover the origin of diseases, in order to find the means of their prevention and their healing.
1.1. Of evolving diseases
The evolution of diseases due in part to advances in medical science: the discovery of new drugs and the huge improvements in the hygiene explain the discontinuation of certain threats epidemic, as in the case of the plague, and the World regression diseases transmitted by contaminated water. But habituation of the organism to medications (→ résitances) - or even changes to the agent responsible for the disease - causes the resurgence of certain infectious diseases.
Diseases contagious have their history: if some disappear, such as smallpox eradicated since 1978, new are emerging (the AIDS in the 1980s); others, after a temporary eclipse, tend to recur. Thus, tuberculosis, plague of xix th century and the first half of the XX th century seems once again become threatening in rich countries after being dammed for almost fifty years. Similarly, each mutation of one of the virus flu causes an epidemic or pandemic.
At the same time, we see exploding the frequency of diseases like obesity, the type 2 diabetes and cardiovascular diseases related to overeating, or the Alzheimer's disease linked to global aging population.
1.2. The social and political factors related to health
Advances in basic research are not enough to fully realize the causes of disease trends, and therefore the evolution of the concept of health. It also depends on social and political factors. Thus, health and social policy implementation at the country level by the state (creation of hospitals, free health care, prevention, etc.), or as part of an international cooperation, she plays an essential role in the improvement of health. Meanwhile, some economic changes also impact on the evolution of diseases and the development of the industry he has led both an urbanization accelerated and the emergence of new problems, including those related to work (occupational diseases ) or pollution.
Finally, the health desire - or the fear of disease - falls within the scope of collective mentalities. At each stage of its development, a company is characterized by a particular vision of the body and death; explicit part, partly unconscious, that vision affects people's behavior in everyday life and therefore influences their relation to disease. This subjective dimension of the problem is important. Work medicine Psychosomatic showed the psychic origin of many organic disorders; ethnopsychiatry studies the psychic disorders of a patient according to the cultural group norms which it belongs.
The concept of health therefore call, in addition to the views of scientific medicine, a historical, sociological and psycho-sociological.
2. Health: Object research and objective
2.1. The ratio of the population to the disease
Over the centuries, from antiquity to the late Middle Ages in particular, the same conceptions that inspired medical research could only help, eventually, to change mentalities. However, the evolution was slow, because subjected to contradictory influences. The economic development of Europe - that can be traced back to the xii th century - allowed, thanks to technical and scientific progress, a better knowledge of nature, both in its geographical variety (role of travel → great discoveries in From the end of the xv th century) and in the complexity of its structures (advances in science).
For more information, see the article History of Medicine.
But overall growth unequally benefits different social groups. Thus the improvement of hygiene is far from universal and continuous; it should be noted in particular that the extension of cities, where popular housing is often precarious, often creates unhealthy islands. The history of European companies is thus punctuated by the regular return of epidemics: the plague, with resurgences of xiv th to xviii th century, remains the most notorious of these; but the cholera again in 1832 killed over 18 000 people in Paris. The typhus, the smallpox, the flu virulent (like the "Spanish flu" that struck France in 1918) were also murderers.
The frequency and magnitude of these infectious diseases are explained by the conditions of existence (promiscuity promotes contagion) and inadequate therapeutic knowledge. But it should be emphasized especially their impact on the ratio of the population with the disease, and therefore on collective mentalities. Faced with a disease that can occur at any time, the feeling of insecurity is spreading. In what appears to the eyes of many, as inevitable, there are extranaturelles explanations: the epidemic would be a punishment of sins, or the result of plots hatched by evil forces (in the Middle Ages were accused Jews of poisoning wells and drinking fountains, and even a rumor in Paris during the 1832 cholera epidemic).
Epidemics were at the origin of collective fears, experienced by all classes of society, although qu'expliquées differently. Hence a conception of disease as an absolute anomaly. The most seriously ill were considered dangerous, and therefore affected by exclusion. The case of leprosy, stationed in reserved areas, forced to wear special clothing reflects this rejection. Other categories of patients - severely disabled in particular - suffer a similar fate. Patients are, to a large extent treated as scapegoats: they are punished because they are held accountable to the public misfortune. They join the category of those who are excluded for reasons unrelated to health: witches, heretics, Jews, etc.
This irrational attitude towards the disease diminishes with the progress of the prophylaxis and education, but it leaves in the collective imagination deep marks: the belief in the fatal inheritance, widespread at the end of xix th century (and as evidenced by the work of the writer Emile Zola), fear of the contagion of tuberculosis is clearly shown. The appearance of AIDS in the 1980s, and the persistence of misconceptions about its modes of contamination show that these obsessions are not totally overcome today.
2.2. The slow birth of a right to health
It is in the Renaissance that among the elite, attitude towards health is fundamentally changed. The Western world then accesses the so-called modernity. This is the culmination of a scientific nature reflections initiated since ancient Greco-Roman and whose development was possible due to the new social and cultural conditions.
Individualism gradually appears as the necessary condition for the proper functioning of society. And its development is done first at the expense of the hegemony of the Catholic Church: free examination of all that existed and exists becomes an intellectual behavior rule. This is the very idea of revealed truth which is implicitly called into question, and it will express the xviii th century by the philosophers of the Enlightenment. For progressive it is, this "cultural revolution" created a great void: we must find a new explanation of the world system as it is and the story as it is. Gradually emerged the idea of continuous progress of humanity. Belief in bliss reserved for the afterlife of life gives way to the affirmation of a possible happiness here and now. And science, continuous development, serves as collateral for this new vision. At the same time, the horizon of research expands focusing on the human being: all the activities of men and women deserve to be studied, those within the art or philosophy such as those ensure the daily well-being.
It is in this context that achieves the disruption of relationships with illness and health: the pain and evil are no longer perceived as inevitable that the most harmful consequences can only mitigate, the physical becomes a normal lens, and the body is restored. Medical research conquers a prominent place in all the sciences. Medicine is a profession (this is already expressed by Molière in the Malade Imaginaire, ridiculing late doctors on genuine knowledge of the body and its disorders). Progress does however benefit only a minority of society, one whose wealth allows access to culture. However, the momentum of the new spirit is to win sooner or later the whole public space of democratic movements xviii th and xix th centuries, with emphasis on human rights, will contribute; they will make the fight against the disease and the health guarantee a universal requirement.
3. The need for public health
The organization of care is long remained the responsibility of private initiative. The role of the Church was, in this respect, decisive: it is around religious institutions, often on the initiative of specialized orders, were born the first forms of hospitals. Later, the charity helped rich people poor access to care. It was generally even during epidemics, the task of the authorities confining itself mostly to the disposal of bodies of the victims to reduce the risk of contagion. The fight against the disease was within a spirit of charity, and was therefore linked to religious beliefs, as well as the assistance provided to the poor.
This is the nineteenth e century that the State was brought in most industrial countries, to support the community's health problems. This birth of Public Health has many causes, including changing attitudes, hastened by political transformations resulting from the democratic revolutions (the French Revolution in particular). When are proclaimed inviolable freedom and equality (Declaration of Human Rights and the Citizen of 26 August 1789) and that "the pursuit of happiness" (United States Declaration of Independence of July 4, 1776) is considered as an "inalienable right", it is normal that the poorest are trying to translate these general principles in concrete terms, daily. Modern politics, which will lead to the triumph of universal, leads to social application for accession to the greater well-being.
3.1. The role of the state facing industrialization
This requirement is made longer by the current development of the industry in xix th century. Especially if the workers are at that time stationed in neighborhoods located generally on the outskirts of cities, they are nonetheless present; and the spectacle of poverty that is often their lot is offered to all eyes. Sociological surveys (as in France, that of Louis-René Villermé on textile workers [1840]) also alert public opinion. A feeling of solidarity spreads, combined with a certain fear: the working classes are also, by their very misery of the "dangerous classes" (in the words of the historian Louis Chevalier) that must prevent violence.
There is yet another reason for the emergence of health problems in the public domain: the production requirements require contractors to ensure a certain standard of living labor. As we will be concerned to provide basic training to workers (in France, with the Jules Ferry laws on primary school), and we will care of the minimum needed to maintain health of the existence of employees - demanding that the unions.
The combination of political factors, the awakening of public opinion and economic imperatives led the government to implement a health policy that integrates the development of social protection. The State is only one with the means necessary to know all the problems and to implement solutions. In most countries, this new orientation is reflected in the establishment of specialized ministries. But it is the xx th century, after the economic crisis of the 1930s - and even more after the Second World War - that health will enroll at the forefront of government concerns. The establishment of various forms of social assistance - which will allow the access to medical care for all categories of the population - will strengthen the concept of the welfare state.
The modalities of state intervention vary by country. Four areas we can nevertheless distinguish: disease prevention, itself dependent upon the organization of research; the establishment of a network of health centers (hospitals, clinics); the accession of the population to routine care (which refers to the operation of Social Security).
3.2. WHO and international cooperation
By Piter
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