While it is undoubtedly true that a biomedical perspective dominated public health in the first half of the twentieth century, there has emerged, largely since World War II, a social science perspective in public health. This perspective has developed in departments of social and community medicine in Europe and in schools of public health in the United States, and it is reflected in the growth of the behavioral and social sciences in the curricula for public health professional and research degrees. This perspective is also evident in the establishment of departments of social and behavioral sciences in universities.
Many social and behavioral science disciplines are relevant to the understanding and articulation of the mission of public health. It would be impossible to document here all the various discipline areas; these include disciplines as diverse as psychology, economics, history, and anthropology. The focus here will be on those disciplines that most directly attempt to describe, understand, predict, and change the public's health.
Social and Behavioral Sciences Literature
A considerable literature on individual behavior and public health has developed in the second half of the twentieth century. The general failure of public health to pick up and nurture the more macro social science perspectives to the same degree has limited the full potential of the impact of the social and behavioral sciences on public health, particularly because the historical roots of public health in the latter half of the nineteenth century included a strong social structural viewpoint. Since that time, the theoretical development of economics, political science, sociology, and anthropology has accelerated, but it was often not brought to bear on contemporary public health issues because these issues were often defined in terms of the characteristics of individuals rather than as characteristics of social structure. The argument is, then, that public health picked up the wrong end of the social science stickthe individual (micro) end rather than the sociocultural (macro) end. This assertion is supported by any perusal of public health journals or literature on social and behavioral science in public health in the second half of the twentieth century. Nonetheless, as the end of the twentieth century in public health witnessed increasing concern with social concepts such as social inequity, inequality, and community interventions, the disciplines of sociology, anthropology, economics, and political science had a more important role in public health, for the determinants of health were being defined in terms of a social and behavioral perspective. For example, many individual behaviors were recognized as risk factors for poor health, but were also seen as embedded in a wider social context. In addition, a social scienceinformed healthful public policy was seen by many as a key to the development of public health strategies to improve health.
The Scientific Disciplines and Public Health
As noted previously, there are several social and behavioral science disciplines applied to public health. What follows is a brief summary of each of the key disciplines, with attention given to the theory and work of each discipline relevant to public health. In some of the social science disciplines there are large subdisciplinary areas devoted to medicine. For example, there are large subdisciplinary fields such as history of medicine, medical sociology, medical anthropology, health psychology, and medical geography. Most of these subdisciplines have university departments, dedicated journals, and professional organizations. However, most of these subdisciplines are concerned with medicine in the very broadest interpretation, including health promotion, clinical care, disease prevention, and biomedical research. Only a part of a subdiscipline such as medical sociology is concerned with public health. Similarly, most of the subdiscipline of history of medicine is concerned with the development and evolution of clinical medicine rather than public health. Thus, the interpretation of the role of the social and behavioral sciences in public health is very much tied to one's definition of public health.
The Social and Behavioral Science Disciplines
The social sciences are concerned with the study of human society and with the relationship of individuals in, and to, society. The chief academic disciplines of the social sciences are anthropology, economics, history, political science, and sociology. The behavioral sciences, particularly psychology, are concerned with the study of the actions of humans and animals. The key effort of the behavioral sciences is to understand, predict, and influence behavior. The chief academic disciplines of the behavioral sciences are anthropology, psychology, and sociology, with the distinction between social and behavioral science often blurred when these disciplines are applied in public health research and practice, particularly in schools of public health and governmental agencies. Many, if not most, public health approaches are problem focused and lead to a multidiscipline solution encompassing several social and behavioral science disciplines and combinations of them (such as social psychology), in addition to other public health disciplines such as epidemiology and biostatistics.
Anthropology. Anthropology is a broad social science concerned with the study of humans from a social, biological and cultural perspective. Historically it is a Western-based social science with roots in Europe and North America. It includes two broad areas of physical and sociocultural anthropology; both are relevant to public health. Physical anthropology divides into two areas, one related to tracing human evolution and the study of primates, and the other concerned with contemporary human characteristics stemming from the mixture of genetic adaptations and culture. Medical anthropologists with this perspective are often concerned with the relationships between culture, illness, health, and nutrition. Sociocultural anthropology is concerned with broad aspects of the adaptation of humans to their cultures with social organization, language, ethnographic details, and, in general, the understanding of culturally mitigated patterns of behavior. In recent decades this perspective has taken a more ecologically focused view of the human species. From a public health perspective, this approach to anthropology is probably most salient in terms of the methodological approaches used by anthropologists. They have a critical concern with understanding communities through participant observation. Indeed, participation is probably the key concept linking modern-day anthropological approaches to twentieth-century concepts of public health community interventions. Although the methodology of rapport-based structured interviews and observation is a highly developed methodology among anthropologists, it has had limited application in public health. More recent efforts in public health to address issues of inequity at the community level have created more attention to anthropological approaches.
Economics. Economics is perhaps the oldest of the social sciences, with its concern with wealth and poverty, trade and industry. However, current economic thinking generally dates from the last three centuries and is associated with the great names in economic thinking, such as Adam Smith, Robert Malthus, David Ricardo, John Stuart Mill, and Karl Marx. Present-day economics is an advanced study of production, employment, exchange, and consumption driven by sophisticated mathematical
models. Basically, the field breaks into two distinctive areas: microeconomics and macroeconomics. Microeconomics is largely concerned with issues such as competitive markets, wage rates, and profit margins. Macroeconomics deals with broader issues, such as national income, employment, and economic systems. The relationship between economics and health is obvious because in developed countries the percentage of gross national product consumed by the health care industry is significant, generally ranging from 5 to 15 percent of the gross national product. In the poorer countries, the cost of disease to the overall economy can prohibit the sound economic development of the country. In recent years there has been a concern with both the global economic burden of disease as well as with investment in health. That poverty is highly related to poor public health is a widely accepted tenet of modernday thinking in public health. However, economic systems ranging from free enterprise through liberal socialism and communism offer quite differing alternatives to the reduction of poverty and the distribution of economic resources.
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Social and Behavioral Sciences: Definition from Answers.com
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