Storylines of family medicine II: foundational building blocks-context, community and health.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'II: foundational building blocks-context, community and health', authors address the following themes: 'Context-grounding family medicine in time, place and being', 'Recentring community', 'Community-oriented primary care', 'Embeddedness in practice', 'The meaning of health', 'Disease, illness and sickness-core concepts', 'The biopsychosocial model', 'The biopsychosocial approach' and 'Family medicine as social medicine.' May readers grasp new implications for medical education and practice in these essays.

ESDM intervention in severe preschool autism: an Italian Case report, psychological and social medicine reflections.

BACKGROUND: The goal of our contribution is to discuss a preschool intervention based on the Early Start Denver Model and the use of the main tools for the detection of adaptive behaviour in cases of autism: Vineland, ABAS. CASE PRESENTATION: the work is the presentation of a clinical case that has benefited from an intervention with the Early Start Denver Model methodology for the benefit of a child with socio-cultural and economic disadvantages. This early intervention, in a child of 36 months, which followed the diagnosis, was possible thanks to the intervention of many third-sector organizations which allowed this child, with a serious autism profile, to receive an evidence-based intervention for free. At the beginning of the intervention, the child presented a diagnosis of severe autism with absence of gaze, vocalizations and other communicative impairments. The level of motor clumsiness was also quite high, as were stereotypies. CONCLUSIONS: Research has shown the usefulness of intervening in this area with an early assessment and/or diagnosis and immediate intervention; however, public health services are not always able to maintain this pace. Our contribution therefore shows on the one hand the evidence of the improvements achieved by the child despite the low intensity of the treatment, and on the other hand, demonstrates the total versatility and adaptability of the Denver Model to the Italian context. In our conclusions, there are also some reflections on the tools used to measure adaptive behavior which seem to have a number of limitations and criticalities.

[Additional qualification "Social medicine" for physicians]. / Zusatzbezeichnung "Sozialmedizin" für Ärztinnen und Ärzte.

Social medicine is the medical field that specializes in relationships between health, disease, and society. The goal of social medical care should be to enable functioning and participation in all areas of life as much as possible. Social medicine can be understood as a bridge between individual health care and public health and to other medical specialties. Expertise in social medicine is also helpful for dermatology and in daily clinical practice. This article presents the specialization "social medicine" in Germany.

[Role of social medicine within the German Federal Employment Agency]. / Aufgabe des Arztes in der Sozialmedizin am Beispiel der Bundesagentur für Arbeit.

Social medicine deals with the interrelationships between health and society-as a cross-sectional subject within medicine and a bridging subject at the interfaces to other specialist disciplines. In the public and within the health system, social medicine still does not receive the attention it should be given, despite to its medical and socioeconomic importance. A significant proportion of social medicine specialists in Germany work as experts for social security providers. Using the example of the Medical Specialist Service ("Ärztlichen Dienstes", ÄD) of the German Federal Employment Agency ("Bundesagentur für Arbeit", BA), the medical tasks in social medicine are outlined. About 350 full-time medical employees nationwide as well as other contracted physicians support the specialists of the employment agencies and job centers to integrate those seeking training, jobs and employees with health restrictions into the labor market or maintaining an existing integration. In each individual case, they assess the extent of the health restrictions, the performance/earning ability, the suitability for training and professions as well as the requirement and type of vocational rehabilitation services. The ÄD's approximately 500,000 expert opinions each year are not only of far-reaching importance for the BA's affected customers, but also contribute to the responsible, effective, and accurate use of social system resources.

Structural competency in global perspective.

This special issue aims to help fill two critical gaps in the growing literature as well as in practice. First, to bring together scholars and practitioners from around the world who develop, practice, review, and question structural competency with the aim of promoting a dialogue with related approaches, such as Latin American Social Medicine, Collective Health, and others, which have been key in diverse geographical and social settings. Second, to contribute to expanding structural competency beyond clinical medicine to include other health-related areas such as social work, global health, public health practice, epidemiological research, health policy, community organisation and beyond. This conceptual expansion is currently taking place in structural competency, and we hope that this volume will help to raise awareness and reinforce what is already happening. In sum, this collection of articles puts structural competency more rigorously and actively in conversation with different geographic, political, social, and professional contexts worldwide. We hope this conversation sparks further development in scholarly, political and community movements for social and health justice.

[Manfred Pflanz (1923-1980) - A key Protagonist for the Institutionalization of Social Medicine and Medical Sociology in Germany]. / Manfred Pflanz (1923­1980) ­ zentraler Akteur bei der Institutionalisierung von Sozialmedizin und Medizinsoziologie.

Manfred Pflanz, an internist with his focus on social medicine, medical sociology and epidemiology, (1923-1980) played a key role in the institutional integration of social science expertise into medicine in the Federal Republic of Germany during the 1960s and 70 s. The present study, a biographic sketch of Pflanz, describes his work, his programmatic ideas on social medicine and medical sociology, and his activities as an expert consultant in public health for various political entities. This should enable getting an insight into the origins and ramifications, as well as the contemporary programs and international embeddedness of the overlapping fields of social medicine and medical sociology in Germany.

Global translation and adaptation of social medicines and structural competencies.

This commentary on the special issue of Global Public Health on structural competency in global perspective asks: what is specific to the U.S. about structural competency, and what is its utility beyond the U.S., especially in the 'global south'? Why are biomedical practitioners the focus of U.S. structural competency? And what can U.S. structural competency advocates learn from the deep and rich social medicine traditions of Latin America? And is there anything that Latin American and other non-U.S. social medicine traditions might learn from U.S. structural competency? The commentary identifies the crucial insights from international comparisons include that racial justice movements are Social Medicine innovators in the U.S., that cultivating allies within biomedicine can enhance the impact of community health movements, and that cross-fertilising U.S. Structural Competency and social medicine traditions across regions should be a priority for the fields.

Latin America at the margins? Implications of the geographic and epistemic narrowing of 'global' health.

To explore the narrowing of the concept of 'global' in global health, this article traces how Latin America has held a place of both privilege and power as well as marginalisation in the field. We employ a modified extended case method to examine how Latin America has been 'seen' and 'heard' in understandings of global health, underscoring the region's shifting role as a key site for research and practice in 'tropical medicine' from the mid-nineteenth century through World War II, to a major player and recipient of development assistance throughout the 'international health' era after World War II until the late twentieth century, to a region progressively marginalised within 'global health' since the mid-1980s/1990s. We argue that the progressive marginalisation of Latin America and Southern theory has not only hurt health equity and services, but also demonstrates the fundamental flaws in contemporary 'global' thinking. The narrowing of global health constitutes coloniality of power, with Northern institutions largely defining priority regions and epistemic approaches to health globally, thus impoverishing the field from the intellectual resources, political experience, and wisdom of Latin America's long traditions of social medicine and collective health.

[Report: Symposium "Fostering the Power to Open Up the Future and Collaboration among Academic Societies in the Field of Social Medicine: How to Promote and Support the Activities of Young Scientists"].

The recruitment and training of early-career researchers are important for the development of science, especially in countries with low birth rates, such as Japan. In several academic societies for social medicine, early-career researchers have formed associations for the purposes of networking and career development. However, to date, little information about the activities of these associations has been shared. Therefore, we organized a symposium at the 93rd Annual Meeting of the Japanese Society for Hygiene (March 4, 2023) to introduce the early-career researcher associations that have been formed within five academic societies namely the Japanese Society for Hygiene, Japan Epidemiological Association, Japan Society for Occupational Health, Japan Society for Medical Education, and Japan Society for Healthcare Administration. In this paper, we summarize the activities, challenges, and future prospects of each association and their strategies for future development and collaboration on the basis of presentations and discussions at the symposium.

The 'new era in medicine': John Ryle and the promotion of social medicine.

John A. Ryle was Britain's first professor of Social Medicine. In the 1930s and 1940s, at the peak of his influence, he was a vigorous proponent of social medicine, then a relatively new, if contested, field. This article examines Ryle's views and activities under three broad headings: What was social medicine? What were Ryle's politics? Why prioritise medical education? We conclude with the apparent failure of the social medicine project, at least as envisioned by Ryle.

Chevalier Jackson: father of endoscopic surgery, and champion of women in medicine, social justice, and public health.

BACKGROUNDS: Chevalier Jackson (1865-1958) was a pioneering force in the medical world, whose extraordinary contributions to surgery and public health have left an indelible impact. He developed the endoscope and perfected the bronchoscope, and his mastery of these tools enabled him to transform the prognosis of foreign body aspiration from 98% mortality to 98% survival. He was also a passionate advocate of public health chairing the national committee on lye legislation, which culminated in the Caustic Poison Act, responsible for poison and antidote labels. Yet Jackson's accomplishments were not limited to these. The aim of this manuscript was to shed light on Chevalier Jackson's lesser-known contributions to surgical science and culture, and to celebrate and honor the life of this remarkable surgeon. METHODS: Digital and physical historical records from the National Library of Medicine, Smithsonian Institution, Heinz History Center in Pittsburgh PA, and Sunrise Mill Museum, Montgomery County PA were reviewed for Chevalier Jackson's scientific, cultural, and social contributions to the field of surgery. RESULTS: Among his lesser-known contributions, Chevalier Jackson was the first to describe erosive esophagitis. He developed the first standardized tracheotomy procedure, still in use today. He was ahead of his time in many ways, pioneering a multidisciplinary approach to medicine, advocating for patient-centered care, and advancing the inclusion of women in the medical profession. CONCLUSION: Chevalier Jackson's legacy extends far beyond the tools and techniques he invented. He was a champion of social justice, a protector of patients, and an inspiration to medical professionals across the globe.

Scandinavian entry points to social medicine and postcolonial health: Karl Evang and Halfdan Mahler in India.

Our contributions examine the Norwegian Karl Evang's (1901-1981) and the Dane Halfdan Mahler's (1923-2016) participation in international health co-operation facilitated by the World Health Organization (WHO) in India in the 1950s. While Evang's was a hectic, but relatively short visit as part of a WHO visiting team of medical scientists in 1953, Mahler's spanned the entire decade on assignments as WHO medical officer to tuberculosis control projects. Mahler's name should be familiar to researchers of international health as the Director-General of the WHO 1973-88, and for his promotion of primary health care through the 1978 Alma-Ata Declaration. Evang, Norway's Director of Health 1938-72, was also a key figure in international health in the mid-twentieth century as one of the original instigators of the WHO, and a participant in much of its early work.A core theme is the place of social medicine, both in Evang's and Mahler's work, and within the WHO and its navigation of complex postcolonial settings in the 1950s. Investigating cross-regional encounters and circulations of social medicine ideas between Evang and Mahler and their Indian interlocutors as well as international WHO staff members, we ask what the role of social medicine was in international health in the early post-war period. Researchers have found that social medicine had its heyday during the 1930s and 1940s, and that a technology-focused, vertical approach became dominant soon after the war. In contrast, we suggest that continued circulation of social medical ideas points towards a more complicated picture.

Negotiating social medicine in a postcolonial context: Halfdan Mahler in India 1951-61.

This article investigates how World Health Organisation (WHO) Director-General Halfdan Mahler's views on health care were formed by his experience in India between 1951 and 1961. Mahler spent a large part of the 1950s in India assigned as WHO medical officer to tuberculosis control projects. It argues that Mahler took inspiration from the official endorsement of the doctrine of social medicine that prevailed in India; even if it was challenged by an increasing preference for vertical, techno-centric campaigns. It shows how, from the outset, Mahler was remarkably hostile towards the highly skilled, clinically oriented doctors, but embraced prevalent ideas of community participation. It suggests that Mahler - although he remained silent on the issue - was impressed by the importance and resilience of indigenous traditions of medicine, despite hostility from leading political figures. In this way, the article attempts to establish links to Mahler's advocacy of primary health care in the 1970s. A broad approach to health, scepticism toward clinically oriented doctors, preference for simple technologies and community participation, as well as an accommodating attitude towards indigenous practitioners, were all features of primary health care, which correlate well with views developed by Mahler as he negotiated social medicine in India between 1951 and 1961.

Toward an Integrated Framework in Health and Human Rights Education: Transformative Pedagogies in Social Medicine, Collective Health, and Structural Competency.

Global health equity is at a historically tenuous nexus complicated by economic inequality, climate change, mass migration, racialized violence, and global pandemics. Social medicine, collective health, and structural competency are interdisciplinary fields with their own histories and fragmentary implementation in health equity movements situated both locally and globally. In this paper, we review these three fields' historical backgrounds, theoretical underpinnings, and contemporary contributions to global health equity. We believe that intentional dialogue between these fields could promote a generative discourse rooted in a shared understanding of their historical antecedents and theoretical frameworks. We also propose pedagogical tools grounded within our own critical and transformative pedagogies that offer the prospect of bringing these traditions into greater dialogue for the purpose of actualizing the human right to health.

Structural competency, Latin American social medicine, and collective health: Exploring shared lessons through the work of Jaime Breilh.

ABSTRACTStructural competency is a recent framework for understanding and addressing the structural drivers of disease. Latin American Social Medicine and Collective Health is a decades-long movement similarly concerned with the study and transformation of social structures to achieve health equity. In this paper, we put insights from Latin American Social Medicine and Collective Health into conversation with the developing structural competency framework. We focus specifically on insights from Jaime Breilh's new article summarising his theoretical work on medical ethics and rights in this special issue and his new book, Critical Epidemiology and the People's Health. This paper is comprised of three parts. Part 1 provides an introduction to the structural competency framework. Part 2 provides an overview of the Latin American Social Medicine and Collective Health movement, along with a summary of the social determination of health paradigm. Part 3 places insights from these works into conversation with structural competency and considers ways in which Latin American Social Medicine and Collective Health might inform the further development of structural competency, and potentially vice versa. The paper closes by calling for greater attention to Latin American Social Medicine and Collective Health among those committed to health equity within the anglophone world.