模糊的学科形象:社会医学发展的批判

A Vague Disciplinary Image: A Critique on the Development of Social Medicine in China

我国社会医学发展四十年,学科形象模糊,亟需反思。梳理了社会医学的中外文献、国内主流教材,评阅了专业期刊和主要社会医学研究团队的文章,发现社会医学学界对本学科研究比例较低,存在学科边界不清、研究内容管理学倾向、研究范式流行病学倾向、理论发展薄弱的问题。原因是学科发展早期受保健组织学影响,并出于卫生改革的需要同卫生事业管理联合发展;之后缺乏自身法定专业和社会科学的学科资源,因而受到管理学、流行病学的过度影响。建议发展社会因素研究,辨清与流行病学、卫生事业管理的区别,加大与社会学的交流。

After forty-year development, social medicine renders a vague disciplinary image, which needs to be rethought proudly. By reviewing the literature of social medicine at home and abroad, examining the main teaching materials in our country, and reviewing the publications of professional journals and major research teams of social medicine, we find that social medicine community contributes only a small portion of their entire research to social medicine per se. There are blurred academic boundaries among social medicine, health administration, preventive medicine and other adjacent areas of public health. The researches of social medicine over focus on management area. The research paradigm of social medicine shows tendency of taking the paradigm of epidemiology. And systematic theories of social medicine are lacking. Causes to these situations include dominant role of health administration in the very early stage of social medicine development, and the united discipline of social medicine and health administration. Inadequate academic interaction between isolated medical academy and social science deteriorates independence of social medicine. Therefore, social medicine should make clear disciplinary boundaries with health administration and other public health areas. Secondly, social medicine should have closer communication with social science, especially sociology, so as to foster studies of social determinants.