How is health both a social and medical issue?

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Lorraine Caplan | College Teacher | (Level 1) Educator Emeritus

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Health is a medical and social issue because the two in combination create our health or lack thereof.  There is good reason for the presence of social workers in clinics and hospitals and now in some medical practices.  Our medical state is a function not just of what happens to us physiologically.  Our social environments have a powerful effect upon our health.  Let's look at two examples at the extreme ends of the continuum of life, the very young and the elderly, to see how important the social aspect is.

Even before a child is born, the social environment is affecting his or her health.  A poverty-stricken mother is going to find it difficult to get good prenatal care, to eat properly, or to even have the knowledge of what not to consume, what to avoid in the environment.  That fetus is not going to develop properly, putting it at risk for any number of medical problems, including low birth weight or toxoplasmosis, which a mother can transmit to a fetus after handling kitty litter. Once a child is born, a poor social environment can cause what is known as a "failure to thrive." This is a failure to gain weight properly with a concomitant delay in developmental milestones. This does not bode well for an infant medically.  In some social environments, children will not be inoculated against diseases. The medical implications of this are clear.  We also are fairly certain that our immune systems are not top notch when our social environments are harsh and abusive.  So that is another way that children's social and medical situations can interact for or against them.  There are countless examples of ways in which a child's health is a consequence of medical and social factors.

For an elderly person, health is also dependent on the social environment. Elderly people who live alone, for instance, may not eat properly or become dehydrated.  They forget to eat, forget to drink, or are dependent on processed food that is bad for them in many ways.  Eating is also a social act, and we all eat better and more happily with company.  Moving an elderly person from the home he or she is accustomed to to a new social setting can be beneficial or detrimental medically, depending on the circumstances.  The elderly, sent to assisted living facilities or skilled care facilities, can rally medically or experience their own kind of failure to thrive, feeling they have been sent there to die.  Someone who does thrive at such a facility is more likely do so if the social environment is positive and engaging, not feeling like a warehouse for old people. This has a powerful effect on their health.

And for all the stages of life in between, our health is a function of medical and social interaction.  We are social animals, and our health is dependent on not simply control of our medical status, but also the social environment in which we live.     

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