The development of medical sociology in the post-Soviet society: the case of Lithuania

This article explores the historical development of medical sociology and analyses the social problems that have had impacted the changes of health care institutionalization particularly in Lithuania during the Soviet and post-soviet period. Approaching the interaction between sociology and public health sciences, it is intended to apply the concept of medical sociology and its determinants in the context of health care and education systems. By analyzing the case past of medical sociology in Lithuania, we claim that its prospects should be associated with the study of new challenges in the biomedical sciences. In order to improve the importance of medical sociology in developing democracies we should focus on the questions, for instance, to what extent modern biotechnologies should be applied, how to improve the situation with patients' rights, and how to combine the knowledge of social sciences and biomedicine in order to improve the quality of healthcare services and to ensure better functioning of the healthcare system in particular district.     

Social Support Functions During a Slowly-Evolving Environmental Disaster: The Case of Amphibole Asbestos Exposure in Libby,Montana

Previous research concluded that victims of rapid-onset natural disasters (e.g., hurricanes) receive and provide high levels of instrumental support. However, different kinds of disasters (natural or human caused [technological, environmental, intentional/terrorism], rapid or slow onset, short or long duration) may create different stressors and thus influence the types of social support most needed and provided. We explored social support functions during an ongoing “slowly-evolving environmental disaster” in Libby, Montana due to widespread exposure to amphibole asbestos. Analyses of focus groups and in-depth interviews focused on the relative salience of support functions (emotional, informational, instrumental, and spiritual) identified as needed or provided. Dominant themes emerged around each function. Results indicated that informational support is particularly salient in this type of disaster. Although not all community members had experienced the disaster’s health consequences (asbestos-related disease [ARD]), all had been affected by the disaster and had informational needs. The nature of those informational needs (e.g., medical vs. financial) varied based on experience with ARD. Experience with ARD was associated with awareness of disaster-related emotional and instrumental support needed or provided. Results have implications for future research on slowly-evolving environmental disasters and institutional and community responses to them.     

The role of environmental health in disaster management: an overview and review of barriers and facilitators for action

Environmental health has a significant role to play in all stages of disaster management, from planning through to recovery. The conceptualizetion of the environmental health role by environmental health practitioners and other disciplines involved with disaster management is the focus of this review. To provide context for this discussion, we present an overview of disasters and disaster management and the public health and environmental health impact of disasters. The literature indicates that the role of environmental health in disaster management is not clearly conceptualized, and the following barriers have been identified: the continued emergence of environmental health as a professional discipline, ambiguity about environmental health functions in disasters, limited representation in disaster planning, low visibility profile of the profession, positioning of environmental health within public health, power and politics within agencies that result in a narrow assignment of the environmental health role, and a top-down approach to disaster management. The Australian experience indicates that if environmental health practitioners can overcome such barriers and increase their involvement in disaster management, then this achievement will raise the profile of the profession and renegotiate the environmental health role in disaster management. Ultimately, this success will also improve our capacity to manage disaster situations, and the higher profile, greater recognition, and representation of environmental health that is gained will then be able to flow into normal day-to-day activities.     

Spatial variation in socio-ecological vulnerability to Covid-19 in the contiguous United States

The health and economic impacts of the Covid-19 pandemic vary across space because social, economic, health and ecological factors are also spatially variable. Social vulnerability indices are attempts to create a relative ranking of vulnerability to a natural or anthropogenic hazard across space and have been widely used to quantify community vulnerability to natural disasters. Here, we develop a hierarchical socio-ecological vulnerability index that compares counties in the contiguous United States based on 18 variables grouped into four dimensions (ecological, social, health, and economic) in order to capture a range of factors that might contribute to community vulnerability to Covid-19. Variables were chosen based on a review of the emerging literature about the factors associated with poor health outcomes from Covid-19, information about the economic sectors most at risk from the pandemic and pandemic response, and existing social vulnerability indices. We find that socio-ecological vulnerability to Covid-19 and its related economic effects varies across the contiguous U.S., with especially high vulnerability in the Southeast U.S. and especially low vulnerability in the Upper Midwest, Great Plains, and Mountain West.     

Mental and social health in disasters: relating qualitative social science research and the Sphere standard

Increasingly, social scientists interested in mental and social health conduct qualitative research to chronicle the experiences of and humanitarian responses to disaster We reviewed the qualitative social science research literature in relation to a significant policy document, the Sphere Handbook, which includes a minimum standard in disaster response addressing "mental and social aspects of health", involving 12 interventions indicators. The reviewed literature in general supports the relevance of the Sphere social health intervention indicators. However, social scientists' chronicles of the diversity and complexity of communities and responses to disaster illustrate that these social interventions cannot be assumed helpful in all settings and times. With respect to Sphere mental health intervention indicators, the research largely ignores the existence and well-being of persons with pre-existing, severe mental disorders in disasters, whose well-being is addressed by the relevant Sphere standard. Instead, many social scientists focus on and question the relevance of posttraumatic stress disorder-focused interventions, which are common after some disasters and which are not specifically covered by the Sphere standard. Overall, social scientists appear to call for a social response that more actively engages the political, social, and economic causes of suffering, and that recognizes the social complexities and flux that accompany disaster. By relating social science research to the Sphere standard for mental and social health, this review informs and illustrates the standard and identifies areas of needed research.     

Comprehensive Child-Oriented Preventive Resilience Program in Israel Based on Lessons Learned from Communities Exposed to War, Terrorism and Disaster

Background

Coping with mass emergencies and disasters has become a growing challenge for children, adults and entire communities. Among the population groups affected by disaster, children are particularly vulnerable. Responsible disaster intervention requires both top-down and bottom-up preparation that endorses an ecological perspective, taking into consideration the impact upon individuals and families as well as on neighborhoods and entire communities. In such an approach, preventive and post-disaster interventions with children should be integrated with community leadership, local schools, welfare units, social institutions and medical centers.

Objective

In this paper we briefly summarize how disaster affects children and their protective matrix. We further discuss the concept of personal and community resilience, its definitions and components. The worldview of this system-oriented approach encompasses perceptions of public health and administration, community capital and resilience and preventive education.

Results

We describe what makes a community a resilient one, and the role played by preparedness. Finally, we describe the Cohen-Harris Model of Urban Resilience, its rationale, and its four resilience programs (health/mental health, population, information and school resilience).In this model, the local authority serves as the command center for emergency preparedness and resilience is developed through everyday activities that are an integral part of the urban routine.

Conclusions

This model relies on interest in child welfare to enlist leaders, institutions and communities to act as well to motivate the entire community and to implement far-reaching and systemic changes. Interest in all aspects of children’s lives serves to integrate the actions of families, organizations and communities.     

Meeting the challenge of epidemic infectious disease outbreaks: an agenda for research

Challenges arising from epidemic infectious disease outbreaks can be more effectively met if traditional public health is enhanced by sociology. The focus is normally on biomedical aspects, the surveillance and sentinel systems for infectious diseases, and what needs to be done to bring outbreaks under control quickly. Social factors associated with infectious disease outbreaks are often neglected and the aftermath is ignored. These factors can affect outbreak severity, its rate and extent of spread, influencing the welfare of victims, their families, and their communities. We propose an agenda for research to meet the challenges of infectious disease outbreaks. What social factors led to the outbreak? What social factors affected its severity and rate and extent of spread? How did individuals, social groups, and the state react to it? What are the short- and long-term effects on individuals, social groups, and the larger society? What programs can be put in place to help victims, their families, and affected communities to cope with the consequences--impaired mental and physical health, economic losses, and disrupted communities? Although current research on infectious disease outbreaks pays attention to social factors related to causation, severity, rate and extent of spread, those dealing with the "social chaos" arising from outbreaks are usually neglected. Inclusion, by combining traditional public health with sociological analysis, will enrich public health theory and understanding of infectious disease outbreaks. Our approach will help develop better programs to combat outbreaks and equally important, to help survivors, their families, and their communities cope better with the aftermath.     

The Role of Public Health Within the United Nations Post-2015 Framework for Disaster Risk Reduction

This article explores the role of public health systems before, during, and after disasters, particularly within the scope of the United Nations Post-2015 Framework for Disaster Risk Reduction. It also examines the role of scientific and technological developments in assisting with improving the resilience of public health professionals and the communities they work in. In addition, it explores how the wide-ranging activities in public health have already contributed to the improved management of disasters and a decrease in associated risks. The article identifies areas of synergy in five key areas of recent policy and practice in public health(the health systems approach, risk assessments, the WHO/UNISDR/HPA Disaster Risk Management fact sheets, chronic disease and disasters, and mental health impacts following disasters) and makes suggestions based on lessons identified from the previous(2005) global disaster risk reduction framework. In particular, we advocate the use of scientific evidence that addresses health and disaster risk simultaneously to increase the effectiveness of policy and practice in disaster risk reduction, health, and public health.     

Disasters, the environment, and public health: improving our response.

Natural and human-made disasters continue to adversely affect all areas of the world in both predictable and unpredictable ways. To highlight the importance of natural disasters, the United Nations declared the 1990s the International Decade for Natural Disaster Reduction. This paper considers the public health response to disasters. It highlights environmental health issues and approaches since disasters are extreme environmental events, and it reviews developments relating to capacity building, training, and collaboration. Although progress is noted, a comprehensive federal or academic approach is not evident in the United States and the proper linkage to environmental health is lacking. With the International Decade now half over, public health professionals and others involved with disaster management should reflect on progress made to date and goals for the future.     

化学事故引发城市灾害的危险识别与控制

城市化学灾害属于局域性环境灾害的范畴。工业性化学事故列首要危险。由流动事故源引起的化学灾害更难控制。对20世纪（1900－1996）139个国家和地区的运输化学事故进行统计，造成城市灾害的概率在0．73％－2．10％。由灾害源和孕灾环境构成的灾害系统中，众多因素共同影响导致灾害发生。孕灾环境不仅包括自然环境要素，还包括社会环境要素。人类对很多环境灾害至今缺乏认识，尚不能在真正意义上防灾。但人类可以控制引起灾害的危险化学品，可以控制能影响和抵御灾害的承灾体能力。大部分城市化学灾害原因基本清楚，可以也应该实行防灾、抗灾和救灾三级预防。     

Political ecology, ecological economics, and public health: interfaces for the sustainability of development and health promotion

This article proposes to focus contributions from political ecology and ecological economics to the field of collective health with a view towards integrating the discussions around health promotion, socio-environmental sustainability, and development. Ecological economics is a recent interdisciplinary field that combines economists and other professionals from the social, human, and life sciences. The field has developed new concepts and methodologies that seek to grasp the relationship between the economy and ecological and social processes such as social metabolism and metabolic profile, thereby interrelating economic, material, and energy flows and producing indicators and indexes for (un)sustainability. Meanwhile, political ecology approaches ecological issues and socio-environmental conflicts based on the economic and power dynamics characterizing modern societies. Collective health and the discussions on health promotion can expand our understanding of territory, communities, and the role of science and institutions based on the contributions of political ecology and ecological economics in analyzing development models and the distributive and socio-environmental conflicts generated by them.     

Impact of public health emergencies on modern disaster taxonomy, planning, and response

Current disaster taxonomy describes diversity, distinguishing characteristics, and common relations in disaster event classifications. The impact of compromised public health infrastructure and systems on health consequences defines and greatly influences the manner in which disasters are observed, planned for, and managed, especially those that are geographically widespread, population dense, and prolonged. What may first result in direct injuries and death may rapidly change to excess indirect illness and subsequent death as essential public health resources are destroyed, deteriorate, or are systematically denied to vulnerable populations. Public health and public health infrastructure and systems in developed and developing countries must be seen as strategic and security issues that deserve international public health resource monitoring attention from disaster managers, urban planners, the global humanitarian community, World Health Organization authorities, and participating parties to war and conflict. We posit here that disaster frameworks be reformed to emphasize and clarify the relation of public health emergencies and modern disasters.     

Preventing disasters: public health vulnerability reduction as a sustainable adaptation to climate change

Global warming could increase the number and severity of extreme weather events. These events are often known to result in public health disasters, but we can lessen the effects of these disasters. By addressing the factors that cause changes in climate, we can mitigate the effects of climate change. By addressing the factors that make society vulnerable to the effects of climate, we can adapt to climate change. To adapt to climate change, a comprehensive approach to disaster risk reduction has been proposed. By reducing human vulnerability to disasters, we can lessen--and at times even prevent--their impact. Human vulnerability is a complex phenomenon that comprises social, economic, health, and cultural factors. Because public health is uniquely placed at the community level, it has the opportunity to lessen human vulnerability to climate-related disasters. At the national and international level, a supportive policy environment can enable local adaptation to disaster events. The purpose of this article is to introduce the basic concept of disaster risk reduction so that it can be applied to preventing and mitigating the negative effects of climate change and to examine the role of community-focused public health as a means for lessening human vulnerability and, as a result, the overall risk of climate-related disasters.     

The role of environmental health in disaster management: a qualitative study of Australian experiences

Even though environmental health is widely considered to be an integral component of disaster management, limited research on this topic has been conducted. Using a qualitative approach, the authors conducted in-depth interviews of practitioners in Queensland, Australia, to explore the role of environmental health in disaster management and determine how those internal and external to the profession perceive this role. The major themes that emerged described a process in which the "view of health" is socially constructed, and this process is instrumental in shaping perception of the environmental health role in disaster management. The authors also found that the role of environmental health in disaster management is experiencing renegotiation due to a complex process of challenging the socially constructed view of health, raising the profile of the profession, and achieving increased representation in disaster management. Ultimately, increased recognition and a heightened profile of environmental health will result in a more effective disaster management system and will carry over into day-to-day activities.     

Toward the way forward: the national children's disaster mental health concept of operations

Although increasing evidence suggests that children are at particular risk from disasters and evidence-based practices have been developed to triage and treat them effectively, no strategy or concept of operations linking best practices for disaster response is currently in place. To our knowledge, this report describes the first effort to address this critical gap and outlines a triage-driven children's disaster mental health incident response strategy for seamless preparedness, response, and recovery elements that can be used now. The national children's disaster mental health concept of operations (NCDMH CONOPS) details the essential elements needed for an interoperable, coordinated response for the mental health needs of children by local communities, counties, regions, and states to better meet the needs of children affected by disasters and terrorism incidents. This CONOPS for children proposes the use of an evidence-based, rapid triage system to provide a common data metric to incident response and recovery action and to rationally align limited resources to those at greater need in a population-based approach.     

The determinants of health: structure, context and agency

Abstract The concept of social structure is one of the main building blocks of the social sciences, but it lacks any precise technical definition within general sociological theory. This paper reviews the way in which the concept has been deployed within medical sociology, arguing that in recent times it has been used primarily as a frame for the sociological interpretation of health inequalities and their social determinants. It goes on to examine the contribution that medical sociologists have made to the debate over health inequalities, giving particular attention to contributions to Sociology of Health and Illness. These have often provided a focus for discussions outside or critical of the mainstream debates that have been driven primarily by epidemiologists. The paper reviews some of the main points of criticism of epidemiological approaches, focusing in particular on the methodological constraints that limit the capacity of epidemiologists to develop more theoretically satisfactory accounts of the inter‐relationships of social structure, context and agency in their impact on health and well being. Some recent examples from the Journal of more theoretically innovative and analytically fine‐grained approaches to understanding the impact of social structure on health are then explored. The paper concludes with an argument for a more historically‐informed analysis of the relationships between social structure and health, using the knowledgeable narratives of people in places as a window onto those relationships.     

Disasters in urban context

This article provides a brief overview of the field of disaster research, summarizing what is known at present about the prevalence of disasters, the range of stressors and outcomes experienced, and sample-, event-, and individual-level risk factors for poor health and mental health outcomes. Prior research does not suggest that an urban context either enhances or reduces risk for individual survivors. It is argued, however, that the influence of extraindividual exposure, ethnic diversity, and support deterioration may be especially salient for understanding urban disasters. Investigators of urban disasters are especially well situated to expand knowledge of ecological and collective aspects of disaster response and recovery.     

Disability, displacement and public health: a vision for Haiti

Refugees and internally displaced persons (IDPs) with disabilities are some of the most neglected and socially excluded groups within any population. Natural disasters are events that cause bodily harm resulting in disability and that result in the displacement of people. Many predict a continual increase of natural disasters in the future due to changing climates. People with disabilities constitute one of the most vulnerable social groups in the case of a natural disaster. In 2010, Haiti suffered a devastating earthquake leading to great social, health and economic hardship including the displacement of people with disabilities. Due to the very extent of the structural devastation Haiti experienced and the international focus on assisting Haitians who suffered injuries leading to disabilities, there is an opportunity for Haiti to become a model for future disaster management in terms of mainstreaming the needs of people with disabilities in the restoration, resettlement and reintegration process.     

Women and health consequences of natural disasters: Challenge or opportunity?

ABSTRACT

Disasters do not affect people equally; the impact of disasters on the lives of women is different from other groups of a community. Women’s fundamental rights to health and safety are violated after disasters. The authors of this study aimed to explore various factors of women’s health with reference to previous natural disasters in Iran. A qualitative approach using in-depth unstructured interviews and field observations was employed to explore women’s health factors in the affected regions. A total of 22 participants affected by disasters, as well as key informants, were interviewed applying the purposeful sampling method. Data were collected in 2014 in three provinces, including East Azerbaijan, Bushehr, and Mazandaran. A content analysis using the Graneheim approach was performed for analyzing the transcribed interviews. Two themes and four categories were extracted from the data. The themes that emerged included psycho-physical effects and women’s health status. Physical and psycho-emotional effects and reproductive and environmental health effects were the four emergent categories. The findings implied that managing women’s health challenges may result in reducing the distressing effects of disaster. These findings support identification and application of the mechanisms by which women’s well-being in physical, mental, reproductive, and environmental aspects can be protected after disasters.     

The role of behavioral sciences in the Hungarian and international medical education: overview and possibilities

The unilateral bio-medical approach cannot be effective in the prevention and effective treatment of chronic disorders of great epidemiological significance, because the behavioural risk factors are strongly influenced by psychosocial factors too. After the change of the political system in Hungary the most important step in curriculum development was establishing the institutes of behavioural sciences. However, the share of behavioural sciences nowhere exceeds 3% of the curriculum. Yet it has an important role in bridging the gap between the natural and social sciences. Built on the firm basis of natural sciences, the behavioural sciences complement this foundation with aspects of social sciences which emphasize the psychological needs of the patients as well as the psychosocial determinants of health and diseases. The most significant field of behavioural sciences is medical psychology but according to the latest reports on medical education development communication, medical sociology, medical anthropology and bioethics have become increasingly important disciplines in developing medical competence. These fields are organized into an integrated process, arching over the six years of medical training. The present paper gives an overview of the situation and perspectives of teaching behavioural sciences at medical universities.