Social pathology and social problems (strictly from the park spm)
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Social Pathology and Social Problems
Park's Textbook of Preventive and Social Medicine
SOCIAL PROBLEMS
In a community, there are both individual and social problems. Individual problems become social problems when they affect a large number of people, amounting to a threat to the welfare or safety of the whole group. But all individual problems are not social problems.
- Poverty, crime, and disease are the common social problems.
- Many public health problems are social problems and vice versa.
- Alcoholism, sexually transmitted diseases, mental illness, and narcotic addiction are both public health and social problems.
- Social problems such as housing, divorce, population growth, and the increased number of old people have public health implications calling for a combined sociological and public health action.
SOCIAL PATHOLOGY
The term "social pathology" is given a restricted interpretation linking it to poverty, crime, delinquency, and vagrancy.
In the modern context, it is also used to describe the relation between disease and social conditions. The social pathology of accidents, diabetes, cardiovascular disease, cancer, and chronic bronchitis have all been the subject of recent investigations in medical literature.
Social pathology is uncovered by "social surveys."
SOCIAL SURVEYS
Social surveys disclose social pathology. They have played an important part in the development of public health. Chadwick's survey led to the foundation of the General Board of Health in 1848 in Great Britain.
- There is a strong kinship between epidemiological survey and social survey.
- When the objective of research is to study the role of social factors in the aetiology of disease, the two merge into what is known as "social epidemiology."
- Large-scale social epidemiological studies have investigated the relationship of social factors to heart disease, cancer, and arthritis.
SPECIFIC SOCIAL PROBLEMS
1. Prostitution
- An age-old social evil; primarily an urban problem.
- Causes: changes in environment, breakdown of family relations, parental quarrels, want of affection, illegitimate love, easy money, low IQ, low moral standards, poverty.
- Legislation: The "Suppression of Immoral Traffic Act" (1956) was amended and retitled as the "Immoral Traffic (Prevention) Act, 1986" - covers all persons exploited sexually for commercial purposes.
2. Delinquency
- A delinquent shows deviation from normal behaviour - offences include theft, sexual offence, murder, burglary, etc.
- Causes: social maladjustment, poverty, disturbed home conditions, alcoholism, drug addiction, modern ways of living.
- Control: The Children Act, 1960 provides a specialized approach toward care, protection, maintenance, training, and rehabilitation of delinquent children. Infrastructure includes Juvenile/Children's Courts, child welfare boards, remand homes, certified schools, children's homes, and after-care facilities.
3. Dowry System
- Started as an innocent custom but has grown into a social evil with instances of bride-burning and suicides.
- Legislation: Under the Dowry Prohibition (Amendment) Act, 1986, minimum punishment for taking or abetting the taking of dowry is 5 years imprisonment and a fine of Rs. 15,000.
- Well-entrenched social customs cannot be easily erased by an Act of Parliament - sustained effort to address root causes is required.
4. Drug Addiction
Definition: A state of periodic or chronic intoxication detrimental to the individual and society, produced by the repeated intake of habit-forming drugs.
Reasons for drug dependence:
- Curiosity and natural tendency to experiment
- Disturbed home environment (broken homes, indifferent parents)
- Escape phenomenon from tensions and frustrations (unemployment, exam failure)
- Impact of disco culture, mobile, TV, internet
- Ignorance of habit-forming nature of drugs
Criteria to call a person a drug addict (all three must be satisfied):
| Criterion | Description |
|---|---|
| (1) Psychological dependence | Overpowering desire (compulsion) to take the drug and obtain it by any means |
| (2) Physical dependence | On withdrawal, patient shows "withdrawal symptoms" - irrational/violent behaviour, nausea, diarrhoea, watering of eyes and nose |
| (3) Development of tolerance | Tendency to increase the dose |
Management:
- (a) Identification and motivation for drug detoxification
- (b) Detoxification (requires hospitalization)
- (c) Post-detoxification counselling and follow-up (clinic + home visits)
- (d) Rehabilitation
Changes in environment (home, school, social circle) are essential alongside medical treatment. A complete break with the addict's group is necessary - otherwise chances of relapse are 100%. Psychotherapy has a valuable place. Preventive measures include public education through TV, radio, and leaflets.
5. Alcohol Abuse
- A world-wide social and medical problem.
- Over the past decades, alcohol consumption has increased in quantity and frequency; age of starting drinking has declined.
- High-risk groups: Those undergoing rapid socio-economic and cultural changes; view alcohol as a symbol of prestige and social status.
Consequences of alcohol abuse:
Crime, murder, prostitution, neglect of families, malnutrition, disease (cirrhosis of liver, alcohol-dependent syndrome, alcoholic psychosis), unemployment, indebtedness, child delinquency, road accidents, loss of friends and self-esteem.
Prevention: Widespread public education, investigation of public attitudes, combined with social welfare and health services. Identification of risk factors is essential.
6. Unmarried Mothers
- Accurate statistics are lacking in India; the problem is considered less significant due to social customs and traditions.
- Such mothers have a multiplicity of needs - medical, psychological (understanding, warmth, guidance).
- In Western societies, special schools and counselling programmes exist for teenage mothers.
7. The Handicapped
India's 2011 data shows 7 main categories:
| Category | Estimated Number in India |
|---|---|
| The blind | 5.03 million |
| Hearing disability | 5.07 million |
| Orthopaedically handicapped | 5.43 million |
| Multiple disabilities | 2.11 million |
| Mentally retarded | 1.50 million |
| Mental illness | 0.72 million |
| Speech disability | 1.99 million |
| Others | 4.92 million |
Rehabilitation services available in India:
- Medical care facilities
- Education for the blind, deaf, and orthopaedically handicapped
- Vocational training
- Job placement and sheltered workshops
- Pensions, scholarships, and allowances for education and training of the handicapped
Source: Park's Textbook of Preventive and Social Medicine (ISBN 9789382219163), Chapter on Social Sciences (blocks 9 and 10).
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