The social shaping of health and smoking.

When major disease processes move from processes that humans cannot control to processes we do understand and do control at least to some extent a social shaping of health disparities occurs. When humans control, it is their policies, their knowledge, and their behaviors that shape the consequences of biomedical knowledge and technology to achieve a powerful social shaping of extant patterns of disease and death. Evidence to support this approach is garnered from data showing dramatic improvements in population health and in the uneven distribution of those improvements across persons, places and times. Health improvements suggest that humans have gained control of disease whereas the uneven and very slow spread of such improvements underscores the critical importance of social factors. Smoking beliefs and behaviors gathered in surveys conducted over the past 50 years conform to this social shaping notion providing insights into the current distribution of beliefs and behaviors.