Martin Lindström1,2. 1. Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, Sweden. 2. Center for Primary Health Care Research, Region Skåne and Department of Clinical Sciences in Malmö, Lund University, Sweden.
Abstract
AIMS: This article discusses the situation of the social medicine specialty in Skåne, southern Sweden with the aim of understanding the long-term trends of this medical specialty in Skåne and its relation to research in social medicine. RESULTS: In the 1950s to 1980s, there was a balance between clinical and preventive practice, and research. This balance was maintained in the 1980s to early 2000s as the medical specialty and the research moved 'upstream' in the chain of causality to psychosocial, socio-economic and contextual determinants of health. The increasingly 'upstream' character of the specialty and particularly its new position in the regional organisation since 2010 may have made it more vulnerable to general executive-level reorganisations. The specialty should maintain its 'upstream' focus but regain its proximal scope in prevention, epidemiology and health equity. It should regain its place in the health-care system organisation or alternatively become a state-based instead of regional specialty.
AIMS: This article discusses the situation of the social medicine specialty in Skåne, southern Sweden with the aim of understanding the long-term trends of this medical specialty in Skåne and its relation to research in social medicine. RESULTS: In the 1950s to 1980s, there was a balance between clinical and preventive practice, and research. This balance was maintained in the 1980s to early 2000s as the medical specialty and the research moved 'upstream' in the chain of causality to psychosocial, socio-economic and contextual determinants of health. The increasingly 'upstream' character of the specialty and particularly its new position in the regional organisation since 2010 may have made it more vulnerable to general executive-level reorganisations. The specialty should maintain its 'upstream' focus but regain its proximal scope in prevention, epidemiology and health equity. It should regain its place in the health-care system organisation or alternatively become a state-based instead of regional specialty.
Entities:
Keywords:
Social medicine; Sweden; clinical practice; health policy; prevention; public health; specialty