The construction of an autonomous knowledge system of social medicine needs to be practice-based Social Science Daily

Build a system of philosophy and social sciences

In April 2022, General Secretary Xi Jinping stressed during an inspection tour of Chinese Min University that "accelerating the construction of philosophy and social sciences with Chinese characteristics is, in the final analysis, the construction of China's independent knowledge system." To construct an independent knowledge system, it is necessary to go deep into its own practical activities and processes, explore the successful experience of social practice, answer major questions in social practice, and form systematic theoretical achievements on the basis of practice. China's independent knowledge system, based on the experience of the road of Chinese-style modernization, occupies an important position in the world's philosophy and social science pattern.

Original text: "Building a Social Medical Autonomous Knowledge System Based on Practice"

Author | Professor Wang Peigang, School of Public Health, Wuhan University

Image | Internet

Use the scene while fully grasping it

Social medicine is an important professional support course in the teaching of mainland medicine and public administration, and is an important part of the modern medical education system. It views, analyzes and studies medicine, hygiene and health issues from a social perspective, reflects the interaction and law between social factors in the field of health and individual and group health and disease, and is the basis and source for constructing China's independent knowledge system in the field of health. The construction of an independent knowledge system of social medicine urgently needs to be based on the grand and unique modern social practice of Chinese style, focus on the personality problems in the process of China's social medical transformation and development and the common problems of today's world development under the background of the healthy China strategy, fully grasp the scene while using the scene, and enrich the theoretical knowledge and solutions in line with China's reality. Firstly, starting from the new social mobilization system representing China's characteristics and the wave of digital society representing the commonality of the world, we will accurately grasp the new situations and challenges facing the determinants of healthy society and knowledge updating, so as to summarize new concepts and expressions that are unique and can integrate the world. Secondly, with policy science experiments relying on Chinese scenes as the core, new ideas and theories on the integration of public policy and health with original and iconic characteristics are extracted, which provides inexhaustible impetus for the construction of China's social medical independent knowledge system.

The new social mobilization system has become an urgent determinant of Chinese-style healthy society

Zheng Yongting defined "social mobilization" as the process of change and development at the ideological level, pointing out: "Social mobilization is social influence in a broad sense, which can also be called social mobilization, which is the process of changing and developing people's attitudes, values and expectations under the influence of certain frequent and persistent social factors." "After the founding of New China, the social mobilization mechanism was considered to be a prominent feature of the mainland's significant improvement in health. The patriotic health movement is a successful practice of social mobilization mechanism applied to health and disease prevention work, and through the integration with grassroots governance work, it promotes the formation of a mass mobilization mechanism that combines top-down administrative mobilization and bottom-up active participation; For example, from the 50s to the 70s of last century, the mainland creatively built a three-level medical and health service network of county-level medical and health service institutions, township hospitals and village clinics, effectively ensuring the health level of rural residents, and was called "a model for developing countries to solve health problems" by the World Health Organization and the World Bank. At the beginning of 2020, after the outbreak of the new crown pneumonia epidemic, a public health emergency, the Party Central Committee made important arrangements and deployments, made full use of emergency mobilization, participatory mobilization and other methods to integrate social resources and gather consensus among all parties, achieving remarkable results in crisis management and effectively protecting people's health. All these highlight the institutional advantages of socialism of "concentrating forces to do great things", grasping key nodes through the model of government leadership and social participation, and surpassing all factors and forces in a specific stage for the improvement of people's health level, and surpassing the single, regular and gradual disease prevention and control model in the past. At the same time, the new social mobilization system creates a specific period, a specific group of people, and a specific environment, and activates a series of external social determinants in a group, thereby achieving a great improvement in the health of the population.

Traditional research on social determinants of health faces great challenges from the wave of digital society

In recent years, the development of social medicine in mainland China has been deeply influenced by the concept of social determinants of health, and related traditional theories and classical models have become research-led. With the rapid advancement of industrialization, urbanization and informatization, artificial intelligence (AI), virtual reality (VR)/augmented reality (AR), blockchain and other disruptive technologies have developed rapidly, and a series of social factors related to population, resources, environment, ecology and so on have undergone earth-shaking changes.

The first is the challenge of the construction of virtual society to the traditional model. The hierarchical model proposed by Dahlgren and Whitehead is a layered evolution relationship from the inside to the outside, and the factors in the inner ring are affected by the outer factors. When the virtual society emerges, the real social subjects carry out social interaction in cyberspace in the form of virtual existence, and the "non-spatial" attribute makes people's social interaction transcend the hierarchical limit. In this way, traditional models cannot be applied, especially in the era of big data, traditional statistical analysis and modeling are challenged, so that their deep digging of real social determinants is biased and no longer in line with reality.

The second is the challenge of the construction of virtual society to traditional theory. For example, social ecology theory is a theory that studies the relationship between people and various social environmental factors, and healthy behavior is an element in the complex system of people and the environment, but with the development of virtual society, social interaction is not limited to actual life, and may form a new virtual communication mode, or a combination of virtual and real communication mode. This makes it difficult to define the boundaries of individual behavior in virtual society and individual behavior in real society, and how to combine online and offline variables in research and how to reflect the reality of healthy social determinants is the direction of future theoretical construction of healthy social determinants. At present, the "Internet +" technology is widely used, and the mainland smart medical care, virtual payment and other aspects are at the forefront of the world, which puts forward higher requirements for us to apply the perspective of the analysis mechanism of social determinants of health, the way to condense the problem, and the model and theory used to analyze the problem, and the development of the social medical discipline system and the improvement of conceptual propositions in the future are also ushering in new challenges. At the same time, the development of virtual society also provides us with important opportunities for discipline development, in the future, we must use the leading edge of artificial intelligence to achieve the rapid development and new breakthrough of social medicine disciplines, including methods and means of analyzing problems.

The development of policy science experiments is an important way to fully respond to the social medical knowledge scene

In recent years, as a new governance mechanism, experiments or pilots have become a hot topic concerned by many scholars. Research from different disciplines such as health, health economics, and even administration is mainly discussed in the framework of the policy process, and the experiment or pilot is regarded as an effective mechanism for policy innovation or diffusion, and then regarded it as an important reason for the success or development of national institutional reform. For example, the English government improved the health and welfare of residents and family relations by implementing a housing improvement project in a poor community in the southern city of Torquay to provide people with better living conditions; In 1987, Canada was the first non-official organization to launch the "Healthy Cities Campaign" from Toronto and the "Healthy Cities and Healthy Towns Movement" from Quebec; U.S. nonprofit or faith-based organizations promote early healthy city visions in the United States; Wait a minute. In contrast, China's policy experiments are based on large-scale crowd pilots to form effective experiences in promoting social reform, and then promote them throughout society. Its organizational, exemplary and empirical nature is a typical feature of China's policy experiment that is significantly different from other national or regional social experiments. For example, in 2016, long-term care insurance pilots were launched in 49 pilot cities across the country, which is an important institutional arrangement for the mainland to actively cope with the aging of the population. In order to promote the Healthy China Initiative, in the same year, the National Patriotic Health Office identified the first batch of 38 national healthy city pilot cities. This kind of social experiment as a unit, the analysis of social determinants of health based on real scenarios has great theoretical and practical significance, because it can intervene in the health improvement of the public group through a stronger, more macroscopic and gradual policy demonstration effect, not just limited to a certain community or an individual. In the past, emphasizing the determinants of healthy society through social experiments often relied on Western classical models, but at this stage, especially in the current Chinese society, we have accumulated a lot of successful experiences and practices, and put more emphasis on macro society to motivate, integrate, innovate and participate.

In short, social medicine has both profound concepts and practical care, the social nature of medical disciplines and the influence of social factors are becoming more prominent, and the interaction between medicine and society is becoming closer and closer. After years of unremitting efforts by scholars, the medical knowledge system of mainland society has made continuous progress in reflection. In the past 30 years, mainland social medicine has shown strong development potential, and in the future, we still need to combine the development law of Chinese-style modernization, extract the essence of ideas that are in line with the spirit of the times and have guiding significance in previous research, and promote it to become an important source for constructing an independent knowledge system of Chinese social medicine. We will continue to devote ourselves to the practice of medical and health reform, carry out creative transformation and innovative development of its scope, concepts and terminology, and strive to build a more complete medical autonomy system in mainland society, with higher localization characteristics and international contributions of disciplines, and contribute more disciplinary spiritual nutrition to the development of health care.

The article is originally published in the 3rd edition of the 1869 issue of the Social Science Daily, and it is forbidden to reprint without permission, and the content of the article only represents the author's views, not the position of this newspaper.

Responsible editor of this issue: Wang Liyao