HOW THE SOCIAL HOW THE SOCIAL SCIENCES CAN SCIENCES CAN

CONTRIBUTE IN THE CONTRIBUTE IN THE BATTLE AGAINST BATTLE AGAINST

INFECTIOUS INFECTIOUS DISEASESDISEASES

Kai-Lit Phua, PhD FLMIKai-Lit Phua, PhD FLMI

Associate ProfessorAssociate Professor

School of Medicine & Health School of Medicine & Health SciencesSciences

Monash University Malaysia Monash University Malaysia CampusCampus

Biographical detailsBiographical details

Kai-Lit Phua received his BA (cum laude) in Public Kai-Lit Phua received his BA (cum laude) in Public Health & Population Studies from the University of Health & Population Studies from the University of Rochester and his PhD in Sociology from Johns Hopkins Rochester and his PhD in Sociology from Johns Hopkins University. He also holds professional qualifications University. He also holds professional qualifications from the insurance industry.from the insurance industry.

Prior to joining academia, he worked as a research Prior to joining academia, he worked as a research

statistician for the Maryland Department of Health and statistician for the Maryland Department of Health and Mental Hygiene and as an Assistant Manager for the Mental Hygiene and as an Assistant Manager for the Managed Care Department of a leading insurance Managed Care Department of a leading insurance company in Singapore. company in Singapore.

He was awarded an Asian Public Intellectual Senior He was awarded an Asian Public Intellectual Senior Fellowship by the Nippon Foundation in 2003.Fellowship by the Nippon Foundation in 2003.

Learning ObjectivesLearning Objectives To gain an understanding of some of the To gain an understanding of some of the

major social science disciplines major social science disciplines

To appreciate the usefulness of the social To appreciate the usefulness of the social sciences in the battle against infectious sciences in the battle against infectious diseasesdiseases

An Introduction to Some of An Introduction to Some of the Social Sciencesthe Social Sciences

History History

Political SciencePolitical Science

Economics Economics

Sociology & AnthropologySociology & Anthropology

Mass CommunicationsMass Communications

HistoryHistory Deals with past events, what led to their occurrence Deals with past events, what led to their occurrence

and how these past events can continue to influence and how these past events can continue to influence the present the present

Seminal works by medical historians include “Rats, Seminal works by medical historians include “Rats, Lice and History” by Hans Zinsser and “Plagues and Lice and History” by Hans Zinsser and “Plagues and Peoples” by William McNeillPeoples” by William McNeill

We can learn a lot from the history of past and We can learn a lot from the history of past and present infectious disease outbreaks e.g. the Black present infectious disease outbreaks e.g. the Black Death, HIV/AIDS, Nipah virus, SARS etc. Death, HIV/AIDS, Nipah virus, SARS etc.

Black Death – Jews as scapegoats; population Black Death – Jews as scapegoats; population movements and spread of the diseasemovements and spread of the disease

HIV/AIDS – initial inaction by President Ronald Reagan HIV/AIDS – initial inaction by President Ronald Reagan for various reasons (thus worsening the problem)for various reasons (thus worsening the problem)

Political SciencePolitical Science Deals with power, authority, legitimacy and the Deals with power, authority, legitimacy and the

struggle for control of resources by different interest struggle for control of resources by different interest groupsgroups

Sub-disciplines include International Relations (deals Sub-disciplines include International Relations (deals with relations between nation-states), Public with relations between nation-states), Public Administration, and Public Policy Analysis (deals Administration, and Public Policy Analysis (deals with public agenda-setting & the politics of public with public agenda-setting & the politics of public policy formulation, implementation and evaluation) policy formulation, implementation and evaluation)

Governance issues are important e.g. public health Governance issues are important e.g. public health laws and regulations; poor public health governance laws and regulations; poor public health governance in China and the spread of SARS to other nations; in China and the spread of SARS to other nations; international governance (WHO, CDC technical international governance (WHO, CDC technical assistance to other nations)assistance to other nations)

EconomicsEconomics Deals with issues related to the efficient Deals with issues related to the efficient

allocation of scarce resources so as to maximize allocation of scarce resources so as to maximize output and utility (consumer satisfaction) output and utility (consumer satisfaction)

Deals with the “market” and the government in Deals with the “market” and the government in the production, distribution, consumption and the production, distribution, consumption and regulation of goods and servicesregulation of goods and services

Economists have special expertise in the area of Economists have special expertise in the area of economic evaluation e.g. cost-effectiveness economic evaluation e.g. cost-effectiveness analysis to promote technical efficiency in the analysis to promote technical efficiency in the provision of health-related servicesprovision of health-related services

Health economists have attempted to estimate Health economists have attempted to estimate the cost of various epidemic disease outbreaks the cost of various epidemic disease outbreaks

Sociology and AnthropologySociology and Anthropology Sister disciplines that deal with how people behave in Sister disciplines that deal with how people behave in

groups & how these are shaped by social institutions groups & how these are shaped by social institutions and socially-derived cultural norms, values and beliefs and socially-derived cultural norms, values and beliefs (including religion) (including religion)

Studies how the socio-cultural environment can Studies how the socio-cultural environment can facilitate/hinder the spread of infectious diseases facilitate/hinder the spread of infectious diseases

Facilitating spread of HIV/AIDS: denial by politicians Facilitating spread of HIV/AIDS: denial by politicians about extent of problem (such as President Thabo about extent of problem (such as President Thabo Mbeki in South Africa), sex work as a survival strategy Mbeki in South Africa), sex work as a survival strategy by poor women or trans-sexuals, needle-sharing by by poor women or trans-sexuals, needle-sharing by drug abusers, large numbers of male migrant workers, drug abusers, large numbers of male migrant workers, disapproval of religious authorities against sex disapproval of religious authorities against sex education in schools and distribution of condoms education in schools and distribution of condoms

Sociology and AnthropologySociology and Anthropology Sociologists have special expertise in Sociologists have special expertise in

studying how social change (including studying how social change (including disease outbreaks) can have differential disease outbreaks) can have differential impact on people categorized according to impact on people categorized according to variables such as ethnicity, social class, variables such as ethnicity, social class, gender, age, geographical location, marital gender, age, geographical location, marital status, educational attainment, religiosity, status, educational attainment, religiosity, disability status or sexual orientation.disability status or sexual orientation.

Mass CommunicationsMass Communications Deals with issues and challenges associated with Deals with issues and challenges associated with

the transmission of information to large numbers the transmission of information to large numbers of peopleof people

Absolutely essential to have a system of effective Absolutely essential to have a system of effective mass communications during disease outbreaks – mass communications during disease outbreaks – prevent panic, provide accurate information, prevent panic, provide accurate information, promote appropriate care-seeking, (including promote appropriate care-seeking, (including reducing unnecessary care-seeking by the reducing unnecessary care-seeking by the “worried well” and “bunching” at particular health “worried well” and “bunching” at particular health facilities that may overwhelm their medical staff), facilities that may overwhelm their medical staff), co-ordinate the work of essential personnel such co-ordinate the work of essential personnel such as health workers (including ambulance drivers) as health workers (including ambulance drivers) and the police etc. and the police etc.

Additional ConsiderationsAdditional Considerations Social scientists should also pay attention to the Social scientists should also pay attention to the

aftermath of infectious disease outbreaks aftermath of infectious disease outbreaks For example, what are the health effects (physical For example, what are the health effects (physical

and mental) on those who were infected but and mental) on those who were infected but survived? How were their family members affected?survived? How were their family members affected?

Did the outbreak result in negative short term and Did the outbreak result in negative short term and long term effects (non-health effects) such as: long term effects (non-health effects) such as: reduced household income, employment problems, reduced household income, employment problems, heavy financial loss, indebtedness, family discord, heavy financial loss, indebtedness, family discord, domestic violence, stigmatization, outmigration, domestic violence, stigmatization, outmigration, population decline? population decline?

Was there any rebound? Did strong community Was there any rebound? Did strong community bonds (social capital) help in the recovery?bonds (social capital) help in the recovery?

THE ENDTHE END

THANK YOUTHANK YOU