Changes in disease patterns and related social trends

Social environment is a major determinant of health and disease patterns in any community. The 19th century revolution in public health had as its cornerstone the improvement of social and physical environment. The favorable social development has since that time significantly contributed to the decrease of traditional health hazards in developed countries. New public health problems, chronic diseases have emerged in these countries. In some of these nations a new trend has started that may be called the second revolution in public health, i.e. the reduction of chronic diseases. However, the major part of the world's population still suffers from the traditional illnesses that should and could have been set aside by the 19th century revolution. Obviously, the social environment has not been altered sufficiently in these areas to have the desired impact on the health status. The observations from the Eastern European countries stress the need for a purposeful avoidance of deprivation in the social and physical environment as prerequisites for the prevention and control of diseases. Generally, low socio-economic status has been found to relate to an increased risk in many diseases. Usually there is a definite time lag between changes in social trends and disease patterns which causes difficulties for research in this area. The same fact generates problems for the planning and implementation of interventions to prevent the socially affected diseases. Changes in disease patterns are not only determined by altered trends, but disease patterns can also influence social tendencies in several ways. Studying the interaction of social and health trends quantitatively and experimentally has yielded results which are hard to interpret. Therefore, observational and 'doft' methods are employed here to describe the relationship of social and health trends more aptly.