The Role Of Social Theories In Public Health: Understanding Interdependencies, Civic Competence, And Decision Making

What are social theories?

Social theories can be understood as ideas, hypothesis, arguments, speculations, though experiments or theories that explains the structure of the society, how they are formed, how it transforms or changes or even disappear over time. The theories are usually supported with researches and are one of the most integral components in Social Sciences. Social theories are required to make generalizations and distinctions about various societies and analyzed how it has changed over time. ^{1, 2} Public health is a branch of healthcare science that is associated with disease prevention, and promoting the health and wellbeing of the public. Supporting public health involves activities such as promotion of healthy lifestyle, researching on diseases, prevention of injuries, as well as detecting, preventing and responding to the spread of infectious diseases in the public. 

Sociology can be understood as a branch of science that deals with the understanding of the various aspects and elements in a society, which can include communities, families or religious groups and how social structures and norms evolves or breaks in a society. Social researchers collect various types of data such as statistics on demography, personal observations and census in order to explain different social phenomenon. Such explanations are the basis of social theories.^6,7,8. The theories help in several key aspects such as:

Developing an understanding of the society and the social dynamics: The social theories utilize human knowledge to develop and understanding on how society works, how it is structured, and the individual interactions within the society. Such knowledge is further utilized to make predictions for the future or explain the past and explore the societal knowledge.⁹

Making Decisions: Making decisions that affect the society or communities is always a sensitive task that involves acquiring a comprehensive knowledge about the society and the communities that would be affected by the decisions. The social theories provides a framework to understand such interplay between the decision making process and its effect of social dynamics. Through social theories, the policy makers can understand the various social issues that are in the focus, and how elected representatives of the society can take effective decisions that address the social issues. 

Civic Competence: Several authors have proposed that social theories provides the vital knowledge that supports civic competence, and provides the civic authorities vital information to take decisions regarding civic policies, such as healthcare policies. Through social research, strategies to make competent decisions can be ensured and helps them understand the social dynamics, or how their decision affects the society, thereby supporting civic competence.^12.

What is public health?

Understanding Interdependencies: One vital aspect about the social theories is that it helps to understand the various interdependent factors that are associated within the society, and how they affect the overall social dynamics. For example, how social determinants can influence the health and wellbeing of people, or how socioeconomic status can influence accessibility to healthcare and education.-

Public health has developed its focus merely from a biomedical point of view to a social context, which involved participation of diverse actors in the maintenance of public health, apart from just healthcare professionals. This has helped in the development of public health policies and various health alliances between different social actors with healthcare system. The alliances can involve professionals from public administration, psychology, healthcare, social sciences and biomedical sciences. Social theories moreover help in the development of theories of public health, which can be used by the policy makers to implement and maintain public well being. ^14. Several theories can be considered that can help to inform the development of public health policies. These theories include:

1. i) Unintended consequences of the purposive by Robert Merton:This theory proposes that every type of social interaction can have unintended outcomes, some of these outcomes can be foreseen and stopped while other outcomes cannot be. Due to this it is vital that all forms of social interactions should be thoroughly evaluated for the different unintended outcomes caused by them, and interactions that can have significant adverse effects or consequences can then be modified or even prevented. This theory can also be understood as the philosophy of ‘non-meleficience’ that is used in healthcare that ensures that healthcare providers do not cause any unintended harm to the patient. In public health, this theory ensures that all the possible effects of public health policies be properly evaluated before implementing them. For example health policies regarding the reporting of infectious disease outbreaks by health authorities.
2. ii) Social Construction of Reality by Peter Berger and Thomas Luckman- According to this theory, the real world is made up of ideas, practices and factors that care socially and culturally accepted, regardless of the biases in them. The perceptions, values and common mindsets that are seen in societies and communities form a part of their reality, and define what is acceptable or not acceptable. For example, abortion is a matter of strong debate in the USA, while in Japan it is accepted. Similarly, mental health issues is considered as a taboo in several countries, as a result of which several patients deter from seeking help for mental health conditions or acknowledge that they have one. Understanding this interplay between the mindsets and the social reality is an important knowledge by the health policy makers, helping them to understand what policies might find acceptance in a society and what will not.¹⁶

iii) Social Suffering Theory: This theory implies that social factors can directly lead to suffering of individuals and groups. Factors such as socioeconomic, sociopolitical, sociophsycological factors can lead to poverty, violence, deprivation and also support the spread of diseases or even reduce access to healthcare. For example, socioeconomic disadvantage can lead to the breakout of diseases or antibiotic resistance. Social suffering theory also implies that the suffering, pain and disorders is not only experienced by an individual but also suffered by their families and social networks, for example a person suffering from Parkinson’s, Alzheimer’s, or Dementia also results in the suffering by the person’s family, caregivers or social networks. This identifies medical health issues, as potential sufferings of the entire societies, having negative outcomes on the public health. ^17.

1. iv) Biopower theory by Michael Foucault- This theory suggests that by controlling the populations and the governing bodies, its effects can be exerted to extend political governance and ensuring the wellbeing of the public. This means that by involving the collection and analysis of data from each citizen, the civic bodies can develop a better understanding of the social problems and implement measures the monitor the issue to a much greater extent, and device policies to prevent their occurrence, For example, surveillance of birth control was made possible in China during the 60’s to 70’s due to a radical collectivist policy of the Maoist principles which was a part of their birth control policy. ¹⁸
2. v) Social Determinants of Health: According to WHO SDOH refers to a set of conditions under which an individual is born, grow, live, work and age as well as the overall factors that influence the conditions of life. Such circumstances are influenced by the distribution of money, resources and power at local, national, and global levels. These determinants are considered to be responsible for much of the health inequalities and health gap in a society, community and nature. In public health, the SDOH theory helps to understand that the determinants of health, and how their negative impacts can be minimized through public health policies to improve the health and well being of individuals. For example, policies on reducing discrimination of the patient can encourage health seeking behavior, or policies regarding advertisement for fast food or sugar sweetened beverages can help to reduce obesity rates.

From the discussion above it can be understood that social theory is an important aspect that helps in the development of public health policies and maintenance of public health and well being. Different types of theories can be utilized in the development of public health policies, which ensures benefit of the public, understand their social dynamics, utilize public data and understand how different factors affects public health. 

Claim 1-  Making Decisions

2- Improving Civic Competence

3- Understanding Interdependencies 

I have shown that

From the discussion above it can be understood that social theory is an important aspect that helps in the development of public health policies and maintenance of public health and well being. Different types of theories can be utilized in the development of public health policies, which ensures benefit of the public, understand their social dynamics, utilize public data and understand how different factors affects public health.