Scott Stonington, Assistant Professor of Anthropology, Lead Editor on case series in The New England Journal of Medicine
Scott Stonington, assistant professor of anthropology, is the Lead Editor on a case series in The New England Journal of Medicine titled "Case Studies in Social Medicine". "Case Studies in Social Medicine" is the first series in a major medical journal dedicated specifically to concepts and data from the social sciences.
"Case Studies in Social Medicine — Attending to Structural Forces in Clinical Practice":
Many clinicians and trainees see the social world as a messy, impenetrable black box: they may acknowledge its influence on their patients’ health, but they lack the understanding and tools for incorporating it usefully into their diagnostic reasoning and therapeutic interventions. But the social sciences of health and medicine provide such tools — theories and methods for understanding social processes and intervening to effect change. Leading organizations in medical education have recommended providing additional training in social medicine, which deploys these approaches to improve health.1,2 In this issue, the Journal launches Case Studies in Social Medicine, a series of Perspective articles, to highlight the importance of social concepts and social context in clinical medicine. The series will use discussions of real clinical cases to translate these tools into terms that can readily be used in medical education, clinical practice, and health system planning.
In their first year in medical school, all students learn to take a social history. As they transform their eyes, ears, and hands into sensors for detecting hidden causes of disease, they also learn to ask probing questions to illuminate patients’ social contexts. What pathogenic exposures might a patient face en route to immigrate to the United States from Guatemala, in being subjected to police violence and arrest in a heavily patrolled nonwhite neighborhood, in working in pesticide-laden fields, or as a result of exclusion from health care coverage? Answers to such questions can dramatically change a diagnostic picture or therapeutic plan. Yet by the clinical years of medical school, students learn that the social history is often collapsed into a record of three biobehavioral exposures — to alcohol, tobacco, and illicit drugs. Much of what they read in clinical journals appears to corroborate the assumption that in clinical medicine, the biologic and behavioral world of a patient’s body is more important than the social world outside it.