HOW THE SOCIAL SCIENCES CAN CONTRIBUTE IN THE BATTLE AGAINST INFECTIOUS DISEASES Kai-Lit Phua, PhD FLMI Associate Professor School of Medicine & Health Sciences Monash University Malaysia Campus

Biographical details Kai-Lit Phua received his BA (cum laude) in Public Health & Population Studies from the University of Rochester and his PhD in Sociology from Johns Hopkins University. He also holds professional qualifications from the insurance industry. Kai-Lit Phua received his BA (cum laude) in Public Health & Population Studies from the University of Rochester and his PhD in Sociology from Johns Hopkins University. He also holds professional qualifications from the insurance industry. Prior to joining academia, he worked as a research statistician for the Maryland Department of Health and Mental Hygiene and as an Assistant Manager for the Managed Care Department of a leading insurance company in Singapore. Prior to joining academia, he worked as a research statistician for the Maryland Department of Health and Mental Hygiene and as an Assistant Manager for the Managed Care Department of a leading insurance company in Singapore. He was awarded an Asian Public Intellectual Senior Fellowship by the Nippon Foundation in He was awarded an Asian Public Intellectual Senior Fellowship by the Nippon Foundation in 2003.

Learning Objectives To gain an understanding of some of the major social science disciplines To gain an understanding of some of the major social science disciplines To appreciate the usefulness of the social sciences in the battle against infectious diseases To appreciate the usefulness of the social sciences in the battle against infectious diseases

An Introduction to Some of the Social Sciences History History Political Science Political Science Economics Economics Sociology & Anthropology Sociology & Anthropology Mass Communications Mass Communications

History Deals with past events, what led to their occurrence and how these past events can continue to influence the present Deals with past events, what led to their occurrence and how these past events can continue to influence the present Seminal works by medical historians include “Rats, Lice and History” by Hans Zinsser and “Plagues and Peoples” by William McNeill Seminal works by medical historians include “Rats, Lice and History” by Hans Zinsser and “Plagues and Peoples” by William McNeill We can learn a lot from the history of past and present infectious disease outbreaks e.g. the Black Death, HIV/AIDS, Nipah virus, SARS etc. We can learn a lot from the history of past and present infectious disease outbreaks e.g. the Black Death, HIV/AIDS, Nipah virus, SARS etc. Black Death – Jews as scapegoats; population movements and spread of the disease Black Death – Jews as scapegoats; population movements and spread of the disease HIV/AIDS – initial inaction by President Ronald Reagan for various reasons (thus worsening the problem) HIV/AIDS – initial inaction by President Ronald Reagan for various reasons (thus worsening the problem)

Political Science Deals with power, authority, legitimacy and the struggle for control of resources by different interest groups Deals with power, authority, legitimacy and the struggle for control of resources by different interest groups Sub-disciplines include International Relations (deals with relations between nation-states), Public Administration, and Public Policy Analysis (deals with public agenda-setting & the politics of public policy formulation, implementation and evaluation) Sub-disciplines include International Relations (deals with relations between nation-states), Public Administration, and Public Policy Analysis (deals with public agenda-setting & the politics of public policy formulation, implementation and evaluation) Governance issues are important e.g. public health laws and regulations; poor public health governance in China and the spread of SARS to other nations; international governance (WHO, CDC technical assistance to other nations) Governance issues are important e.g. public health laws and regulations; poor public health governance in China and the spread of SARS to other nations; international governance (WHO, CDC technical assistance to other nations)

Economics Deals with issues related to the efficient allocation of scarce resources so as to maximize output and utility (consumer satisfaction) Deals with issues related to the efficient allocation of scarce resources so as to maximize output and utility (consumer satisfaction) Deals with the “market” and the government in the production, distribution, consumption and regulation of goods and services Deals with the “market” and the government in the production, distribution, consumption and regulation of goods and services Economists have special expertise in the area of economic evaluation e.g. cost-effectiveness analysis to promote technical efficiency in the provision of health-related services Economists have special expertise in the area of economic evaluation e.g. cost-effectiveness analysis to promote technical efficiency in the provision of health-related services Health economists have attempted to estimate the cost of various epidemic disease outbreaks Health economists have attempted to estimate the cost of various epidemic disease outbreaks

Sociology and Anthropology Sister disciplines that deal with how people behave in groups & how these are shaped by social institutions and socially-derived cultural norms, values and beliefs (including religion) Sister disciplines that deal with how people behave in groups & how these are shaped by social institutions and socially-derived cultural norms, values and beliefs (including religion) Studies how the socio-cultural environment can facilitate/hinder the spread of infectious diseases Studies how the socio-cultural environment can facilitate/hinder the spread of infectious diseases Facilitating spread of HIV/AIDS: denial by politicians about extent of problem (such as President Thabo Mbeki in South Africa), sex work as a survival strategy by poor women or trans-sexuals, needle-sharing by drug abusers, large numbers of male migrant workers, disapproval of religious authorities against sex education in schools and distribution of condoms Facilitating spread of HIV/AIDS: denial by politicians about extent of problem (such as President Thabo Mbeki in South Africa), sex work as a survival strategy by poor women or trans-sexuals, needle-sharing by drug abusers, large numbers of male migrant workers, disapproval of religious authorities against sex education in schools and distribution of condoms

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

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

Additional Considerations Social scientists should also pay attention to the aftermath of infectious disease outbreaks Social scientists should also pay attention to the aftermath of infectious disease outbreaks For example, what are the health effects (physical and mental) on those who were infected but survived? How were their family members affected? For example, what are the health effects (physical and mental) on those who were infected but survived? How were their family members affected? Did the outbreak result in negative short term and long term effects (non-health effects) such as: reduced household income, employment problems, heavy financial loss, indebtedness, family discord, domestic violence, stigmatization, outmigration, population decline? Did the outbreak result in negative short term and long term effects (non-health effects) such as: reduced household income, employment problems, heavy financial loss, indebtedness, family discord, domestic violence, stigmatization, outmigration, population decline? Was there any rebound? Did strong community bonds (social capital) help in the recovery? Was there any rebound? Did strong community bonds (social capital) help in the recovery?

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