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In recent decades, physicians have diagnosed fictional and non-fictional characters through portraits, biographies and writing. We argue that such an exercise can be beneficial for a uniquely health humanities reason-better understanding of our current world and the social determinants of health. Drawing on the method of health and social justice studies, we explore the character of Shosha, who appears repeatedly in the writings of Nobel Prize winner Isaac Bashevis Singer. Singer's strong story-telling skill and commitment to writing about the Jewish communities of prewar Poland in vivid detail preserve a slice of history, ensure that future generations will better understand what was destroyed by Nazi extermination policies, and provide lessons for modern political, hunger and war threats to human health. Shosha suffers from a lifelong debilitating disease that neither Singer nor subsequent commentaries ever name. The authors focus first on diagnosing the disease by consulting medical literature and experts. They then examine the value and pitfalls of this exercise and suggest that the lessons of understanding the disease historically, for teaching physicians how to recognise diseases rooted in war and poverty, and for enlightening all of us to the risks faced in human health by a world increasingly taking up arms and sliding towards fascism make diagnosing Shosha necessary and meaningful., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Four historical events provide context for racial injustices and inequities in medicine in the United States today: the invention of race as a social construct, enslavement in the Americas, the legal doctrine of Partus sequitur ventrem, and the American eugenics movement. This narrative review demonstrates how these race-based systems resulted in stereotypes, myths, and biases against Black individuals that contribute to health inequities today. Education on the effect of slavery in current health care outcomes may prevent false explanations for inequities based on stereotypes and biases. These historical events validate the need for medicine to move away from practicing race-based medicine and instead aim to understand the intersectionality of sex, race, and other social constructs in affecting the health of patients today., Competing Interests: Financial Disclosure The author did not report any potential conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Culturally relevant stressors and protective factors are vital to understanding and effectively supporting Native American/Alaska Native (NA/AN) college students' mental health and well-being. This study examined the theorized pathways among historical loss, well-being, psychological distress, and the proposed cultural buffer of ethnic identity in the indigenist stress-coping model (ISCM). Cross-sectional data were collected via online survey and analyzed using structural equation modeling. Participants were a national sample of 242 NA/AN college students. Participants were predominantly women ( n = 185; 76%) and median age was 21 years. Partial support was found for the ISCM. Participants reported frequent thoughts of historical loss, which were associated with lower well-being and higher levels of psychological distress. Ethnic identity moderated the relationship between historical loss and well-being such that those with stronger ethnic identities reported a weaker relationship between historical loss and lower well-being. Results underscore the importance of culturally specific risk and protective factors in NA/AN college students' resiliency and inform needed interventions and systemic change in higher education. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The "great AIDS patient revolt" had a major impact on the world of health care in Western countries. It is considered to be one of the social factors that led to the emergence of the notion of health democracy at the turn of the century. A look back at a historic struggle., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Background: This study investigated socioeconomic inequalities in premature cancer mortality by cancer types, and evaluated the associations between socioeconomic status (SES) and premature cancer mortality by cancer types., Methods: Using multiple databases, cancer mortality was linked to SES and other county characteristics. The outcome measure was cancer mortality among adults ages 25-64 years in 3,028 U.S. counties, from 1999 to 2018. Socioeconomic inequalities in mortality were calculated as a concentration index (CI) by income (annual median household income), educational attainment (% with bachelor's degree or higher), and unemployment rate. A hierarchical linear mixed model and dominance analyses were used to investigate SES associated with county-level mortality. The analyses were also conducted by cancer types., Results: CIs of SES factors varied by cancer types. Low-SES counties showed increasing trends in mortality, while high-SES counties showed decreasing trends. Socioeconomic inequalities in mortality among high-SES counties were larger than those among low-SES counties. SES explained 25.73% of the mortality. County-level cancer mortality was associated with income, educational attainment, and unemployment rate, at -0.24 [95% (CI): -0.36 to -0.12], -0.68 (95% CI: -0.87 to -0.50), and 1.50 (95% CI: 0.92-2.07) deaths per 100,000 population with one-unit SES factors increase, respectively, after controlling for health care environment and population health., Conclusions: SES acts as a key driver of premature cancer mortality, and socioeconomic inequalities differ by cancer types., Impact: Focused efforts that target socioeconomic drivers of mortalities and inequalities are warranted for designing cancer-prevention implementation strategies and control programs and policies for socioeconomically underprivileged groups., (©2021 American Association for Cancer Research.)

This paper explores the historical developments of admission registers of psychiatric asylums and hospitals in England and Wales between 1845 and 1950, with illustrative examples (principally from the archives of the Rainhill Asylum, UK). Standardized admission registers have been mandatory elements of the mental health legislative framework since 1845, and procedural changes illustrate the development from what, today, we would characterize as a predominantly psychosocial understanding of mental health problems towards primarily biomedical explanations. Over time, emphasis shifts from the social determinants of admission to an asylum to the diagnosis of an illness requiring treatment in hospital. We discuss the implications of this progressive historical diminution of the social determinants of mental health for current debates in mental health care.

From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

A review of the published literature on the origin of medical sociology and its field of action was made. For this, several publications were analyzed and the most relevant aspects were summarized. Although the concept of disease has always been linked to sociocultural aspects, only until the mid-twentieth century, Medicine recognized the importance of sociology to explain health-related issues, especially the social determinants of health. Currently, sociologists work in a multidisciplinary way with doctors to investigate and analyze issues concerning the health of people, to improve the welfare and quality of life of the population. In this sense, the contribution of Sociology has not only enriched the understanding of some diseases, but also different aspects of the work of Medicine.

The so-called social determination is a key concept for Latin American Social Medicine (LASM). LASM criticizes epidemiology frequently, mainly because of its reductionist vision and its distance from social reality. This paper makes an opposite analysis, in other words, 21st century epidemiology criticizes LASM, using the disciplinary development in Colombia as an example. The history of Colombian epidemiology is reviewed, noting that it has not had sufficient development and that LASM tends to reject quantitative methods based on the epidemiological practices used four decades ago. Additionally, some developments of the quantitative methods used in epidemiology are reviewed, explaining that many of the limitations indicated by LASM have been overcome. In conclusion, LASM uses social determination as part of its leftist political platform; however, current quantitative methods and the 21st century theoretical developments in epidemiology show a pragmatic superiority, useful for solving current public health issues.

This article presents an epistemological discussion that underlies the proposal of social determination of the health-disease process, framing this discussion in the history of the current of thought known as Latin American Social Medicine, and analyzing the way in which this current approaches the study of health-disease processes in contemporary societies. To this end, a brief historical framework is elaborated, and the epistemological implications of the concept of social determination of the health-disease process are analyzed. Finally, three examples illustrate how the ideas about determination in the concrete study of reality are applied.

Introduction: Literacy is linked to a range of health outcomes, but its association with reproductive health in high-income countries is not well understood. We assessed the relationship between early-life literacy and childbearing across the reproductive lifecourse in the USA., Study Design: A prospective cohort design was employed to assess early-life literacy and subsequent childbearing, using data from the National Longitudinal Survey of Youth 1979. The US youth aged 14-22 years in 1979, including 6283 women, were surveyed annually through 1994 and biannually thereafter. Literacy was assessed in 1980 using the Armed Services Vocational Aptitude Battery Reading Grade Level (RGL). Cumulative childbearing and grand multiparity (≥5 births) were assessed in 2010. Summary statistics, χ 2 , Kruskal-Wallis, test for trend and logistic regression, were used., Results: Of 6283 women enrolled, 4025 (64%) had complete data and were included in the analyses. In 1980, these women were on average 18 years old and in 2010 they were 45. Median cumulative parity decreased for each RGL and ranged from 3.0 (<5th grade) to 2.0 (>12th grade) (p=0.001). Adjusting for race/ethnicity, poverty status, whether a woman had had a child in 1980, and age in 1980, odds of grand multiparity were 1.9 (95% CI 1.1 to 3.5) and 1.8 (95% CI 1.0 to 3.3), greater among women with <5th or 5-6th grade literacy compared with those ≥12th literacy., Discussion: In the USA, early-life literacy is associated with total parity over a woman's lifecourse. Literacy is a powerful social determinant of reproductive health in this high-income nation just as it has been shown to be in low-income nations., Competing Interests: Conflicts of Interest: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

André Feil (1884-1955) was a French physician best recognized for his description, coauthored with Maurice Klippel, of patients with congenital fusion of cervical vertebrae, a condition currently known as Klippel-Feil syndrome. However, little is known about his background aside from the fact that he was a student of Klippel and a physician who took a keen interest in describing congenital anomalies. Despite the relative lack of information on Feil, his contributions to the fields of spinal disease and teratology extended far beyond science to play an integral role in changing the misguided perception shrouding patients with disfigurements, defects, deformities, and so-called monstrous births. In particular, Feil's 1919 medical school thesis on cervical abnormalities was a critical publication in defying long-held theory and opinion that human "monstrosities," anomalies, developmental abnormalities, and altered congenital physicality were a consequence of sinful behavior or a reversion to a primitive state. Indeed, his thesis on a spinal deformity centering on his patient, L. Joseph, was at the vanguard for a new view of a patient as nothing less than fully human, no matter his or her physicality or appearance.

Background: Behaviour is guided by perceptions and traditions. As such, understanding culture and religion is important in order to understand healthcare behaviour. Religious perceptions shape a person's understanding of the world and are maintained through texts and tradition. One such important religious text in relation to sexual and reproductive health is the Nativity story. This account of the conception and birth of Jesus is well known in the Christian cultural sphere and beyond, and it has for generations shaped perceptions of childbirth., Methods: This paper attempts a re-reading of the Nativity story using a hermeneutic approach., Results and Conclusion: This reveals a dual understanding of the Nativity, not just as an account of immaculate transcendence and a rosy Christmas tale, but as a source of identification for pregnant women and mothers and a call to action for improved maternal and child healthcare.