Abstract
To a large extent, behavioral medicine originates from the United States, and more specifically from the scientific traditions of pragmatism and behaviorism. The core notion of individual learning, mastery, and development embedded in these traditions has lent support to an almost exclusive concern with individual behavioral modification. However, individual mastery and welfare are increasingly threatened by powerful adverse socioeconomic and sociocultural developments, especially by growing social inequalities in health and by expanding social disintegration. Social differentials in morbidity and mortality are documented even in the most economically advanced countries where health-damaging lifestyles (e.g., cigarette smoking, diet) and stressful conditions of relative deprivation in occupational life and elsewhere contribute to the observed pattern. In addition, detrimental effects on health produced by social disintegration are manifest, most notably in societies that undergo rapid socioeconomic change. Implications of these developments for future behavioral medicine are discussed at the level of scientific analysis and of preventive and therapeutic intervention.
References
Ames, B. N., & Shigenaga, M. K. (1993). Oxidants are a major contributor to cancer and aging. In B. Halliwell & O. I. Aruoma (Eds.), DNA and free radicals (pp. 1–15). New York: Ellis Horwood.
Berkman, L., & Orth-Gomér, K. (1996). Prevention of cardiovascular morbidity and mortality: Role of social relations. In K. Orth-Gormér & N. Schneiderman (Eds.), Behavioral medicine approaches to cardiovascular disease prevention (pp. 51–67). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
Bobak, M., & Marmot, M. (1996). East-West mortality divide and its potential explanations: Proposed research agenda. British Medical Journal, 312, 421–425.
Cockerham, W. C. (1992). Medical sociology. Englewood Cliffs, NJ: Prentice-Hall.
Durkheim, E. (1951). Suicide. New York: Free Press.
Elias, N. (1987). Die Gesellschaft der Individuen [The society of individuals]. Frankfurt, Germany: Suhrkamp.
Fox, J. (Ed.). (1989). Health inequalities in European countries. Aldershol, Great Britain: Gower.
Henry, J., & Stephens, P. A. (1977). Stress, health and the social environment. New York: Springer.
Hertzman, C. (1995). Environment and health in central and eastern Europe. Washington. DC: World Bank.
Hurrelmann, K., & Losel, F. (Eds.). (1990). Health hazards in adolescence. Berlin, Germany: de Gruyter.
Karasek, R. A., & Theorell, T. (1990). Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books.
Kok, G., Hospers, H. J., den Boer, D., & de Vries, H. (1996). Health education at the individual level. In K. Orth-Gomér & N. Schneiderman (Eds.), Behavioral medicine approaches to cardiovascular disease prevention (pp. 185–202). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
Lahelma, E., & Valkonen, T. (1990). Health and social inequities in Finland and elsewhere, Social Science and Medicine, 31, 257–265,
Marmot, M. G. (1994). Social differentials in health within and between populations. Daedalus, 123, 197–213.
Marmot, M. C. & McDowall, M. E. (1986). Mortality decline and widening social inequalities. Lancet, ii, 274–276.
Marmot, M. G., Shipley, M. G., & Rose, G. (1984). Inequalities in death-specific explanations of a general pattern? Lancer, i. 1003–1006.
Pappas, G., Queen, S., Hadden, W., & Fisher, G. (1993). The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. New England Journal of Medicine, 329, 103–109.
Peto, R., Lopez, A. D., Borcham, J., Thun, M., & Heath, C. (1994). Mortalityfrom smoking in developed countries 1950–2000. Indirect estimates from national vital statistics. Oxford. England: Oxford University Press.
Rosen, G. (1979). The evolution of social medicine. In H. Freeman, S. Levine, & L. Reeder (Eds.), Handbook of medical sociology (pp. 23–50). Englewood Cliffs, NJ: Prentice-Hall.
Roth. G. (1995), Das Gehirn und seine Wirklichkeit [The brain and its reality]. Frankfurt, Germany: Suhrkamp.
Scherwitz, L. W., Perkins, L. L., Chesney, M. A., Hughes, G. H., Sidney, S., & Manotio, T. A. (1992). Hostility and health behaviors in young adults: The Cardia Study. American Journal of Epidemiology. 136, 136–145.
Schnall, P. L., Landsbergis, P, A., & Baker, D. (1994). Job strain and cardiovascular disease. Annual Review of Public Health, 15, 381–411.
Schneiderman, N., & Orth-Gomér. K. (1996). Blending traditions: A concluding perspective on behavioral medicine approaches to coronary heart disease prevention. In K. Orth-Gomér & N. Schneiderman (Eds.), Behavioral medicine approaches to cardiovascular disease prevention (pp. 279–299). Mahwah. NJ: Lawrence Erlbaum Associates, Inc.
Schwartz, G. E., & Weiss, S. M. (1978). Behavioral medicine revisited: An amended definition. Journal of Behavioral Medicine, 1, 249–251.
Siegrist, J. (1996). Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1, 27–41.
Syme, S. L. (1986). Strategies for health promotion. Preventive Medicine, 15, 492–507.
Uemura, K., & Pisa, Z. (1988). Trends in cardiovascular disease mortality in industrialized countries since 1950. World Health Statistical Quarterly, 41, 155-I78.
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This article was presented as the opening address by the President of the international Society of Behavioral Medici ne (ISBM) at the Fourth International Congress of Behavioral Medicine, Washington, DC, March 13, 1996.
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Siegrist, J. The challenges of future behavioral medicine. Int. J. Behav. Med. 3, 195–201 (1996). https://doi.org/10.1207/s15327558ijbm0303_1
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DOI: https://doi.org/10.1207/s15327558ijbm0303_1