Community medicine: its contribution to the social science of medicine

The Division of Behavioral Sciences operates today in a social climate different from that in its formative years. The federal agencies created specifically to stimulate and support social research have been cut back severely over the past two decades, and in some instances have been eliminated. The official policy of the National Institute of Mental Health, once the main source of support for both training and research in social science in medicine, has changed to a much narrower biomedical focus. On the other hand, there are more social scientists engaged in integral roles both locally at Mount Sinai, at medical institutions nationally, and internationally (25-26). Further, reassertion of the importance for medical education of social science specifically, and of behavioral sciences more broadly defined, has been endorsed in the strongest terms by both the Association of American Medical Colleges and the National Board of Medical Examiners (27). Also, the published literature now incorporates what we in the Division of Behavioral Sciences judge to be a richer intellectual contribution to the field than ever before (28). Perhaps most important, funding for health services research and epidemiological studies has been increased in recent federal budgets. Therefore, the division is planning for expansion of both its research and education, perceiving the future as a challenge continuous with challenges of the past: finding new ways to understand the relation between social factors and the problems of health and illness.