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SOCIAL	EPIDEMIOLOGY
NAJMAH,	SKM,	MPH,	PHD
NURMALIA	ERMI,	SST,	MKM
Refleksi	Bonita’s Story
Menurut saya, dari kasus Bu Bonita kita dapat
mendapat pelajaran bahwa kasus HIV tidak hanya
menyerang orang-orang pekerja seks dan orang yang
bersalah ataupun akibat dari perilaku nya sendiri.
Tetapi dapat menyerang siapa saja, kita harus lebih
berhati-hati dalam melakukan apapun termasuk dalam
melakukan hubungan seks dengan pasangan. Dan
perlu adanya keterbukaan antara pasangan suami dan
istri sehingga tahu latar belakang masing-masing.
(FARIDA NUR AZIZA)
Dari membaca kisah Ibu Bonita tadi hal yang dapat
saya ketahui yaitu bagaimana pentingnya pendidikan
tentang hiv/aids kepada seluruh kalangan termasuk ibu
rumah tangga, karena selama ini pendidikan tersebut
condong berpusat diberikan ke pekerja seks.
(DIAN PALUPI )https://www.insideindonesia.org/ibu-rumah-tangga-dan-
hiv
Today
(1)	Definition	of	Social	Epidemiology	epidemiologi
sosial
(2)	History	of	Social	Epidemiology
(3)	Sociostructural factors and determinants in	the
field of social epidemology
Definition of Social Epidemiology
Social	Epidemiology	is	a	branch	of	epidemiology	that	focuses	particularly	on	the	
effects	of	social-structural	factors	on	states	of	health.
Social	epidemiology	assumes	that	the	distribution	of	advantages	and	
disadvantages in	a	society	reflects	the	distribution	of	health	and	disease.
The	central	and	initial	question	of	social	epidemiology	to	be	answered	is	what	
effect	do	social	factors	have	on	individual	and	population	health.
Social	epidemiology	focuses	particularly	on	the	effects	of	socio-structural	
factors	on	states	of	health	
Sumber:	HONJO,	Kaori,	2004, Social	Epidemiology:	Definition,	History,	and	
Research	Examples
In	other words.....
The	field	of	social	epidemiology,	suggesting	a	
multilevel	framework	within	which	to	think	about
causation	and	making	it	acceptable	for	social	
epidemiologists	to	make	their	central	focus	the	
study	of	how	social	factors,	such	as	social	ties,	
poverty,	and	racial	segregation,	might	shape the	
health	of	populations.
Pathways:	the	social,	cultural, political	and	
economic	context
Sumber:	Galea,	Sandro	&	Link,	Bruce	G,	2013,	Six	Paths	for	the	Future	of	
Social	Epidemiology
History of Social Epidemiology
France	
• Villerme	examined	
differences	in	mortality	
between	the	poor	and	
the	affluent
Germany
• Virchow	reported	the	
relationship	between	
poor	social	conditions	
and	the	typhus	
epidemic	in	Upper	
Silesia
London
• Chadwick	reported	
that	unsanitary	soil,	air	
and	water	were	major	
causes	of	diseases
19th	century:	
Societal
conditions affect
physical health`
The	improved
schooling and working
conditions would
reduce disparities in	
mortality between the
poor and the affluent
Unequal access to
society’s products was
the fundamental	cause
of unequal distribution
of diseases in	the
society
promoting sanitation
measures to improve
the health of the poor
Germ theory
• New	germs	cause	
diseases
The	rise	of	
infectious	
diseases
• Exposure to a single
individual	risk factors
to multipe single risk
factors
Modern	
epidemiology
• Social epidemology—
the importance of
socio-structural factors
on health as	well as	in	
a population
perspective
20th	century:	
Web	of causation
Social epidemiologist argue
“how do social conditions produce patterns and diseases”?
The	central question of social epidemiology
“What are	the effects of social factors such as	social structure,	culture and
environment on both individual	and population health?”
Sociostructural factors in	the field of
social epidemology
SOCIAL	
EPIDEMIOLOGYSocial class
Gender
Race/Ethni
city
Discrimina
tion Social
network
Income
distribution
Social
policy
Sumber:	HONJO,	Kaori,	2004, Social	Epidemiology:	Definition,	History,	and	Research	Examples
Social
determinants
of health
Example1:
Integrated
care:asolution
forimproving
Exchildren's
health?
Ingrid Wolfe, Claire Lemer, Hilary Cass, 2013, Integrated care: a
solution for improving children's health?
How to understand the concept
Let’s Reflecting on Bonita’s story
What factors that contribute to women’s vulnerability to HIV?
Please list them:
1. .........................................................................
2. .........................................................................
3. .........................................................................
4. .........................................................................
5. .........................................................................
6.........................................................................etc
Individual	factors: Interpersonal/Family	factors:
Social and community (health services)	networks Socio-economic,	cultural and environmental
conditions
Please	categorise	the	factors	into	social	
determinants	of	health	(from	Bonita’s	story)
How to create a health promotion to reduce
the women’s vulnerability to HIV	in	
Indonesian	context?
https://www.youtube.com/watch?v=G2quVLcJVBk
Let’s do a group discussion
Visit	E-learning Unsri
https://elearning.unsri.ac.id/

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