Ecological Observations of the Relation of Physical Illness, Mental Illness, and the Social Environment

Abstract

The relation between health and the social environment is not a simple one. Long years of asymptomatic productivity, unmarred by disability or evidence of illness, has been observed in people from many ethnic groups from several societies, and at all levels of our own society. Within very wide limits, some people are able to tolerate and even thrive upon social and physical conditions that others regard as intolerable and incapable of supporting a healthy life. A man''s relationship to his social environment is largely a communicative one, based upon the receipt of information from the environment, its evaluation largely within the central nervous system, and the organization of responses based on this evaluation. The problem of making an estimate of the probable meaning of a given situation to a given individual involves formidable methodologic difficulties. However, a useful approximation can be obtained by making assumptions based upon the cultural background of the individual, his role within his society, and his unique experiences with his family in his development and throughout his past life, plus a knowledge of the actual situation in which the man finds himself, and the information that he has regarding it. Studies based on these assumptions indicate that, when humans are involved in life situations which they find frustrating, overdemanding, depriving, threatening, or conflict inducing, they are more likely to have a variety of illnesses involving a number of causal agents. In order to preserve health or treat disease, the physician must concern himself with the patient''s relation to his life situation. This may make it necessary for him to acquire special skills but will not require the creation of a new brand of medicine.