Last update:
03-Jun-2020

The recent "re-establishment" of the specialty of Public Health – Social Medicine in Greece raises several questions regarding the meaning of the terms "Public Health" and "Social Medicine". The roots of public health are found in the need to control the endemic and epidemic diseases in the cities of the industrial revolution, in the early 19th century. Sanitary, hygienic measures were applied, at which time the dominance and application of the germ theory enhanced their effectiveness. Social medicine appeared in the middle of the 19th century to highlight the social factors which affect health, that were subsequently referred to as the social determinants of health. Public health shares common interests yet differing roles with all the other medical specialties, and in particular with Primary Health Care and General/Family Practice. From the 1970s onwards, recognition of the specialty has gradually spread to several countries, albeit with different names. In the Member States of the European Union the term varies, with the terms public health, social medicine and hygiene, used alone or in different combinations. The recognition of the medical specialty does not refute the multidisciplinary nature of public health. In Greece, after its independence, the hygiene services and the position of the Prefecture Medical Officer of Health went through several ups and downs, going through periods of organisation and periods of decline, depending on the outbreak of epidemics or other health crises. During the latter part of the 20th century, "public health" replaced "hygiene" at the level of the Ministry of Health, the Prefectures and the Regional Authorities. The recognition of the specialty of Social Medicine in 1983, with the law that established the National Health System (ESY), did not have any practical consequences, since there was no actual follow-up, similarly, with the renaming of the specialty as "Public Health Medicine" in 2005. In 2018 the specialty was renamed once more as "Public Health – Social Medicine", with a renewed curriculum. It remains to be seen whether this curriculum will be put into practice, so as to grant the specialty, after appropriate training, to young physicians and dentists. In any case, the challenges are huge and make it imperative for Greece to adopt an evidence-based health policy that will enjoy the consensus of the scientific community, of the political parties and of the public at large, so that it is applied with consistency and continuity.

Key words: History of medicine, Hygiene, Medical specialty, Public health, Social medicine.