Re: [Gnumed-devel] Thoughts about social history

[Elizabeth Dodd]

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On Fri, 9 Aug 2002 22:00, richard terry wrote:
> Could we have a little debate about the following please. I think we need a
> dedicated gmSocialHistory.py (split from the combined social and family
> history)
>
Ok
I spent two hours today out on the roadside, marshaling for a cycle race, so I
took a notebook and thought about all this.

Social history - my working definition
A collection of information about lifestyle, culture, behaviour of an
individual which assists the doctor with assessment of disease risk for this
individual and the effect of disease on this individual.
Some is collected for legal and administrative needs and this varies in each
country.

I have many lists of things which may be in a social history. I am not guilty
of ever taking a history like this - my knowledge expands over time knowing
the individual and their family.
There is no particular order to these and the list can't be all inclusive

Ethnicity
Immigrant status - year
- - ? interned (not a new idea in australia, many of our local immigrants were
interned for 1939-1945)
- - country of birth
- - reasons for move (economic, religious, family, war)
Housing (house, flat, caravan, shack, tent, natural shelter, group
accommodation)
Family type in dwelling (Nuclear family, 3 generation family, multiple adults)
Education ( primary, secondary, tertiary)
Language used at home
Jobs - past and present
Actual place of work
If ever in prison
Drug use (Intravenous, smoking, oral, sniffed; substances {tobacco, alcohol,
THC, amphetamines})
Retired /Jobseeking/ Not in regular Workforce/ Subsistence existence/ Not cash
economy.
Leisure activities
Sporting activities (past and present)
Marital status/ Sexuality
Dependents
Religion
War Service (conflict, type of service eg navy, guerilla)
Political affiliation (not commonly recorded in australia, but I need to know
who when I need political messages carried)
Does another individual deal with this person's financial affairs (legal or
informal arrangement)
Does another individual deal with this person's medical decisions?
This person's goals for their own life - usually recorded along the way in
progress notes.

How to order and present all this info????
Multiple choices, some sort of drop down box, a database of useful suggestions
but a free text option also. Will this free text get into the database as an
entry?
Some has to be marked confidential (at various levels, I do recall)
We need basic categories on a front tab
Define basic according to what is most useful according to what we do with
this information (eg assessing disease risk) and what we have to collect for
our jurisdiction
Less needed opotions on other tabs

Possible uses for yet more databases are ethnic effects on health (eg
australian aboriginal in urban society has a large risk of central obesity
with hypertension, diabetes and early death)
I think that disease risk should be able to be listed from a disease database
(eg lived in Papua New Guinea, has malaria risk; outdoor worker with pale
skin, risk of skin cancer) I don't mean to pre define these risks, i want a
way of having these properly filed after I think of them in a consultation
Liz
Ready for more discussion

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