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What is social science? A social life of antibiotics view

What social sciences are and what disciplines they cover, as well as how they can be used in AMS.
My name is Alex Broom. I’m a professor of sociology at the University of Sydney. And I’m going to talk to you today about the social life of antibiotics. This major global issue of antimicrobial resistance, I’m going to argue today, is a social problem, not just a medical issue. And I’m going to unpack some of the many reasons why antimicrobial resistance is actually about a whole variety of choices about the way we live, the way we relate to another, and, essentially, provide a social science understanding of the social life of antibiotics. So to just talk a little bit about antimicrobial resistance as a global threat, it is a truly global crisis.
We have two main issues that we know are driving this crisis of AMR. It’s excess consumption or misuse. And it’s a limited antimicrobial pipeline, or the development of drugs. Now, misuse is what I’m going to talk about primarily today. And that is how social issues or social dynamics shape ongoing misuse of antimicrobials, our diminishing resources of which are going to pose a major, major threat to society– lots of different societies– and the globe within probably a few decades.
So what– if we distill today’s talk down to a key question, for me, that is, given widespread acknowledgment that antimicrobial resistance is set to become the most pressing global health threat of the 21st century, why do we continue to misuse our available antimicrobial resources? It simply doesn’t make sense. Or does it? From a social science perspective, as you’ll see as I go through the various social processes that are underlying this problem, it actually does make sense. There is a series of important understandings of why we misuse that provide an answer to this question and ultimately, hopefully, some solutions to it as well.
If we take a look at the hospital sector, for example, in Australia, as we have over the last eight years, and this is a context where we really closely examine antimicrobial usage, still, quite significantly more than 20% of antibiotics that are used are inappropriate. So in the hospital sector, where stewardship is mandated– you can’t be accredited as a hospital unless you’ve got it– we have all of the controls, if you will, but yet people continue to do things that are broadly considered inappropriate or irrational. Why is this? From a social science perspective, that’s an intriguing issue. Why does irrational behaviour, if you like, continue, despite what we think is best practise?
And this is where a social science perspective can come into, I guess, its own, can be highly valuable in making sense of this problem. I’m going to take hospitals as my primary example today. However, in primary care, in general practise, and in the context of farming, even higher levels of misuse occur daily in Australia and internationally. They have similar reasons underpinning why that happens. In terms of the international trends, what we see is consistent overuse across nations. I have to point out that Australia, as shown on the current graph, is ultimately doing fairly poorly in relative to other OECD countries.
So clearly, a well-resourced environment, with relatively well-resourced health care sector, is still considerably overusing despite well-known threats of antimicrobial resistance. You can see this across nations, with relatively few having highly successful strategies or national plans to tackle AMR. So why is this? Why does this problem of global proportions continue to see countries misusing available antimicrobials? There is absolutely no lack of national action plans. There’s no lack of surveillance. There’s no lack of data across many national contexts. We know, in the large part, what people are doing. We know that resistance is rising. We know that fewer and fewer drugs are being developed. So we know a lot. We have a lot of data on this very significant and accelerating problem.
But yet we’re struggling to actually figure out what to do about it. And this is, I would argue, largely because of a lack of exploration of the social, the economic, or the political, and leveraging those understandings to enact meaningful change. So the question of why– why we act the way that we do– rather than the question of what– i.e. what are we doing?– that is what social science can offer to the issue of antimicrobial resistance.

In this video we hear from Professor Alex Broom from School of Social and Political Sciences, University of Sydney in Australia.

Social science is the study of society and the manner in which people behave and influence the world around us, this includes the relationships among individuals, and how these might affect or be affected by the world around us.

Social science covers a broad range of disciplines – including economics, social anthropology, politics and international relations, sociology and social work.

Social science research can provide vital, contextual information to governments, policy makers, local-authorities, non-governmental organisations and other stakeholders about the determinants of health, illness and healthcare delivery and use.

In the video Professor Alex Broom discusses:

  • Thinking about antimicrobial resistance in terms of the social life of antibiotics.
  • How a social science approach can enhance our understanding of some of the behavioural drivers for antibiotic misuse.
  • The types of questions that social science can help us to answer.

Further information on the application of social sciences is available on the ESRC website and Public Health England Improving People’s Health Behavioural Strategy.

In the comments below please let us know:

  • Before starting this course, what was your understanding of the use of social science in AMS?
  • How has this changed so far?

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Tackling Antimicrobial Resistance: A Social Science Approach

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