Bio-psycho-social medicine is a comprehensive form of medicine bridging clinical medicine and public health

The journal, BioPsychoSocial Medicine, was launched in January 2007, and more than three and a half years have passed since the start of publication. A total of 70 articles have been published, as of August 2010, but the number of those directly discussing issues of public health or social medicine is relatively small [1-4]. Psychosomatic medicine, or biopsychosocial medicine, encompasses all aspects of the interrelationships between the biological, psychological, social, and behavioral factors of health and illness, and is not limited to mind and body connections in humans. Thus, it is meaningful that social aspects of health and illness are discussed in the current issue of this journal. In the symposium addressing the “healthy hospital”, Kawachi has set the scene for a debate about people’s health by pitting medical care against population-level preventive activities [5]. In this debate, patient-centered clinical care is positioned at one pole, while populationwide public health activities such as encouraging healthier lifestyles or improving the physical and social environment end up being positioned at the opposite pole. Such debates are unnecessarily polarizing and run the risk of oversimplifying the determinants of population health to the point of caricature [5]. According to Article 1 of the Medical Practitioners Act in Japan [6], medical practitioners or physicians should focus on the improvement and promotion of public health by using both medical care and health guidance to secure a generally healthy life for a broad range of people in Japan. Clinical medicine is closely linked to a public health approach, and medical practices should be undertaken within the limited human, time, and financial resources available. In addition to a high-risk approach for those who suffer or are likely to suffer from illnesses, a population approach emphasizing health communication, a health program, and the health system should be employed to maintain people’s health. In this sense, psychosomatic medicine helps to create a bridge between clinical medicine and public health. In this special series on public health, five articles are presented to introduce important concepts of social medicine relevant to the research fields of psychosomatic medicine. The first concept is health literacy [7]. Health literacy is a concept that has been intensively applied to medical research since the 1990s and defined as the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health [8]. Ishikawa and her colleagues have been studying health literacy after publishing several reports examining the patient-doctor relationship [9-11]. Communication between patients and physicians is fundamental for improved patient care, but physicians often ignore or are not focused on levels of patient knowledge. With increasing medical costs, self-care, including the early recognition of disease, has become increasingly important as a way of reducing medical expenditures. Health literacy should be developed at both the individual and mass media levels for appropriate medical care. The second concept is work engagement [12]. Burnout syndrome due to overwork has been intensively studied for many years, but this approach is ill-health oriented. Occupational health psychology involves the application of psychology to improving the quality of work life and to protecting and promoting the safety, health, and wellbeing of workers [13]. Engagement is defined as a positive, fulfilling, work-related state of mind that is Correspondence: [email protected] Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan Full list of author information is available at the end of the article Nakao BioPsychoSocial Medicine 2010, 4:19 http://www.bpsmedicine.com/content/4/1/19