Bulletin Spring‧Summer 1999

As its name implies, community and family medicine is inextricably related to schools and families, the very basis of a community. Targeting the Community Not the Individual As a medical discipline, c ommun i ty and f am i ly medicine covers theories of epidemiology, the epidemiology of communicable and non-communicable diseases, occupational health, environmental health, principles of f am i ly medicine, and the treatment of common illnesses. 'Community and family medicine is concerned with the health of populations rather than individuals. This is its main difference f r om other medical specialities,’ said Prof. S.H. Lee, professor of community medicine at the University. He continued, 'Most of the patients who come in have minor problems such as headaches, fever, and flu, rather than serious illnesses. We also look after infant and maternal health and rehabilitation. Our targets are healthy people.' Hence the development of community and family medicine has to be synchronous w i t h changes in societal conditions such as in demography, disease pattern, lifestyle, the environment, and health costs. In terms of teaching, the curriculum has been continously reviewed and renewed all these years and many higher degree, certificate and continuing programmes have been offered to train community and family doctors. The department's main research interests include osteoporosis, athritis, elderly health, smoking and health, sero-epidemiology of Hepatitus A and B, environmental pollution, noise-induced hearing impairment, neurobehavioural disorders caused by organic solvents, health service delivery, disease mapping and surveys. Tackling Problems 'Upstream' For the past 10 years, the health environment and the need for health care in Hong Kong have undergone significant changes. ‘Factors affecting our health are not confined to bacteria and viruses,' said Prof. Lee. 'Unhealthy personal habits such as smoking, alcoholism, promiscuity, drug abuse ， lack of exercise can all damage our health. Air, noise, and environmental pollution can lead to respiratory diseases, hearing impairment, and food poisoning. Changes in social structure and ageing of the population can result in greater need for elderly, health services. Work pressure can cause psychiatric problems. Poverty can lead to malnutrition. Genetic mutations can breed new diseases.' Prof. Lee believes the right to handle illnesses is to go to the root of the problem, to explore their upstream' causes and accordingly take measures for prevention. For instance, teaching shcool children the harms of smoking may reduce their chances of acquiring the habit in adulthood and as a result reduce the prevalence of respiratory diseases. Treating only the symptoms would do little to cure the patient and would actually lead to escalations in government spending on health care. Last year the University decided to reorganize the Department of Community and Prof. S.H. Lee Medical Teaching and Research at CUHK 23