Social Norms of Morbidity As Specific Factors in the Demand for Health Services

Seeking professional medical help is caused not only by medical criteria health pathology. There is a complex system of social factors of the transition from the physical sensations of discomfort or psychological distress to get help from a professional medicine, i.e  make it socially relevant fact. This is the most important cause why the accounting treatment for medical help and he true morbidity can not match . The different access to health care for different social groups is the most actively studied. among these social factors. But there are many other social factors and in countries and cities where the network of medical institutions sufficiently developed they are more important. This result was obtained in representative survey in St. Petersburg (2007-2011). The most part of them are the social attitudes / norms which give rise to refuse treatment in medical institutions and relates to the culture of health behaviors. This culture is very contradictorily. Improving education increases the tendency of self-medication. Massive short duration diseases (e.g ARDS)  are treated within the family without recourse to occupational medicine in 75% of cases. Social attitudes of non-professional care are supported by widespread corporate informal norms to continue work in diseases with partial loss of ability to work. Such practice is supported by other informal social contract employees with employers: rejection of the fixing of cases of the disease in the social insurance company. This and other identified dependencies suggest that the indices of morbidity are subject to change without unambiguous connection with the actual number of patients and the duration of their illness. Methodological conclusion: for the considered social and medical conditions the survey are necessary for the correction usual morbidity data. Conclusions on the basis of registration of patients who seek health care may reflect the actual changes of many factors