Social paediatrics

Social paediatrics aim to think of child health holistically, within its environment and to act socially. 

   Entering the words “pédiatrie sociale” and “social paedriatics” in search engines will lead to the conclusion that the concept was developed in the French-speaking sphere at the turn of the 20th and 21st century by Quebec doctor Gilles Julien, who championed community-based social paediatrics. For his part, Julien acknowledges a debt to the book Social Paediatrics, edited by Bengts Lindstrom & Nick Spencer (Oxford University Press, 1995). Practitioners’ sites suggest that the theory and practice only recently spread from the English-speaking to the French-speaking world. It is, however, worth noticing that the editors of the Social Paediatrics collection entrusted Michel Manciaux (1928-2014) with the task of defining social paediatrics, for the French physician was indeed ideally placed to account for the origins and genealogy of the concept.

   Social paediatrics surfaces in French and English-speaking medical literature directly after the Second World War in connection with the eponymous course delivered by Robert Debré (1882-1978) in Paris, starting in 1946. Debré adopted the term suggested by a Polish colleague, as well suited to the action-driven thinking he wished set at the heart of the International Children Centre which he created in 1949 in cooperation with UNICEF and the WHO. A humanist as well as a natalist, Debré thought that health should be given pride of place in the ongoing politization of childhood initiated in the 18th century with the Enlightenment. He defined social paediatrics as “all the collective efforts in favour of the population’s younger component”. According to him, and as exposed in one of his lectures, family paediatrics is a private endeavour whereas social paediatrics is a collective or public effort.

   In France, the aftermath of the Second World War brought about the recognition of economic and social rights in relation to health, children and families. Debré wanted paediatrics to be social, a truly collective and political project. As the rights of the child were being elaborated at the United Nations in 1959, society acknowledged its duties towards vulnerable children, and their fundamental rights e.g., to protection via a health care approach taking social factors into account towards a just outcome. “Think globally. Act socially” Such was the watchword of the social paediatrics course delivered at the ICC, for the child is thought as a contemporary issue. An all-encompassing social paediatrics was to command all child-related knowledge, based on a pluri-disciplinary coordination of the work of childhood professionals at the opposite of overspecialization. This was a novel stance. Robert Debré’s social paediatrics is essentially an intellectual construct, aimed at envisaging “the child as a whole” and at bringing childhood/family-related social issues within the medical realm. Its inception may also be seen as a larger defence of paediatrics in a context of competing sciences (medical specialities, brain and mind sciences).

   In 1969, in the context of the ICC, French-speaking paediatricians (French, Belgian, Swiss) founded the Club International de Pédiatrie Sociale, becoming in 2012, the Association Internationale de Pédiatrie Sociale (AssIPS). Meanwhile, the previous year, (2011), the European Society for Social Paediatrics, created in Sweden in 1977, had become the International Society for Social Paediatrics and Child Health (ISSOP). The rivalry between French-speaking and North European practitioner associations at work here has been detrimental to the history of this approach. Social paediatrics, as a whole and as a philosophy, supposes the merging of a broad range of knowledge, combined with an intellectual bent, a stance, an ethos and the law, towards paediatrics dedicated to the child as a person within their life environment.

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