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The relationship between the social environment and illness is complex. Data shows that more than half of all illness is experienced by less than a quarter of the population, a fact not accounted for entirely by genetic factors and exposure. Social and interpersonal environment are responded to largely on an individual basis and much of this response is unconscious and inestimable to subject and observer alike. Though each individual reacts uniquely, certain general assumptions can be made from a study of the social environment. Conversely, one may predict, from the subjective response to the life situation, periods during which clusters of illness are likely to occur in an individual. In a study of sixty-eight Hungarian refugees, clusters of illness were found to occur during periods of unsatisfactory relationship to the social environment.
Illness often appears to be related to the social environment as subjectively experienced. The ecologist views the social environment not as a unique entity, but as part of the world in which man lives. It differs from the 'real' world only in that it is a complex set of factors dependent both on the intrinsic quality and upon the interpretative meaning applied by the individual. The author argues that the study of medicine should include response to environment and that the latter should not be made a different kind of medicine by the device of labeling it 'psychosomatic'.