Discourses and polarities concerning health promotion in the Brazilian health system

Abstract

This paper presents theoretical reflections on health promotion in the Brazilian public health context. Some characteristics and problems of the international debate are highlighted, but our focus is the position of health promotion as it is discussed in the Brazilian health system. We follow the foucauldian perspective of biopower and resistence to discuss the selected texts and documents related to health promotion that were considered relevant for the purpose of this investigation. Health promotion is discussed as a field of discourses, practices, knowledge production and power. We concentrate our analysis on the debate proposed by collective health researchers on the repercussions of the Lalonde Report in the international Health Promotion Charts, and on the connexion between health promotion and the Brazilian health system. The discussion demonstrates that health promotion work requires constant attention and significant effort from managers, technicians, and health system users, and that each step forward reveals new challenges and calls for new actions.Kind L, Ferreira-Neto JL. Discursos y polaridades relativas a la promoción de la salud en el sistema de salud brasileño. Salud Publica Mex 2013;55:427-432.

Beyond the Traditional Epidemiology of Risk Factors: Socioeconomic Inequity and Cultural Dimensions of Health-Disease Process

“…This universal symbolic authority of epidemiology of risk factors has become emblematic with the incorporation of lifestyle rhetoric [1][2][3]. In advocating such an approach, the area has departed from its historical and epistemological assumptions (population and social context of illness) over the valuation of individual perspective inherent to the emergence of a new globalized economic order, which has gradually shifted the collective concerns of health public to a marginal position [4,5] especially in peripheral capitalist countries [6].Proposals subsidized by epidemiological inferences about risk behaviors, underestimate the macro-economic and political contexts of health problems and the subjective dimensions of social determinants of health-disease-care process [7]. Despite the undeniable heuristic value that epidemiology (descriptive) has accumulated so far, as a successful field in coping with human diseases over time, several questions are postulated to the epidemiology of risk factors -specific mote in criticism by researchers from the field itself [1,2].…”

“…This universal symbolic authority of epidemiology of risk factors has become emblematic with the incorporation of lifestyle rhetoric [1][2][3]. In advocating such an approach, the area has departed from its historical and epistemological assumptions (population and social context of illness) over the valuation of individual perspective inherent to the emergence of a new globalized economic order, which has gradually shifted the collective concerns of health public to a marginal position [4,5] especially in peripheral capitalist countries [6].…”