For a General Theory of Health: preliminary epistemological and anthropological notes

Filho, Almeida; de, Naomar Monteiro

doi:10.1590/s0102-311x2001000400002

Cited by 62 publications

(47 citation statements)

References 12 publications

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“…To use an example from the health sciences, synergic effects of risk factors, produced by interaction processes, may be taken generally as sources of emergence in epidemiological systems. [6][7][8][9][10][11]31,70 In a study of gender, social class and race/ethnicity on prevalence of depressive disorders, 14 gender followed a pattern, confi rmed in different studies worldwide: women´s risk for depression is twice as high as men´s. Social class and race/ethnicity alone yielded low-risk estimates.…”

Section: Epistemological Backgroundmentioning

confidence: 99%

“…Considering the defi nitions of hierarchical interfaces and planes of emergence, a conceptual frame may be useful as a basis for integrating the contributions of health sciences and applied social sciences in a unifi ed theory of health. [6][7][8] This framework (Table 1) organizes the terminology used for categories of non-health available to different health sciences, in addition to distinguishing between the varied defi nitions of normalcy and health and their potential empirical descriptors. It implies an effort to translate Canguilhem's model into the theoretical specifi cations of Modes of Health.…”

Section: Health As Plurality and Totalitymentioning

confidence: 99%

“…Indeed, health objects are plural, multifaceted, transdisciplinary, simultaneously ontological and heuristic models capable of cutting across (and being traversed by) dimensions, spheres and domains referring to different levels of complexity. 3,[6][7][8]15 On the other hand, to respect its integrity-totality, the model-object 'health' is crucially defi ned as a meta-synthetic theoretical device. In sum, oriented by complexity approaches, model-objects such as disease-illness-sickness -the DIS Complex -articulated with life-function reference objects, must be treated as a plural-total construct: the health-disease-care integral.…”

Section: Health As Plurality and Totalitymentioning

confidence: 99%

“…54 For the past 15 years, colleagues and I have developed a conceptual framework for modeling health in the light of complexity approaches. [2][3][4][5][6][7][8][9][10][11][12][13][14][15]33 Results from this line of theoretical research allowed preliminary proposals of a Theory of Modes of Health 8 and the concept of Health-Disease-Care Integrals. 6 This paper is the fi rst of a series of essays intended to advance, revise, correct and abridge updated versions of such proposals, as well as to assess feasibility and possibilities for the integration/convergence/fusion of these approaches into a unifi ed theory of health-illness-sickness.…”

Section: Introductionmentioning

confidence: 99%

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Towards a Unified Theory of Health-Disease: I. Health as a complex model-object

Almeida-Filho¹

2013

Rev. Saúde Pública

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Theory building is one of the most crucial challenges faced by basic, clinical and population research, which form the scientifi c foundations of health practices in contemporary societies. The objective of the study is to propose a Unifi ed Theory of Health-Disease as a conceptual tool for modeling health-disease-care in the light of complexity approaches. With this aim, the epistemological basis of theoretical work in the health fi eld and concepts related to complexity theory as concerned to health problems are discussed. Secondly, the concepts of modelobject, multi-planes of occurrence, modes of health and disease-illness-sickness complex are introduced and integrated into a unifi ed theoretical framework. Finally, in the light of recent epistemological developments, the concept of Health-Disease-Care Integrals is updated as a complex reference object fi t for modeling health-related processes and phenomena. DESCRIPTORS: RESUMOA elaboração de teorias constitui um dos desafi os mais cruciais enfrentados pela pesquisa básica, clínica e populacional que forma as bases científi cas das práticas de saúde nas sociedades contemporâneas. O objetivo deste estudo é propor uma teoria unifi cada da saúde-doença como ferramenta conceitual para a modelagem da saúde-doença-cuidado à luz de abordagens da complexidade. Discute-se a base epistemológica do trabalho teórico no campo da saúde bem como conceitos relacionados à teoria da complexidade aplicada a problemas de saúde. Em segundo lugar, os conceitos de objeto-modelo, multi-planos de ocorrência, modos de saúde e complexo doença-enfermidade-moléstia são introduzidos e integrados numa estrutura teórica unifi cada. Finalmente, à luz de desenvolvimentos epistemológicos recentes, atualiza-se o conceito de integrais de saúde-doença-cuidado como um complexo objeto de referência ajustado para a modelagem de processos e fenômenos relacionados com a saúde.DESCRITORES: Modelos Teóricos. Processo Saúde-Doença. Assistência Integral à Saúde.

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Section: Epistemological Backgroundmentioning

confidence: 99%

Section: Health As Plurality and Totalitymentioning

confidence: 99%

Section: Health As Plurality and Totalitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Towards a Unified Theory of Health-Disease: I. Health as a complex model-object

Almeida-Filho¹

2013

Rev. Saúde Pública

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“…En este mismo sentido, Almeida propone el modelo "Complejo enfermedadpadecimiento-malestar", que destaca el componente salud pública de méxico / vol.49, no.1, enero-febrero de 2007 ENSAYO Salud-padecimiento-enfermedad-atención: estudio socioantropológico político e ideológico de la práctica médica, basada en relaciones de poder que propician la distribución diferencial de enfermedades y tratamiento. 33 …”

Section: Perspectiva Antropológicaunclassified

Reflections on the health-illness-disease-care: a socio-anthropological view

Moreno-Altamirano¹

2007

Salud pública Méx

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ResumenLas reflexiones actuales sobre el trayecto salud-padecimiento-enfermedad-atención surgen de una herencia compleja y antigua en la que se anudan diversas tentativas para su comprensión. En este trabajo se revisan someramente algunos estudios que han abordado este trayecto a lo largo de la historia. El énfasis principal está puesto en los enfoques social y antropológico; se señala el papel de la eficacia simbólica, concepto antropológico de la "cura por la palabra". Como aspecto central se revisan los modelos propuestos por Canguilhem para su interpretación; se describen los modelos ontológico, dinámico y social. Posteriormente se hace un recorrido a partir de las décadas centrales del siglo XIX, en plena instalación del positivismo, cuando se desarrollaron las bases científicas de la medicina. Se describe la insuficiencia del modelo unicausal y se señalan otras explicaciones sobre los factores que intervienen en la gé-nesis de las enfermedades. Asimismo, se menciona la situación sociopolítica como condicionante de la enfermedad y la manera en que tomó auge la concepción sociológica. Al final se describen algunas corrientes contemporáneas desde la perspectiva interpretativa de la antropología médica, enfatizando el desarrollo de los conceptos de enfermedad (disease), padecimiento (illness) y disfunción social (sickness). AbstractCurrent reflections on the health-disease-care process are due to a complex and ancient legacy where diverse attempts at understanding it have their roots. This work consists of a brief overview of some approaches that have been used to interpret this process throughout history. The social and anthropological approaches are specially emphasized; the role of symbolical efficiency and the anthropological concept of "word-healing" are also mentioned. As a central point, the ontological, dynamical, and social models proposed by Canguilhem to interpret these processes are reviewed. Afterwards, the decades central to the 19st century are discussed, when positivism and the scientific basis for medicine were fully established. The insufficiency of the single-cause model and other explanations for factors involved in generating disease are described. In addition, the socio-political situation as a factor for disease is considered, as is the way in which the sociological concept became widely held. Finally, contemporary trends are described based on the interpretative perspective of medical anthropology, with special emphasis on the development of the concepts of disease, illness, and sickness.

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