Social inequities and contemporary struggles for collective health in Latin America

Abstract

As part of a planned series from Global Public Health aimed at exploring both the epistemological and political differences in diverse public health approaches across different geographic and cultural regions, this special issue assembles papers that consider the legacy of the Latin American Social Medicine and Collective Health (LASM-CH) movements, as well as additional examples of contemporary social action for collective health from the region. In this introduction, we review the historical roots of LASM-CH and the movement's primary contributions to research, activism and policy-making over the latter-half of the twentieth century. We also introduce the special issue's contents. Spanning 19 papers, the articles in this special issue offer critical insight into efforts to create more equitable, participatory health regimes in the context of significant social and political change that many of the countries in the region have experienced in recent decades. We argue that as global health worldwide has been pushed to adopt increasingly conservative agendas, recognition of and attention to the legacies of Latin America's epistemological innovations and social movement action in the domain of public health are especially warranted.

Generalized Violence as a Threat to Health and Well-Being: A Qualitative Study of Youth Living in Urban Settings in Central America’s “Northern Triangle”

“…It is, therefore, critical that we adopt the Latin American Social Medicine and Collective Health (LASM-CH) approach [50,51,52,53,54,55,56,57] to interpret our findings and to conceptualize how the phenomenon of generalized violence itself must be analyzed and addressed in relation to the root factors that produce and sustain the violence. Based on this approach, we need both a broader conceptualization of health and solutions from and for the Global South [57,60]. Specifically, we must not simply address the social determinants of health as conceptualized by the World Health Organization [58], but also transform the unequal power relations that drive the social determinants of health [59] in the first place.…”

“…A LASM-CH approach, which prioritizes perspectives from the region [50,51,52,53,54,55,56,57], is also useful to translate the findings into multi-sectoral policies and interventions with the aim of creating widespread and long-lasting change in the region. This approach encompasses the broad context of health as a human right, including addressing social determinants, improving the living conditions of the majority populations, and ensuring the equitable distribution of health knowledge, resources, and services.…”

“…In this study, we adopt the Latin American Social Medicine and Collective Health (LASM-CH) approach [50,51,52,53,54,55,56,57] to conceptualize how the phenomenon of generalized violence itself must be analyzed and addressed in relation to the adverse factors that generate and reproduce the violence in the first place. Generalized violence is viewed as a systemic phenomenon that stems from the complex interactions of structural inequities and unequal power relations.…”

“…From this perspective, the LASM-CH approach is a broader political, social, and cultural movement that prioritizes a broader conceptualization of health and solutions from and for the Global South [57,60]. This approach is particularly useful in conceptualizing the epidemic of generalized violence in the “northern triangle” of Central America as rooted in a larger socio-political context characterized by prolonged civil wars (in El Salvador and Guatemala), adverse colonial legacies, poverty among the majority population, unequal power relations, and wide social and health inequities.…”

Planning for health equity in the Americas: an analysis of national health plans

“…There is a growing recognition that improvements in health and well-being have not been shared across populations. Among world regions, the Americas have a disproportionate share of highly unequal contexts, as measured in terms of income inequality (1), access to health care, and well-being (2)(3)(4)(5)(6)(7). Empirical evidence suggests a central role for public policy in producing or shifting the drivers of inequity (8).…”