Acessibilidade / Reportar erro

SOCIAL DETERMINATION OR SOCIAL DETERMINANTS OF HEALTH: TEXT AND CONTEXT IN LATIN AMERICA

Abstract

The social determination of health and the social determinants of health have been presented as synonyms in a context in which this topic is being revisited. The conception of determination and determinants and the historicity of these theoretical models transcend the academic realm, once we consider the particularity involving public health, collective health, and social medicine, in which science and politics have a close relationship. Through the description of the differences between these two terms, our aim in this essay was to bring back, in theory, the elaboration of the social determination of health, highlighting its relationship with the knowledge produced in Latin America and its repercussions in Brazil, as well as the influences of the scientific and epistemological paradigms, the set of theories, and the projects that are in dispute in this field. In order to encompass the academic and political dimensions contained in the theoretical models, we sought the help of authors that move among different fields of knowledge. Without the intention of covering all of the points of observation that our incursion provided, we present a summary of our conception of the theoretical model of the social determinants of health and, chiefly, of the social determination of health, which we suggest should be divided into two categories, structural determination and structural-relational determination, in order to enable a better observation of the theoretical and methodological improvements, by emphasizing complexity epistemologically.

social determination of health; collective health; epidemiology; epistemology

Fundação Oswaldo Cruz, Escola Politécnica de Saúde Joaquim Venâncio Avenida Brasil, 4.365, 21040-360 Rio de Janeiro, RJ Brasil, Tel.: (55 21) 3865-9850/9853, Fax: (55 21) 2560-8279 - Rio de Janeiro - RJ - Brazil
E-mail: revtes@fiocruz.br