[健康的社会决定因素、复杂性、殖民性和长期性]。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Cadernos de saude publica Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI:10.1590/0102-311XPT035724
Gil Sevalho
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引用次数: 0

摘要

这篇文章将健康、殖民和时间的社会决定的关键知识作为认识论的基础。在复杂的跨学科工作中,时间是一个相关的因素,尽管在公共卫生中还没有得到深刻的反思。这篇文章回顾了历史基础,更新了关于健康的社会决定的辩论,强调了Naomar de Almeida Filho和Jaime Breilh的贡献,他们的思想主要集中在全球南方,北美和欧洲中心霸权之外。复杂性、对社会转型的承诺和非殖民化的观点激发了公共卫生、费尔南德·布罗代尔和伊曼纽尔·沃勒斯坦对现代世界体系中长期和历史资本主义的反思以及非殖民化思想及其殖民概念之间的交集。布劳德雷尔的概念包含了多重暂时性,并辩证地将长期的变化和永久结合在一起,而非殖民化的反思则将殖民性插入到这种长期的时间跨度中。殖民性是健康的社会决定的一部分,或者作为一种产生和再生产经济、性别和民族-种族不平等和社会压迫的机制,或者在其认识论方面作为流行病学概念化背后知识的殖民性。布罗代尔的长时间人格、沃勒斯坦的世界体系和非殖民化思想都是健康思想中值得进一步探索的贡献。将时间的认识论整合到流行病学反思中,可以揭示抹去并(重新)构成历史背景和持续时间,其复杂性摆脱了风险因素流行病学笛卡尔功能主义产生的决定因素的碎片化和静态视图。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Social determination of health, complexity, coloniality, and the long term].

This essay connects critical knowledge on the social determination of health, coloniality, and time as an epistemic foundation. Time is a relevant element in the articulation of complex interdisciplinary work, though it has not been deeply reflected upon in Public Health. The essay revisits historical bases and updates the debate on the social determination of health, highlighting the contributions of Naomar de Almeida Filho and Jaime Breilh - authors whose thoughts primary focus are on the Global South, outside of the North American and Eurocentric hegemony. Complexity, commitment to social transformation, and a decolonizing perspective inspire the intersection between public health, the reflections of Fernand Braudel and Immanuel Wallerstein on the long term and historical capitalism in the modern world-system, and decolonial thought with its concept of coloniality. The Braudelian conception encompasses multiple temporalities and dialectically integrates change and permanence in the long term, while decolonial reflection inserts coloniality into this longue durée. Coloniality is part of the social determination of health, either as a mechanism that produces and reproduces economic, gender, and ethno-racial inequalities and social oppression, or in its epistemological dimension as the coloniality of knowledge behind epidemiological conceptualization. Braudel's longue durée, Wallerstein's world-system, and decolonial thought are contributions to be further explored within health thinking. The epistemological integration of time into epidemiological reflection can reveal erasures and (re)constitute historical contexts and durations whose complexity escapes the fragmented and static view of determinants produced by the Cartesian functionalism of risk factor epidemiology.

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来源期刊
Cadernos de saude publica
Cadernos de saude publica 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.30
自引率
7.10%
发文量
356
审稿时长
3-6 weeks
期刊介绍: Cadernos de Saúde Pública/Reports in Public Health (CSP) is a monthly journal published by the Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (ENSP/FIOCRUZ). The journal is devoted to the publication of scientific articles focusing on the production of knowledge in Public Health. CSP also aims to foster critical reflection and debate on current themes related to public policies and factors that impact populations'' living conditions and health care. All articles submitted to CSP are judiciously evaluated by the Editorial Board, composed of the Editors-in-Chief and Associate Editors, respecting the diversity of approaches, objects, and methods of the different disciplines characterizing the field of Public Health. Originality, relevance, and methodological rigor are the principal characteristics considered in the editorial evaluation. The article evaluation system practiced by CSP consists of two stages.
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