Promoção de Saúde, práxis de autonomia e prevenção da violência

Abstract

HEALTH PROMOTION IS UNDOUBTEDLY ONE OF THE MOST PROMISING strategies for the production of health in today's societies, given its potential in addressing chronic-degenerative diseases 1-3 , violence and accidents 4,5 , and communicable diseases, especially the emerging, re-emerging and neglected diseases 6. Finally, in addressing the whole spectrum of morbimortality whose causes are related to the sociocultural, economic, political, and environmental way of life of all people 7-10. It enjoys worldwide prestige and attention, at least judging by the important initiatives taken towards its development and implementation, such as the Global Health Promotion Conferences: Ottawa, in 1986, which represents the basis for the Health Promotion; Adelaide, in 1988, and the emphasis on intersectorality; Sandsval, in 1991, with the theme of equity; Jackarta, in 1997, the need for expansion with new partners and production of knowledge; Bangkok, in 2005, the proposal to expand social determinants; Nairobi, in 2009, focused on the guidelines for practical action; and Helsinki, in 2013, with the proposal of Health in All Policies 11. Also in the international arena, the World Health Promotion Conferences, organized triennially by the International Union for the Health Promotion and Education (Uipes) and which constitute important initiatives bringing together professionals, researchers and managers from around the world, to "learn, share, and build the future of Health Promotion and seek equity in health" 12. Another example of the recognition given to it is its association with the New Millennium Goals, including combating poverty and inequality and the pursuit of prosperity, well-being, health and education 11. In Brazil, Health Promotion is intertwined with the advent and development of the Unified Health System (SUS), whether because of the need to reverse the health care model, or because of the need for coherence with health milestones as an expanded model 3,13 , having recently gained reinforcement with the institution, in 2006, of the National Policy for Health Promotion and with its revision in 2014, expanding it 14. Defined as a health approach that incorporates the different social aspects in the explanation and production of health and disease 15 , Health Promotion has in its scope innumerable formulations, which are inserted in a wide range, comprised between two distinct currents: one that refers, predominantly, to the lifestyle, with a behavioral/individualistic approach; and another that is based on social determinations and falls within the so-called structural approaches. The first one goes back to the multicausal theory of the health /disease process, whose natural history involves risks related to the agent-host-environment triad, which are susceptible to primary prevention 16. Structural models, on the other hand, conceive health as well as the behavior of individuals in relation to health as conditioned and/or socially

Perspectiva dos trabalhadores da Estratégia de Saúde da Família na promoção da saúde ao idoso rural

“…Vigiar comportamentos e tentar controlá-los por meio de orientações prescritivas e vinculadas ao uso correto da medicação, alimentação saudável, prática de exercícios fortalece, ainda mais, a visão mercantilista da saúde. 13 É o que Breilh traz quando afirma que a economia é de morte, 14 pois segundo ele é incompatível a vida com o sistema capitalista vigente. Pois, ao passo que se tem ações que visam à emancipação da pessoa enquanto cidadão, estimulando a reflexão acerca de suas possibilidades e apropriação quanto ao que fazer e como fazer; se tem por outro lado, um sistema que limita, aprisiona, e dita o que pode ser feito em relação à saúde por meio do incentivo à medicalização de certas doenças.…”