Social Medicine Then and Now: Lessons From Latin America

Abstract

The accomplishments of Latin American social medicine remain little known in the English-speaking world. In Latin America, social medicine differs from public health in its definitions of populations and social institutions, its dialectic vision of "health-illness," and its stance on causal inference. A "golden age" occurred during the 1930s, when Salvador Allende, a pathologist and future president of Chile, played a key role. Later influences included the Cuban revolution, the failed peaceful transition to socialism in Chile, the Nicaraguan revolution, liberation theology, and empowerment strategies in education. Most of the leaders of Latin American social medicine have experienced political repression, partly because they have tried to combine theory and political practice--a combination known as "praxis." Theoretic debates in social medicine take their bearings from historical materialism and recent trends in European philosophy. Methodologically, differing historical, quantitative, and qualitative approaches aim to avoid perceived problems of positivism and reductionism in traditional public health and clinical methods. Key themes emphasize the effects of broad social policies on health and health care; the social determinants of illness and death; the relationships between work, reproduction, and the environment; and the impact of violence and trauma.

Epidemiología, equidad en salud y justicia social

“…En Latinoamérica surge en la década de los 70 el movimiento de la Medicina Social Latinoamericana y la Salud Colectiva, a partir de una tradición crítica de la sociedad para comprender y transformar los fenómenos relacionados con el proceso salud -enfermedadcuidado en nuestro subcontinente [44][45][46][47]. Aunque surge del pensamiento crítico, no es un movimiento homogéneo pues se alimenta intelectualmente del materialismo histórico, de las teorías del conflicto en las ciencias sociales, de la antropología crítica y de corrientes neo-marxistas [48].…”

Conceptualizing a Human Right to Prevention in Global HIV/AIDS Policy

“…Such a rights-based focus on access to health services has reduced the unit of analysis to the individual, advancing an individual right at the expense of collective health promotion and disease prevention programs through public health systems (Waitzkin, 2001). Although public health has come to appreciate underlying determinants of health, international human rights law has not kept pace with this societal understanding of health, advancing individual medical solutions to harms requiring collective societal change (Chapman, 2002).…”

Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians

“…[1][2][3][4][5][6] The influence of such inequities on health has long been noted by clinicians and public health practitioners, but such content has been incorporated unevenly into medical education and clinical training. [7][8][9][10][11][12][13][14][15][16] Proposed by clinicians and scholars in the medical social sciences, a Bstructural competency^framework calls for a Bshift in medical education…toward attention to forces that influence health outcomes at levels above individual interactions.^1 7(p. 126-27) BStructures^or Bsocial structures^in this sense indicate the policies, economic systems, and other institutions (policing and judicial systems, schools, etc.) that have produced and maintain social inequities and health disparities, often along the lines of social categories such as race, class, gender, and sexuality.…”