What do we call collective health today?
Abstract
The article begins with the analysis of the advances and restrictions in the field of public health; later
it deals with the debate on community health. It is recognized that public health care prevailing in
Ecuador and in Latin America is based on a metaphor derived from the philosophical-theoretical assumption
of disease and death, the positivist method, the structural functionalism and the recognition
to the state’s power as a privileged force to assure the prevention of disease. These categories made it
possible for health providers to behave as technical-normative interventors. Changes occurred in the
last decades of globalization compels public health care to find its new path by which it can understand
and act upon health and life and not only upon disease, interpret population’s culture and its forms of
power exercise and give more strength to social action and to the new identities that fight for health.
In this way, the health provided should play the role of interpreter-mediator of several proposals in the
process of health construction. The improvement of the concept of conventional public health care lies
in looking and interpreting the process of health-disease in a different way, that is, to see population’s
health within its historical realities, its context matrix, its vital substantiation rather than seeing it as
mere elimination of disease. It is also required to shift those practice only seeking technical success
to the compromise of attaining practical achievements. In doing so, we should develop that quadruple
movement of construction of sense, construction of meaning, constitution and determination that
Mario Testa recommends. Being Community Health an articulate set of technical, ideological, political
and economic practices, always open to incorporation of innovating proposals, it constitutes a high
valuable source for reflection and advance of alternative public health.
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