Suchergebnisse

Introducción: En Brasil, los accidentes y la violencia son los principales problemas de la muerte. Las consecuencias de la violencia llegan al sistema de salud mediante el aumento del coste de las emergencias y rehabilitaciones. Acerca de 3,3% del PIB se gasta en los costos directos de la violencia. El trabajo intrasectorial surge como una herramienta capaz de integrar las políticas públicas con el fin de mejorar la seguridad y la salud pública. Material y método: Se trata de un estudio epidemiológico ecológico que se basa en la acción intrasectorialidad realizado entre la policía civil y militar de Sao Paulo, entre los meses de septiembre 2014 a diciembre 2015 en el oeste del área del municipio Sao Paulo. Datos recolectados a través del sistema de información criminal, del Secretaría de Seguridad Pública del Estado de Sao Paulo. Se seleccionaron los crímenes de trascendencia para la salud pública, como la cantidad de homicidio intencional, lesiones intencionales, violación, delitos con el uso de arma de fuego y robos a mano armada. Metodología utilizada: estadística descriptiva, para considerar los cambios antes y después de la acción intrasectorial y los reflejos en la cantidad de delitos. Resultados: Operaciones integradas entre la policía civil y militar, a través de un nuevo modelo de ocurrencias de gestión de registros ha logrado resultados sustanciales en la reducción de la delincuencia. Reducción del 4% en lesiones corporales (3931 casos a 3781), los homicidios disminuyeron 7% (de 143 a la 133), delitos con arma de fuego (27 a 15), los robos (de 18 a 13 casos). Sólo violaciones aumentaron en 25% (de 118 a 148 casos). Conclusiones: La intrasectorialidad entre la policía civil y militar proporcionado resultados significativos para la salud y la seguridad pública, lo que demuestra la necesidad de revisar el modelo dicotómico adoptada por Brasil.

Question: Are Public policies that contemplate intrasectorality capable of producing better results for society, public health and safety? Design: Descriptive study with data analysis from September 2014 to December 2015. Participants: Civil and Military Police of São Paulo State (western region of São Paulo City). Intervention: Analysis of criminal indicators of public health interest in the western region of São Paulo City during the period of applicability of intrasectorality as public health and safety policy. Outcome measures: analysis of the management model and record of reports interesting to public health. The first analysis was carried out in 3 police districts, later spreading to the entire western region of São Paulo City. Qualitative variables were based on the International Code of Diseases (ICD). The quantitative results obtained were extracted from the Criminal Intelligence System. Data were analyzed using descriptive statistics with a significance level of 95%. The software used was the bioestat 5.0 for windows. Results: There was a reduction of 4% to 44% in criminal indicators of public health interest. Conclusion: Intrasectorality was able to improve public health outcomes when used as public policy in police institutions, reducing the impact of violence on public health.

Los eventos que han asaltado la política brasileña desde 2016 han puesto en peligro al Sistema Único de Salud (SUS) y la democracia brasileña. El 16 de mayo de 2016, comenzó el proceso de impeachment de la presidenta de Brasil, Dilma Rousseff. Ahí se inició uno de los períodos más turbulentos en la historia de la joven y frágil democracia brasileña. Este hecho fue interpretado por muchos como un golpe por el parlamento. El SUS no es inmune a todo esto; nunca en su historia había recibido tantos golpes como ahora, y estos amenazan su desmantelamiento. Nuestra investigación se ubica en tres fuentes: (1) literatura científica (artículos); (2) medios electrónicos; (3) y manifiestos en defensa del SUS, con las palabras clave: "Amenaza al SUS" y "Resistencia al desmantelamiento del SUS" como nuestra lente de búsqueda. Esta búsqueda no fue exhaustiva y si panorámica, pero enfatiza el corazón de la amenaza al desmantelamiento y la naturaleza de las resistencias articuladas por entidades profesionales y movimientos sociales y políticos. Esperamos que este artículo pueda contribuir a futuras investigaciones que quieran enfrentar la pregunta evaluativa que nos atrevemos a preguntar: "¿La fuerza de este movimiento de resistencia ha sido suficiente para evitar el desmantelamiento de las políticas sociales, en general, y del SUS, en particular?". Con la epidemia del coronavirus, aparecen nuevos elementos de análisis que refuerzan la defensa de los sistemas universales de salud.

Since the Ottawa Charter 25 years ago, community participation has been adopted worldwide by nation states and communities as a core health promotion strategy. Rising inequities since that time, however, have been largely unchecked in the Americas and globally, and have presented us with an acutely paradoxical time for community participation and action. On the one hand, transnational globalized markets and accompanying economic and environmental devastation have challenged the effectiveness of community action to create health. On the other hand, hopeful signs of local through national and international activism and of new mechanisms for community engagement continue to surface as meaningful and effective democratic acts. This article presents a dialogue on these issues between colleagues in the United States and Brazil, and considers the broader applicability to Latin America and worldwide. We begin by discussing how community participation and community organizing grew out of our respective histories. We consider the catalytic role of the Ottawa Charter in spurring a reorientation of health promotion and the genesis of healthy city and community initiatives, as well as other current community organizing strategies and the growth of participatory research/CBPR. We unpack the potential for co-optation of both community and social participation and end with recommendations for what we can do to maintain our integrity of belief in democratic social participation to promote improved health and health equity. ; Univ New Mexico, Publ Hlth Program, Dept Family & Community Med, Albuquerque, NM 87131 USA ; Universidade Federal de São Paulo UNIFESP, CEPEDOC Cidades Saudaveis, Santos, Brazil ; Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA ; Saude Colet Fac Med ABC, São Paulo, Brazil ; Universidade Federal de São Paulo UNIFESP, CEPEDOC Cidades Saudaveis, Santos, Brazil ; Web of Science

RESUMO O ensaio busca problematizar temas importantes para a construção teórico-conceitual da Promoção da Saúde, que é discutida a partir de múltiplas concepções. Por meio de revisão bibliográfica, buscou-se embasamento para a defesa de que a Promoção da Saúde é mais ampla que a prevenção de doenças, mas não pode prescindir dela, além da possibilidade de mudanças comportamentais construídas a partir do empoderamento dos sujeitos e coletividades e da importância da abordagem individual. Conclui-se que a Promoção da Saúde é uma importante forma de produzir saúde, o que inclui as ações cotidianas nos serviços de saúde e no espaço micropolítico da vida.

Introducción: La Declaración de Curitiba incorpora el espíritu del compromiso local y global hacia la democracia, la equidad y la justicia. Fomenta los derechos sociales y "la salud para todos' en un mundo inclusivo y sostenible. Material y método: Ella representa la voz de los 1200 investigadores, profesionales de salud, movimientos sociales y los que formulen políticas que participaron en la 22a Conferencia Mundial de Promoción de la Salud de la Unión Internacional de Promoción e Educación en la Salud celebrada en Curitiba, Brasil en Mayo de 2016. La Declaración articuló 120 recomendaciones de los participantes y se centra en cómo fortalecer la promoción de la salud y la mejoría de la vida de las personas en cualquier lugar en donde vivan, jueguen y aprendan. Las contribuciones recibidas durante y después de la conferencia, en el sitio web y en los apps, se organizaron en 14 temas. De las palabras clave y expresiones relacionadas con ellos, un primer borrador de la Declaración fue construido y posterior-mente completado por los miembros del Comité Global de organización. Esta versión fue enviada a los organizadores de la 9ª Conferencia Mundial de Promoción de la Salud, organizado por la Organización Mundial de la Salud, y se utilizó como texto de referencia. Resultados: Las 21 recomendaciones que fueran sintetizadas resultaron en un llamamiento a las Organizaciones Internacionales, a los Gobiernos de todos los niveles, al Sector de la Salud, a los Ciudadanos, a los Profesionales de la Salud y a los Investiga-dores reafirmando que los objetivos de la Promoción de la Salud solamente serán plenamente alcanzados al incorporar estos cuatro principios fundamentales: la equidad, los derechos humanos, la paz y la participación. Conclusiones: Los participantes de la 22da Conferencia Mundial de Promoción de la Salud reconocen su propio rol y el de la sociedad global en la búsqueda de una agenda común y vínculos de solidaridad que colectivamente aboguen por la priorización de la democracia y de los derechos humanos como condiciones esenciales para la promoción de la salud y de la equidad. Todos los protagonistas involucrados en la arena local, nacional e internacional, deben intentar trabajar aunados para producir direcciones comunes que tengan en cuenta sus roles respectivos.

All three of the interacting aspects of daily urban life (physical environment, social conditions, and the added pressure of climate change) that affect health inequities are nested within the concept of urban governance, which has the task of understanding and managing the interactions among these different factors so that all three can be improved together and coherently. Governance is defined as: "the process of collective decision making and processes by which decisions are implemented or not implemented": it is concerned with the distribution, exercise, and consequences of power. Although there appears to be general agreement that the quality of governance is important for development, much less agreement appears to exist on what the concept really implies and how it should be used. Our review of the literature confirmed significant variation in meaning as well as in the practice of urban governance arrangements. The review found that the linkage between governance practices and health equity is under-researched and/or has been neglected. Reconnecting the fields of urban planning, social sciences, and public health are essential "not only for improving local governance, but also for understanding and addressing global political change" for enhanced urban health equity. Social mobilization, empowering governance, and improved knowledge for sustainable and equitable development in urban settings is urgently needed. A set of strategic research questions are suggested.

All three of the interacting aspects of daily urban life (physical environment, social conditions, and the added pressure of climate change) that affect health inequities are nested within the concept of urban governance, which has the task of understanding and managing the interactions among these different factors so that all three can be improved together and coherently. Governance is defined as: "the process of collective decision making and processes by which decisions are implemented or not implemented": it is concerned with the distribution, exercise, and consequences of power. Although there appears to be general agreement that the quality of governance is important for development, much less agreement appears to exist on what the concept really implies and how it should be used. Our review of the literature confirmed significant variation in meaning as well as in the practice of urban governance arrangements. The review found that the linkage between governance practices and health equity is under-researched and/or has been neglected. Reconnecting the fields of urban planning, social sciences, and public health are essential "not only for improving local governance, but also for understanding and addressing global political change" for enhanced urban health equity. Social mobilization, empowering governance, and improved knowledge for sustainable and equitable development in urban settings is urgently needed. A set of strategic research questions are suggested.

All three of the interacting aspects of daily urban life (physical environment, social conditions, and the added pressure of climate change) that affect health inequities are nested within the concept of urban governance, which has the task of understanding and managing the interactions among these different factors so that all three can be improved together and coherently. Governance is defined as: "the process of collective decision making and processes by which decisions are implemented or not implemented": it is concerned with the distribution, exercise, and consequences of power. Although there appears to be general agreement that the quality of governance is important for development, much less agreement appears to exist on what the concept really implies and how it should be used. Our review of the literature confirmed significant variation in meaning as well as in the practice of urban governance arrangements. The review found that the linkage between governance practices and health equity is under-researched and/or has been neglected. Reconnecting the fields of urban planning, social sciences, and public health are essential "not only for improving local governance, but also for understanding and addressing global political change" for enhanced urban health equity. Social mobilization, empowering governance, and improved knowledge for sustainable and equitable development in urban settings is urgently needed. A set of strategic research questions are suggested.

This Statement represents the voice of participants in the 22nd IUHPE World Conference on Health Promotion, held in Curitiba, Brazil, in May 2016. The Brazilian political context at that time greatly influenced the drafting of the Curitiba Statement, which was considered by many participants as an opportunity to categorically express that Brazilian democracy was threatened, as well as the danger of fiscal austerity implemented by many governments of the world. The conference organizers also perceived the launching of this Statement as an opportunity to influence the WHO Shanghai Declaration, since it very strongly stated the influence of commercial interests and corporate practices of the market that are harmful to health. The Curitiba Statement gathers 120 suggestions made by conference participants and focuses on how strengthening health promotion and equity can improve people's lives. The 21 recommendations were summarized and resulted in appeals to International Organizations, all levels of Governments, Health Sector, Citizens, Health Professionals and Researchers. Unlike a declaration from government summit that are restricted by governments negotiations from different ideological spectrum, the Curitiba Statement was developed in a free environment to foster professional activism. We reaffirm that the objectives of Health Promotion in the Sustainable Development will only be fully achieved by incorporating these four fundamental principles: democracy, social justice, social mobilization and equity. Health Promotion in the twenty-first century needs new narratives and inputs from professional associations, which can be more assertive and to influencing the official declarations of government

ABSTRACT This article analyzes the breadth of experiences of educational projects in Public Health/ Collective Health in Brazil, with an emphasis on contextual elements, so as to point out characteristics and key questions present in the Brazilian experience of this mode of education. The work and education of sanitarians are traced historically, and their contradictions, alignments and perspectives identified. This will be discussed over six different historical periods starting in 1889, on the basis of the following analytical categories: a) socio-political conjunction; b) sanitarians practice; c) educational projects; and d) institutionalization and organization of public health. An analytical table is presented and discussed. Based on it, evidence of the mutual influence over time of socio-health contexts, educational projects and sanitarians world of work is pointed out. The challenge is to provide a counter-hegemonic education vis-à-vis the capitalist model, and that Public Health/Collective Health graduates manage to position themselves and work within this perspective. Making adaptations to the educational project seems valid. However, it may not be enough to alter structural tensions, since the political and economic setting has historically determined 'for what', 'where', 'how' and 'for whom' sanitarians work.

The trajectory of participation in health research by community social actors worldwide has been built on a history of community participation from the Ottawa Charter Health Promotion call for community mobilization, to the emancipatory educational philosophy of Paulo Freire, to social movements and organizing for health and social justice. This paper builds on this history to expand our global knowledge about community participation in research through a dialogue between experiences and contexts in two prominent countries in this approach ; the United States and Brazil. We first focus on differences in political and scientific contexts, financing, and academic perspectives and then present how, despite these differences, similarities exist in values and collaborative methodologies aimed at engaging community partners in democratizing science and knowledge construction. We present three case studies, one from the U.S. and two from Brazil, which illustrate similar multi-level processes using participatory research tools and Freirian dialogue to contribute to social mobilization, community empowerment, and the transformation of inequitable societal conditions. Despite different processes of evolution, we observed a convergence of participatory health research strategies and values that can transform science in our commitment to reduce health and social inequities and improve community wellbeing. ; National Institutes of Health ; Amazonia project FUNASA ; Capela project FAPESP ; Univ New Mexico, Coll Populat Hlth, Ctr Participatory Res, Albuquerque, NM 87131 USA|L Univ Sao Paulo, Sch Publ Hlth, BR-01246904 Sao Paulo, SP, Brazil ; Univ Sao Paulo, Inst Energy & Environm, BR-05508010 Sao Paulo, SP, Brazil ; Environm Hlth Master Degree Program, Complexo Educ Fac Metropolitanas Unidas FMU, BR-05690050 Sao Paulo, SP, Brazil ; Univ Fed Sao Paulo, Dept Publ Policy & Collect Hlth, BR-11065240 Sao Paulo, SP, Brazil ; Univ Estado Rio De Janeiro, Coll Nursing, UERJ, BR-20551030 Rio De Janeiro, RJ, Brazil ; Hlth Native Communities Partnership Inc, Shiprock, NM 87420 USA ; Univ Fed Sao Paulo, Dept Publ Policy & Collect Hlth, BR-11065240 Sao Paulo, SP, Brazil ; NIH: U261HS300293 ; NIH: U261IHS0036 ; NIH: 5R01NR015241-02 ; Web of Science