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Published on: January 12, 2018
[Health inequalities: new theoretical perspectives]
1PhD en Epidemiología. Investigador I-A del Conselho Nacional de Desarrollo Científico y Tecnológico (CNPq). Profesor Titular jubilado, Instituto de Saúde Coletiva, Universidade Federal da Bahia. Profesor Visitante, Instituto de Estudios Avançados Universidade de São Paulo, Brasil. naomaralmeida@gmail.com.
Abstract:
This article, I intend to articulate the theoretical problem of economic and social inequalities with the issue of the social determination of health. Initially, I provide a summary of Rawls' and Sen's theories of justice and equity as an illustration of the dominant perspective in Northern epistemologies. Second, I discuss applications of this theoretical framework in the literature on social inequalities and the social determination of health-illness-care. Thirdly, I present a semantic matrix proposed for the difference-distinction-inequality-inequity-iniquity series to help reduce the existing terminological confusion. Next, I introduce a synthetic theoretical model about the poverty-inequality dyad, referring to the concepts of social resources, health practices, health services, and health situation/conditions. Finally, oriented by an epistemological perspective from the global South, and taking the current Brazilian situation as a case study, I discuss political implications of the complex contemporary conjuncture, pertinent to the hypothesis that a process of transformation of economic inequalities into new forms of social inequities and health iniquities is currently underway.
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