Revisão do pensamento sanitário como foco no Centro de Saúde / Review of sanitary thought with a focus on Health Centre

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

This study reviews the history of ideas in the public health of Brazil. The reform of the Health Service of Sao Paulo in 1925 and the establishment of the Family Health Program in 1994 set the general limits of the review. It considers the possibility that the discourse on the Health Centre inaugurated a new epistemological era in public health, defined by the individual dimension of "health education", to the detriment of the "medicine of the cities" or "bacterial era". New concepts emerged, sustained and were sustained by the displacement of French intellectual and political influence for the United States, embodied in the actions of the Rockefeller Foundation, based on the Johns Hopkins University. São Paulo was one of the cities chosen for massive investment, as "demonstration effect" of those new ideas. Although the institutional performance of the Foundation has had a planetary scale, the discursive appropriation and local adaptation was earlier and more cohesive in Latin America, giving rise to creation and strengthening of a true Pan-Americanism in public health, with the participation of Brazil. Nationwide, the "health education" ideas and its corollaries "preventive medicine", "comprehensive medicine", "community medicine and primary care, was cleaved by three major political perspectives that ensued and prevailed at different times. The "classical thought", in a liberal perspective, gave local significance to the ideas present in the international debate since the 1920s. The "radical thought", under a Marxist matrix, arouse in the second half of the 1970s, especially within academic intellectuals, and "community thought" in public health, stimulated by the Family Health Program in the 1990s. The radical thought in public health movement was strengthened in opposition to the military regime and the classical thought. "Collective health" replaced the previous expressions and focuses on social determinants of health, relegating the services organization in the background. Although lacking the necessary clarity, community thought recovers and seeks to update many of the classical concepts, in composition with the radical discourse. Some concepts originally linked to the ideals of the Health Centers are highlighted throughout the studied period: integration (comprehensiveness), decentralization and socialization (universality). In a broader historical view, it is current recognized the role of the Brazilian public health in the national identity construction started in the First Republic, but actually put into action in the Vargas era. Health Centres, today represented in the ideas of primary care, not only participated in this history, as indeed they were largely its protagonists

ASSUNTO(S)

educação médica medicina social organização pan-americana da saúde/história preventive medicine saúde pública/história health services planning health centers community medicine health policy education medical atenção primária á saúde centros de saúde medicina preventiva política de saúde medicina comunitária public health/history reforma dos serviços da saúde social medicine primary health care pan american health organization/history

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