Salud Colectiva最新文献

The life trajectories of transgender individuals are marked by multiple vulnerabilities. This study aims to explore healthcare accessibility for trans people in the province of Córdoba, Argentina. Using a narrative design and a biographical approach, eight semi-structured interviews were conducted between 2022 and 2023 with trans individuals to examine the barriers to healthcare access and the strategies they employed. The accounts reveal that while discrimination and mistreatment remain the primary barriers, a notable concern is the lack of training and knowledge about trans health among healthcare professionals. Among the strategies highlighted are the involvement and efforts of collective spaces and LGBTTTIQ+ social organizations, which play a key role in facilitating access to healthcare. Social networks for disseminating information emerge as critical strategies, alongside inclusive comprehensive healthcare clinics within health services.

This study aims to analyze the configuration of inequalities in one of Argentina's most significant production zones for fresh vegetables and cut flowers, located in Greater La Plata, Buenos Aires Province. This ongoing anthropological research, initiated in 2021, employs methods such as participant observation, interviews, food mapping, and digital ethnography. Among the main findings, we highlight that this production zone exhibits, in both its origins and daily operations, certain racist dynamics that are not solely generated by the host society toward migrants but are disseminated throughout the social fabric, including by migrant producers themselves. Positive valuations of ultra-processed foods by those living and working in the area reflect the importance of belonging to the host society, running parallel to strategies for preserving food preparations from before migration. These include the recreation of a "food identity" and the proliferation of "legumbrerías" (legume shops) and "paisano eateries" (restaurants serving traditional food). These transformations are intertwined with the productive changes migrants have experienced, shifting from peasant economies in their places of origin to intensive production in Greater La Plata.

The use of psychotropic drugs has become a public health issue due to their high consumption worldwide. In the context of traditional populations, the literature on the use of these medications is scarce. This study presents a descriptive analysis of psychotropic drug use among Indigenous and Quilombola communities in the states of Minas Gerais, Rio Grande do Norte, Alagoas, and Piauí in Brazil. Data collection was conducted between March and June 2023 using two structured questionnaires with closed-ended questions applied during home visits. These questionnaires gathered sociodemographic profiles of the Indigenous and Quilombola communities and general psychotropic drug usage. Out of 335 individuals from the four states who responded to the questionnaires on general psychotropic drug use, 53 reported using these medications. The users were predominantly adult women with low educational attainment, older age, low income, and reliance on social programs. Antidepressants were the most commonly used therapeutic class. The study concludes that economic and social vulnerability is likely a significant factor in the social determinants of psychological distress and psychotropic drug use.

This article analyzes the impact of psychotropic drug use on individuals diagnosed with schizophrenia, bipolar affective disorder, and severe depression in Chile. Using a qualitative narrative approach, the experiences of 25 patients from 2018 to 2021 are examined. Participants describe how these medications, while effective in symptom control, generate psychological suffering and a sense of coercion in daily life. The results reveal that prolonged use of psychotropic drugs leads to significant side effects, including physical, cognitive, and social deterioration, as well as a persistent sense of dependence on these medications. Furthermore, the article critiques the medicalization of mental disorders within modern psychiatry, where the biomedical approach predominates, reducing human distress to a neurochemical problem and disregarding social factors. The study concludes that while psychotropic drugs can stabilize patients, they also perpetuate forms of control and suffering.

Indigenous populations show high prevalence rates of mental disorders and limited access to mental health services. The aim of this study was to analyze the mental health care trajectories of indigenous youth living in the Metropolitan Area of Oaxaca, Mexico. Between May and August 2023, we conducted a qualitative study involving non-participant observation, in-depth interviews with seven indigenous youth, and semi-structured interviews with nine health professionals, healers, or leaders of mutual support groups. We identified processes, not exempt of tensions, in how these young people perceive themselves as both young and indigenous, in the development of their mental disorders, and in the ways they seek treatment. Their care involved the use of psychological and psychiatric services, mutual support groups, and, to a limited extent, traditional medicine. This study concludes that these dynamics are interwoven and amplified by interpersonal, institutional and epistemic racism, which must be dismantled to improve the mental health of indigenous youth.

This article explores the life and work of Jeremiah Noah Morris (1910-2009), a pioneer in social epidemiology. Morris advocated for a social interpretation of health and disease, emphasizing the impact of social inequalities on morbidity and mortality. His work, Uses of epidemiology, promoted the study of chronic diseases from a population-based perspective. He contributed to the development of the Black report in 1980, which highlighted health inequalities in the United Kingdom, and to the concept of a "minimum income for a healthy life." His research linked physical activity to the prevention of coronary diseases, and he championed the role of community physicians in public health care. Morris saw epidemiology as a historical science oriented towards solving practical problems, and in doing so he showed an openness to other knowledge, including researchers from different disciplines, which allowed him to approach the complexity of social problems. This article reviews his contributions and key debates, addressing the relevance of his ideas in today's context and the apparent neglect of his legacy in modern epidemiology.

This article discusses the experience of a permanent health education initiative focused on institutional racism with health professionals from the Brazilian Unified Health System (SUS) holding management positions in a municipality in the interior of Bahia, in Northeastern Brazil. A workshop was held in September 2022, based on a problematizing methodology called the Maguerez Arc, conducted by residents of the Multiprofessional Family Health Program. Ten managers participated in the workshop, most of whom were women. Despite acknowledging the presence and impact of racism in health services, managers find it challenging to recognize and address racism in its institutional dimension. A recurring discourse aligned with the myth of racial democracy was notable, and a higher level of commitment among Black women was observed throughout the workshop. Permanent health education emerges as an essential strategy to combat racism, necessary to expand such discussions within health services.

Adherence to psychopharmacological treatment essentially involves a process of meaning-making. The objective of this study was to explore the experience of people undergoing chronic psychiatric treatment from the patients' perspective. In 2018, using the photovoice methodology, four sessions were conducted with the participation of 11 individuals from a community school in a socially marginalized neighborhood of a southeastern Spanish city, some of whom were also users of a social rehabilitation and integration center and a day center. Participants took and selected 41 photographs under the premise: "Photograph your experience regarding health and medication." A categorization of the emerging narratives was carried out during a dialogical session between participants and researchers, which was recorded for subsequent transcription and analysis. The experiences were divided into two major symbolic themes that seek to give therapeutic meaning to medication: one of conflict and the other of motivation.

The aim of this study, based on health care and social learning theories, is to understand the degree of implementation and reach of the "Brief Anti-Alcohol Counseling in Pediatric Age" protocol, a preventive intervention addressing alcohol consumption among minors within the Health Service of the Principality of Asturias, Spain. Using a qualitative methodology, based on thirteen semi-structured interviews conducted in June 2022, the study analyzes the development of the protocol, the perceptions of pediatric service professionals regarding its implementation, and their cultural representations of alcohol consumption within the Asturian and Spanish context. The results reveal limited reach due to the heterogeneity in its application and the difficulty in measuring its impact compared to other areas of pediatric health. Furthermore, the importance of the educational and caregiving dimensions of the pediatric and nursing areas is emphasized, as well as the need for a comprehensive approach that involves families and other institutions to improve alcohol consumption prevention from an early age.

Physiotherapy rehabilitation must address the cultural preferences of the population, and as its main tool, physical activity should be analyzed from an intercultural health approach. This study aims to characterize the experiences of physical therapy care related to physical activity from an intercultural perspective. Using a qualitative approach, between June 2021 and March 2023, eight semi-structured individual interviews were conducted with adult Mapuche individuals, professionals in the field, and workers from the Indigenous Health Program in primary care centers in an urban municipality in Santiago, Chile. There are challenges to implementing interculturality, such as the gap between health programs, lack of professional training, and discrimination against the Mapuche community. In rehabilitation services, particularly in physical activity practices as a treatment strategy for Mapuche individuals, cultural relevance is limited or nonexistent.