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      Los determinantes sociales de la salud: más allá de los factores de riesgo Translated title: The social determinants of health: beyond the risk factors perspective Translated title: Determinantes sociais da saúde: além dos fatores de risco

      research-article
      1
      Revista Gerencia y Políticas de Salud
      Pontificia Universidad Javeriana
      social determinants of health, health inequalities, risk factors, equity in Health, Social Environment, quality of life, public health, health inequalities, risk factors, equity in health, public health, determinantes sociais da saúde, desigualdades em saúde, fatores de risco, qualidade de vida, meio social, saúde pública, disparidades no atendimento de saúde, fatores de risco, equidade em saúde, saúde pública, determinantes sociales de la salud, desigualdades en la salud, factores de riesgo, equidad en salud, medio social, calidad de vida, salud pública, disparidades en atención de salud, factores de riesgo, equidad en salud, salud pública

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          Abstract

          El análisis de los problemas de salud con el denominado enfoque de los determinantes sociales y económicos es un tema central en la agenda de la Organización Mundial de la Salud (OMS) y de algunos ministerios de Salud. A pesar de los avances teóricos y de la evidencia recogida sobre la influencia de la estructura social en el estado de salud de los individuos, los grupos y las naciones, para algunos se trata de un campo de estudio en construcción, todavía no suficientemente delimitado, que en ocasiones tiende a confundirse con el tradicional enfoque de factores de riesgo. En este artículo se plantean las principales perspectivas teóricas disponibles para analizar los determinantes de la salud y algunas particularidades de su estudio en el caso colombiano.

          Translated abstract

          The analysis of the health population status from the perspective of the social determinants of health (SDH) are a crucial topic in the World Health Organization and some Health National Ministry`s agenda. Despite of its theoretical foundations and the empirical evidence elicited on the influences of social structures on the individual and groups' health status, for some scholars the SDH is a field in incipient stage with no clear definitions. Others consider it as similar to the traditional risk factors theory. In this article the main theoretical perspectives to analyze the SDH are revised as well as some particular challenges by doing research from this perspective in the Colombian society.

          Translated abstract

          A análise dos problemas de saúde com o denominado enfoque dos determinantes sociais e econômicos é uma questão central na agenda da Organização Mundial da Saúde (OMS) e alguns ministérios da saúde. Apesar dos avanços teóricos e as evidências coletadas sobre a influência da estrutura social no estado de saúde dos indivíduos, os grupos e as nações, para alguns, é um campo de estudo em construção, ainda não está suficientemente delimitado que às vezes tende a ser confundida com o enfoque tradicional dos fatores de risco. Neste artigo são propostas as principais perspectivas teóricas disponíveis para analisar os determinantes da saúde e algumas particularidades de seu estudo, no caso colombiano.

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          Most cited references72

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          Theories for social epidemiology in the 21st century: an ecosocial perspective.

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            Fetal origins of coronary heart disease.

            The fetal origins hypothesis states that fetal undernutrition in middle to late gestation, which leads to disproportionate fetal growth, programmes later coronary heart disease. Animal studies have shown that undernutrition before birth programmes persisting changes in a range of metabolic, physiological, and structural parameters. Studies in humans have shown that men and women whose birth weights were at the lower end of the normal range, who were thin or short at birth, or who were small in relation to placental size have increased rates of coronary heart disease. We are beginning to understand something of the mechanisms underlying these associations. The programming of blood pressure, insulin responses to glucose, cholesterol metabolism, blood coagulation, and hormonal settings are all areas of active research.
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              The concepts and principles of equity and health.

              In 1984, the 32 member states of the World Health Organization European Region took a remarkable step forward in agreeing unanimously on 38 targets for a common health policy for the Region. Not only was equity the subject of the first of these targets, but it was also seen as a fundamental theme running right through the policy as a whole. However, equity can mean different things to different people. This article looks at the concepts and principles of equity as understood in the context of the World Health Organization's Health for All policy. After considering the possible causes of the differences in health observed in populations--some of them inevitable and some unnecessary and unfair--the author discusses equity in relation to health care, concentrating on issues of access to care, utilization, and quality. Lastly, seven principles for action are outlined, stemming from these concepts, to be borne in mind when designing or implementing policies, so that greater equity in health and health care can be promoted.
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                Author and article information

                Contributors
                Role: ND
                Journal
                rgps
                Revista Gerencia y Políticas de Salud
                Rev. Gerenc. Polit. Salud
                Pontificia Universidad Javeriana (Bogotá )
                1657-7027
                December 2009
                : 8
                : 17
                : 69-79
                Affiliations
                [1 ] Universidad de Antioquia Colombia
                Article
                S1657-70272009000200005
                7fbc876c-2556-4105-9225-57946b389db9

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=1657-7027&lng=en
                Categories
                PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

                Public health
                social determinants of health,health inequalities,risk factors,equity in Health,Social Environment,quality of life,public health,equity in health,determinantes sociais da saúde,desigualdades em saúde,fatores de risco,qualidade de vida,meio social,saúde pública,disparidades no atendimento de saúde,equidade em saúde,determinantes sociales de la salud,desigualdades en la salud,factores de riesgo,equidad en salud,medio social,calidad de vida,salud pública,disparidades en atención de salud

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