De los determinantes sociales a la interdependencia social: teoría, reflexión y aplicación / From social determinants to social interdependency: Theory, reflection, and engagement

William Ventres, Shafik Dharamsi, Peter De Wetter, Robert Ferrer


Marco Teórico: Los académicos y profesionales de la medicina y la salud pública han dedicado mucho tiempo y esfuerzo para definir lo que significa los determinantes sociales de la salud e identificar las desigualdades en los efectos. Desafortunadamente, los profesionales de la salud pueden creer erróneamente que el origen de los malos resultados de la salud no están relacionados con las formas por los cuales los factores sociales, económicos, políticos y ambientales se establecen y se mantienen.

Razonamiento: Introducimos el concepto de interdependencia social de la salud y la enfermedad para (1) reforzar la necesidad de considerar las causas fundamentales de los determinantes sociales, y (2) ser consciente de la responsabilidad comunal y personal para ayudar a reducir sus efectos. El desarrollo de una comprensión profunda de la interdependencia social en la práctica clínica, en la investigación de la salud pública y en la promoción de salud implica un proceso repetitivo de observación, reflexión y acción. Efectuar este cambio positivo dentro de esas áreas es una obligación compartida.

Conclusión: Desarrollando y aplicando un abordaje de interdependencia social significa ser consciente de nuestra interconexión humana. Este abordaje demuestra cómo vivimos en un mundo en el que no estamos tan separados unos de los otros para que no podamos beneficiarnos solo con imaginarnos y desear para los demás lo que deseamos para nosotros mismos, lo cual puede motivarnos a considerar nuestro trabajo como profesionales de la salud como una fuerza positiva, no solamente para atender a las enfermedades, si no también para promover la buena salud.

Palabras Claves: Actitudes de los profesionales en salud; Cultura; Inequidades en Salud; Salud Pública; Determinantes de Salud; Responsabilidad Social; Poblaciones vulnerables


Introduction: Scholars and practitioners in medicine and public health have devoted significant time and effort to defining the social determinants of health and identifying resulting inequities in health outcomes. Unfortunately, however, health care professionals can be led to believe that the origins of poor health-related outcomes are disconnected from the ways in which social, economic, political, and environmental factors are established and maintained.
Discussion: We introduce the concept of social interdependency in health ¬and illness as a way to (1) reinforce the need to identify the root causes of social determinants, and (2) accept not only personal but also shared responsibility for acting to ameliorate their effects. Developing a sound understanding of social interdependency in clinical practice, public health research, and health care advocacy involves an iterative process of observation, reflection, and action. Effecting positive change within these disciplines is a shared obligation.
Conclusion: Developing and applying a social interdependency approach means appreciating our human interconnectedness This approach showcases how we live in a world where none of us is so separate from another that we cannot benefit by envisioning and desiring for others what we might desire for ourselves, and can motivate us to consider work in the health professions as a force not only to attend to disease, but also to encourage health.
Keywords: Attitude of health personnel; bioethics; culture; health inequities; public health; social determinants; social responsibility; vulnerable populations

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