Elsevier

The Lancet

Volume 358, Issue 9278, 28 July 2001, Pages 315-323
The Lancet

Public Health
Social medicine in Latin America: productivity and dangers facing the major national groups

https://doi.org/10.1016/S0140-6736(01)05488-5Get rights and content

Summary

There is little knowledge about Latin American social medicine in the English-speaking world. Social medicine groups exist in Argentina, Brazil, Chile, Colombia, Cuba, Ecuador, and Mexico. Dictatorships have created political and economic conditions which are more adverse in some countries than others; in certain instances, practitioners of social medicine have faced unemployment, arrest, torture, exile, and death. Social medicine groups have focused on the social determinants of illness and early death, the effects of social policies such as privatisation and public sector cutbacks, occupational and environmental causes of illness, critical epidemiology, mental health effects of political trauma, the impact of gender, and collaborations with local communities, labour organisations, and indigenous people. The groups' achievements and financial survival have varied, depending partly on the national context. Active professional associations have developed, both nationally and internationally. Several groups have achieved publication in journals and books, despite financial and technical difficulties that might be lessened through a new initiative sponsored by the US National Library of Medicine. The conceptual orientation and research efforts of these groups have tended to challenge current relations of economic and political power. Despite its dangers, Latin American social medicine has emerged as a productive field of work, whose findings have become pertinent throughout the world.

Section snippets

National groups

Since the late 1960s, groups in several Latin American countries have worked under challenging and sometimes dangerous conditions. All groups have made major contributions in research, teaching, and public service. Figure 1 shows their locations. In addition to these groups, smaller networks have emerged in other countries, including Peru, Uruguay, and Venezuela.

Financial survival

Financial support for research, educational, and service projects also varies widely among Latin American countries. Although Juan César García had orchestrated financial support for several social medicine groups from his position at the Pan American Health Organisation, after his death in 1984 this organisation became less reliable as a source of funding.1 The Canadian Association of Public Health has assisted several national groups with project-based funding over extended periods of time.

Conclusions

Although social medicine groups have varying effects on medical practice, public health programmes, and medical education in their respective countries, they have built an important network of groups conducting research and intervention programmes in the tradition of social medicine. Wider knowledge of this work would prove helpful, not least because of the courage of the individuals and groups that have continued their efforts under dangerous working conditions. A focus on the social origins

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