Abstract
Epidemiology as any other scientific work dealing with social and human wellbeing runs under great social pressure. Its conceptual and practical tools have developed in concrete historical conditions facing evident social inequity. In recent times, neoliberal economic acceleration, through the ongoing fourth industrial revolution, has globalized massive unhealthy processes and expanded economic and political influences.
In Latin America critical epidemiology evolved from the early 1970s social medicine movement. However limited by its subordinate position with respect to mainstream medicine, this insurgent academic position grew as a counteractive intellectual and political tradition that based its initial impulse on epistemological clarity and activism. Contrary to the linear functionalist thinking of conventional medical science—that separates the understanding of health conditions from their social and cultural contexts—critical social medicine broke away from that positivist framework.
This chapter discusses the historical roots, epistemological and methodological ruptures of critical epidemiology. It describes the formation of the social determination of health paradigm of dialectical, complex, critical thinking with its potential for an emancipatory perspective of health reform. In the same breath, it presents a sound critique of the “knowledge illusion” of linear, reductionist causal thinking, while assuming transformative science as the reference for an integral scientific objectiveness that confronts and redefines the traditional notion of objectivity and recovers the active transforming role of the subject in science. It proposes complex thinking to decipher the real requisites of rigorous epidemiology, which does not only depend on the accuracy, reliability and validity of its empirical methods, calculations and observations but on a rigorous and multidimensional/complex/transdisciplinary/intercultural understanding of society and health.
I should like to express my grateful thanks to Michael Harvey (Professor at the University of California) and Maria Cristina Breilh for their rigorous and generous support in the translation of some of my original texts in Spanish the conceptual explanation and synthesis of recent works being prepared in English. Their contribution was decisive for the preparation of this chapter’s original English version.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsNotes
- 1.
Conjunction refers to external causal links; it is fully discussed further on.
References
Allende, S. (1939). La realidad medico social chilena. Santiago: Ministerio de Salud.
Almeida Filho, N. (2000). La ciencia tímida: ensayos de de deconstrucción de la epidemiología. Buenos Aires: Lugar Editorial.
Ayres, J. R. d. C. M. (1997). Sobre o risco: para compreender a epidemiologia. São Paulo: Hucitec.
Barreda, A. (2010). Economía ecológica y ecología crítica. Quito: Seminario del doctorado en Salud Colectiva Ambiente y Sociedad, Universidad Andina Simón Bolívar, Sede Ecuador.
Bartra, A. (2009). El capital en su laberinto. México, DF: Universidad Autónoma de la Ciudad de México: Editorial Itaca: CEDRSSA (Mécico Bartra, A. (2006). El capital en su laberinto: de la renta de la tierra a la renta de la vida).
Bhaskar, R. (1986). Scientific realism and human emancipation. London: Verso.
Bourdieu, P. (1998). O poder simbólico (p. 15). Rio de Janeiro: Bertrand Brasil.
Bowker, G. C., & Star, S. L. (1999). Sorting things out: Classification and its consequences. Cambridge, MA: MIT Press.
Bradford Hill, A. (1965). The environment and disease. Association or causation. Proceedings of the Royal Society of Medicine, 58, 295–300.
Breilh, J. (1977). Crítica a la interpretación ecológico funcionalista de la epidemiología: un ensayo de desmitificación del proceso salud enfermedad. México: Universidad Autónoma Metropolitana de Xochimilco, Tesis de Maestría.
Breilh, J. (1994). Las ciencias de la salud pública en la construcción de una prevención profunda. In M. I. Rodríguez (Ed.), Lo biológico y lo social: Su articulación en la formación del personal de salud (Serie Desarrollo de Recursos Humanos) (Vol. 101, pp. 63–100). Washington: OMS.
Breilh, J. (1997). Nuevos conceptos y técnicas de investigación. Guía pedagógica para un taller de metodología (3ra. Edición, Vols. 1–1). Quito - Ecuador: CEAS.
Breilh, J. (2003). Epidemiología crítica ciencia emancipadora e interculturalidad (2da ed.). Buenos Aires: Lugar Editorial.
Breilh, J. (2010). Epidemiología: economía política y salud (7a ed.). Quito [Ecuador]: Universidad Andina Simón Bolívar/Corporación Editora Nacional.
Breilh, J. (2011). The subversion of the good life (enlightened rebelliousness for the 21st century: A critical perspective on the work of Bolívar Echeverría). Salud Colectiva English Edition, 7(3), 389–397.
Breilh, J. (2015). Epidemiología crítica latinoamericana: raíces, desarrollos recientes y ruptura metodológica. (La determinación social de la salud como herramienta de ruptura hacia la nueva salud pública – Salud Colectiva). In Tras las huellas de la determinación (Memorias de Seminario Inter-universitario de determinación social de la salud) (pp. 19–75). Bogotá: Universidad Nacional de Colombia.
Breilh, J. (2015b). Epidemiologia del siglo XXI y ciberespacio: repensar la teoría del poder y la determinación social de la salud. Revista Brasileira de Epidemiologia, 18(4), 965–975.
Breilh, J., & Tillería, Y. (2008). Global acceleration and dispossession: Regression in the right to life and public health during Ecuador’s neoliberal decades (1st ed.). Ottawa: University of Ottawa.
Carrillo, R. (1951). Plan sintético de Salud Pública 1952 1958. Buenos Aires: Ministerio de Salud Pública de la Nación.
Cockburn, A. (1963). The evolution and eradication of diseases. Baltimore: The Johns Hopkins Press.
De Castro Ildeu, G. (1992). Caos. Rio de Janeiro: Ciência Hoje. Sociedad Brasileira para o Progresso da Ciência (UFRJ), 14(80), 62–63.
Duarte, E. (1986). Ciencias sociales y salud en América Latina: tendencias y perspectivas. Washington: Organización Panamericana de la Salud.
Espejo, E. (1994). Reflexiones sobre la utilidad, importancia y conveniencias que propone Don Francisco Gil, Cirujano del Real Monasterio de San Lorenzo, y su sitio, e individuo de la Real Academia Médica de Madrid, en su disertación físico-médica, acerca de un método seguro para preservar a los pueblos de viruelas. Quito: edición facsimilar de la Nueva Editorial de la Casa de la Cultura. (Facsimilar). Quito: Nueva Editorial de la Casa de la Cultura Ecuatoriana.
Foucault, M. (1982). The subject and power. In H. L. Dreyfus & P. Rabinow (Eds.), Michel Foucault. Beyond structuralism and hermeneutics. New York: Harvester Wheatsheaf.
Foucault, M., Lotringer, S., & Hochroth, L. (2007). The politics of truth. Los Angeles, CA: Semiotext(e).
Franco, S., Duarte, E., Breilh, J., & Laurell, A. C. (1991). Debates en medicina social (Desarrollo de Recursos Humanos) (Vol. 92). Quito: OPS.
Harvey, D. (2003). The new imperialism. Oxford: The Oxford University Press.
Harvey, D. (2007). Espacios del capital: hacia una geografía crítica. Madrid: Akal Ediciones, S.A.
Irvine, J., Miles, I., & Evans, J. (Eds.). (1979). Demystifying social statistics. London: Pluto Press.
Jones, R., & Wilsdon, J. (2018). The Biomedical Bubble. Why UK research and innovation needs a greater diversity of priorities, politics, places and people. London: Nesta.
Klein, N. (2008). La doctrina del shock. El auge del capitalismo del desastre. Buenos Aires: PAIDOS.
Krieger, N. (2011). Epidemiology and the people’s health: Theory and context. New York: Oxford University Press.
Laurell, C., & Noriega, M. (1989). México: ERA.
Leavell, H., & Clark, G. (1965). Preventive medicine for the doctor in his community. New York: McGraw-Hill.
Lefebvre, H. (1991). The production of space. Malden, MA: Blackwell.
Leiss, W. (1972). The domination of nature. New York: Beacon Pub.
Levins, R., & Lewontin, R. (1985). The dialectical biologist. Cambridge: Harvard University Press.
Lewontin, R., Rose, S., & Kamin, L. (1984). “Not in our genes” biology, ideology and human nature. New York: Pantheon Books.
MacMahon, B. (1975). Principios y métodos de la epidemiología. México: La Prensa Médica Mexicana.
Marmot, M. G., & Wilkinson, R. G. (Eds.). (2006). Social determinants of health (2nd ed.). New York: Oxford University Press.
Marx, K. (1971). Elementos fundamentales para la crítica de la economía política (Grundisse) (pp. 1857–1858). México: Siglo XXI Editores.
Marx, K. (1972). Elementos fundamentales para la crítica de la economía política (borrador) 1857–1858. Buenos Aires: Siglo XXI.
Osorio, A. (1988). Hamiltonian systems: Chaos and quantization. Cambridge: Cambridge University Press, 238 p.
Otero, G., Pechlaner, G., Liberman, G., & Gürcan, E. (2015). The neoliberal diet and inequality in the United States. Social Science & Medicine, 142, 47–55. https://doi.org/10.1016/j.socscimed.2015.08.005.
Paredes, R. (1938). El imperialismo en el Ecuador. Oro y sangre en Portovelo. Quito - Ecuador: Editorial Artes Gráficas.
Pradeepa, R., & V Mohan, V. (2017). Prevalence of type 2 diabetes and its complications in India and economic costs to the nation European. Journal of Clinical Nutrition, 71, 816–824.
Punch, K. (2014). Introduction to social research: Quantitative and qualitative approaches. Los Angeles: Sage.
Ribeiro, S. (2016). Cuarta revolución industrial, tecnologías en impactos. El ciervo Herido, Blog de Omar González. https://elciervoherido.wordpress.com/2016/11/21/cuarta-revolucion-industrial-tecnologias-e-impactos-silvia-ribeiro/
Rosen, G. (1958). A history of public health. New York: MD Publications.
Samaja, J. (1993). Epistemología y metodología: elementos para una teoría de la investigación científica. Buenos Aires: Eudeba.
Samaja, J. (1996). Epistemología y metodología. Buenos Aires: Eudeba.
Santos, M. (1996). A natureza do espaço: técnica e tempo; razão e emoção. São Paulo: Editora Hucitec.
Sigerist, H. (1945). Civilization and disease. Ithaca: Cornell University Press.
Subirats, J. (2019, febrero). ¿Del poscapitalismo al postrabajo? Nueva Sociedad, 279, 34–48.
Tashakkori, A. T. C. (1998). Combining qualitative and quantitative approaches (Applied social research methods series) (Vol. 46). London: Sage.
Veraza, J. (2008). Subsunción real del consumo al capital. México: Editorial Itaca.
Virchow, R. (1848). Report on the Typhus Epidemic in Upper Silesia. Medical Reform, 8.
Waitzkin, H. (2011). Medicine and public health at the end of empire (pp. 9–10). Boulder, CO: Paradigm Publishers.
Waitzkin, H., Iriart, C., Estrada, A., & Lamadrid, S. (2001, October). Social medicine then and now: Lessons from Latin America. American Journal of Public Health, 91(10), 1592–1601. https://doi.org/10.2105/AJPH.91.10.1592
Waitzkin, H., & Working Group for Health Beyond Capitalism (Eds.). (2018). Health care under the knife: Moving beyond capitalism for our health. New York: Monthly Review Press.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this paper
Cite this paper
Breilh, J. (2019). Critical Epidemiology in Latin America: Roots, Philosophical and Methodological Ruptures. In: Vallverdú, J., Puyol, A., Estany, A. (eds) Philosophical and Methodological Debates in Public Health. Springer, Cham. https://doi.org/10.1007/978-3-030-28626-2_3
Download citation
DOI: https://doi.org/10.1007/978-3-030-28626-2_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-28625-5
Online ISBN: 978-3-030-28626-2
eBook Packages: Mathematics and StatisticsMathematics and Statistics (R0)