bluuebunny/crossref_metadata_2025 huggingface dataset:
Caring for the other: The moral career of the dependent adult
Authors: Sánchez Ramírez Georgina
Published: January 2025

Book review: Meza, Alejandro y Escalera Alejandra, 2017. Cuidar al otro. La carrera moral del adulto dependiente. México. UANL. 160 pp. ISBN 78-607-27-0806-8
Substance Use and Mental Health Effects of Disrupting Treatment and Shelter Services on Boston Harbor’s Long Island
Authors: Ha Laura C. , Foo Karen T. , Harp Hannah L. , Brody Leslie R. , Cohen Mardge H.
Published: January 2025

Objective: To understand the impact of Boston’s October 2014 Long Island Bridge Closure.
Methods: We conducted a qualitative analysis of semi-structured interviews with nine individuals displaced from programs on the Island. Participants were recruited and interviewed during March and April of 2015. Interviewers administered a 22-item questionnaire and a semi-structured interview at the temporary shelters and programs at South End Fitness Center, BHCHP, Woods-Mullen Shelter, and Shattuck Hospital. Thematic analysis of the transcribed interview data was conducted using an inductive framework approach.
Results: Thematic analysis of the interviews revealed that the most prominent ramifications of the bridge closure were worsening of mental health, substance use behavior, and housing insecurity. Further analysis revealed the importance of stable housing in maintaining sobriety and mental health.
Conclusions: When medical and social services for vulnerable populations are at risk of closure, careful planning, quick mobilization of resources, and investment in affordable housing, are crucial in preventing adverse mental health outcomes. Maintaining shelter and substance use treatment programs should be a high priority, even when government funding is at risk.
Ethical Practices in participatory health research: A systemic review of studies in Latin America and the Caribbean
Authors: Tolli Marina Verónica , Muñoz Rodríguez Laura Mariela , Sabéz María Julia
Published: January 2025

Many community health interventions, besides trying to produce a change in the health situation of the population, pursue the gathering of scientific data. The ensuing question is how explicit this is to the community, as it affects the rights of the participants. A systematic review was conducted to determine what ethical aspects are taken into account in participatory community health research in Latin America. The search was performed in LILACS, 21 studies were identified. In addition, the authors were contacted to complete additional information through a survey. The degree of community participation is heterogeneous; it range from attending workshops to interventions planned and carried out by community members. Half of the identified articles indicates the use of ethical tools, however there is little explicitation of specific ethical aspects of the processes of participatory research. In conclusion, participatory health research would fail into implement ethical aspects, including the real participation of communities in all research steps and the contribution of community members in the construction of knowledge.
Social violence in the post-conflict and its impact on health services
Authors: Hernández Reyes Antonio Alberto
Published: January 2025

In order to understand the social violence currently raging in El Salvador - and its impact on health services, we must begin our analysis during the period of civil war and continue until the arrival of progressive governments in the last decade. Doing so we can identify the key moments when El Salvador became the world´s most violent country and its capital (San Salvador) the capital with the highest number of murders.

The transformation of Salvadoran society and its associated social violence has configured an informal, unpublished map of El Salvador with new boundaries and borders. Gangs have control of some of these areas, a situation related to the weakness of current state institutions. The population (called ´civils’ by the gangs) has restricted access to health, education, work, housing and security.
The end of 50 years of armed conflict in Colombia: the consequences of antipersonnel mines
Authors: Botero Suárez Stephanie Andrea , González Vásquez Julián Felipe , Quintanilla Pinto Andrés Felipe
Published: January 2025

Among the great tragedies produced by the armed conflict in Colombia, antipersonnel mines (MAP) have left their trail of pain, mainly due to the large number of victims affected both directly and indirectly. In the worst cases, MAP cause the death of its victims. Survivors have to deal with limb injuries and/or damage to vital structures. The Colombian health system is not trained to provide optimal health services for people affected by the armed conflict. The Colombian health system is not trained to guarantee optimal health services for people affected by the armed conflict. According to the Pan American Health Organization (PAHO) there are barriers to the provision of appropriate care for victims. These include lack of knowledge of their rights, lack of remuneration for FOSYGA, and lack of medical resources. All of these factors highlight the importance of (MAP) within the Colombian in public health services. According to the Directorate for Integral Action against Antipersonnel Mines (DAICMA), 11,472 people were affected by antipersonnel mines were documented from 1990 to 2016. 1,165 victims were minors and 243 were fatalities. The departments of Antioquia, Meta and Caquetá have the highest number of accident and event figures due to MAP and unexploded ordnance (MUSE).
Interview: Elidio La Torre Lagares teaches, Department of Comparative Literature, University of Puerto Rico, Río Piedras
Authors: Vargas Iris Mónica
Published: January 2025

Interview between a medical student who was an activist in the protests, with Elidio la Torre Lagares, essayist, narrator, poet and professor of literatura and literary creation at the Faculty of Humanities, University of Puerto Rico.
Interview: Stephanie Padilla is a social justice activist in Puerto Rico
Authors: Vargas Iris Mónica
Published: January 2025

Interview between a medical student who was an activist in the protests, as well as a well-known Puerto Rico, who was also very active in the movement that made the governor resign in the Summer 2019.
Praxis, resistance, and health as seen in social and oral histories
Authors: Pulido Navarro Margarita , Cuéllar Romero Ricardo
Published: January 2025

The purpose of this article is to consider the role that oral history can play in recovering the processes that the working class has used to further develop work carried on within the context of a Marxist “sociology based on “class consciousness.” The result is the possibility of a narration that can be separated from “oral histories” and which allows for events, vital experiences, memories, ways of developing, and differing lifestyles. This type of oral history permits us to take the first – and foundational – step in developing a class consciousness that would be centered precisely in what some have called “the sphere of private life” while others simply refer to it as “daily life”. Such a narration that can be separated from oral histories, where events, vital experiences, memories, lifestyles, means of living, allowing us to unearth that first and functional step in developing a class consciousness, that is to be aware of one’s self. This is a work still in the process of developing. In other words, we can place it in the world of daily praxis, of common sense, of utility; of that which is not explained to us, but which places us in our living conditions, and then places us within the world. Finally, it incorporates health and disease in the processes previously mentioned in the elaboration of class status. What we, in particular, want to do, is to go beyond a simplistic, immediate understanding and to develop a subjectivity which recognizes the need to develop a different type of subjectivity as well as to learn how to develop alternate and alternative forms of consciousness. How do such alternative understandings develop within the contradictions of a capitalist social structure? How can we create a praxis of resistance, open, collective, and organized so as to go beyond current hegemonic practices. This challenge considers work in terms that are hegemonic and alienating. Alternative understandings would go beyond seeing work as a simple activity involving manipulation in function of the reproduction of capital, In the words of Georges Navel.”: There is a sadness of the working class which can only be cured by political participation.
Review of Journals about Environmental and Occupational Health
Authors: Pouradeli Shiva , Rezaeian Mohsen
Published: January 2025

Health in workforce leads to economic success and population health. It is essential that the results of research about the work environment and occupational health be published in relevant journals. The aim of this study was to review specialized journals about the work environment and occupational health field.This descriptive study was conducted in 2018. The Scimago Journal & Country Rank (SJR) portal was used to search for the journals related to occupational health. NLM catalog of the PubMed database was searched to find and characterize journals. In the initial search, 508 titles of journals were found in the SJR portal in the public health, Environmental and Occupational Health field from which 38 specific journals publish articles related to environmental and occupational health. United States with 11 journals and the United Kingdom with 9 journals publish the maximum number of specific journals. Taylor & Francis Company publish most of these journals and only eight of them are open access. Five of these eight journals are published in Asia. Occupational and Environmental Medicine Journal has a higher impact factor (IF=3.965). The oldest journal began publication in 1949. Articles on environmental and occupational health are published in public health journals and specialized journals. Researchers can select the best journal related to environmental and occupational health to publish articles and the authors can publish their articles in any of the journals of this list, depending on the quality, time, place of research and the budget of the study.
The virus and the economy
Authors: Martin Brian
Published: January 2025

What is the best way to respond to covid-19? There is commonly assumed to be a trade-off between lives and the economy: precautions and controls are needed to save lives but they cause damage to the economy.

There’s an unstated assumption in this thinking, namely that “the economy” is vital to people’s wellbeing. This needs to be questioned. It has been long known that the Gross Domestic Product or GDP is not an accurate reflection of people’s wellbeing. GDP is boosted by negatives such as traffic accidents, environmental destruction and ill health.

A deeper problem is that people’s happiness levels are not very sensitive to increases in average income, at least above some basic level. Happiness depends more strongly on things like close personal relationships, having a purpose in life, physical activity, expressing gratitude and helping others. In countries with a high GDP per capita, average happiness levels have been mostly stable for decades despite continuing economic growth.
Factors Predicting Self-Care Behaviors among low health literacy hypertensive patients based on Health Belief Model in Bushehr district, south of Iran
Authors: Larki Azam , Reisi Mahnoush , Tahmasebi Rahim
Published: January 2025

Background: Hypertension is an important worldwide public-health challenge, which can lead to very serious consequences. The most important strategy for controlling blood pressure and maintaining it in the optimal range is patient compliance with self-care behaviors. The aim of this study was to determine the factors influencing adherence to self-care behaviors among low health literacy hypertensive patients based on health belief model.
Methods: A cross-sectional study was conducted among 152 hypertensive patients with low health literacy during July and August 2017. Patients with limited health literacy were identified by S-TOFHLA questionnaires. The data were collected using H-scale for assessing self-care behaviors and, HK-LS for assessing knowledge of hypertension. A researcher made questionnaire was applied for collecting data of health belief model constructs. Data were analyzed by SPSS version 22 with using multiple logistic regression analyses.
Results: The mean (±SD) age of participants was 56.86(8.7). The best compliance with self-care behaviors was related to lack of alcohol (78.9%) and tobacco use (55.9%), and the lowest was related to low salt diet (5.3%) and proper use of drugs (9.2%). Perceived self-efficacy was associated with all self-care behaviors except medication regimens. There was a significant association between perceived susceptibility about hypertension complications and adherence to both low-salt diet (OR = 3.47) and non-smoking Behavior (OR = 1.10). Individuals who had more perceived severity (OR = 1.82), had significantly greater adherence to their medication regimens compared to those who had less perceived severity. Perceived benefits and barriers were not significantly associated with either type of hypertension self-care behaviors.
Conclusion: It seems that designing and implementation of educational programs to increase self-efficacy of patients and promote their beliefs about perceived susceptibility and severity of complications, may be usefulness of the results in order to improve self-care behaviors among low health literacy hypertensive patients.
Evaluating Perception of Child Health and Safety Needs in a Community Through the Perspective of Caregivers and Physicians
Authors: Teoh Zheyi , Zerr Ashley , Black Allison , Caperell Kerry , Rice Wayne , Anderson Brit
Published: January 2025

Objective: To identify and compare child health and safety concerns in the community from the perspective of physicians and caregivers in Louisville. Design: We administered surveys to physicians and caregivers who were asked to list, via open-ended questions, the top three health or safety concerns they had for children in three separate age groups (≤ 3, 4-11, and ≥12 years old). Four reviewers assigned responses to a pre-specified category/subcategory through a schematic designed by the study team and a fifth reviewer addressed any discrepancies and assigned final categories. Agreement in assigning overall categories was measured using Fleiss Kappa and descriptive statistics were used to characterize the responses. Setting: Surveys were administered to caregivers who attended community events in Park Duvalle, a lower socioeconomic neighborhood in Louisville whose residents are predominantly black. Surveys were simultaneously administered to physicians throughout the University of Louisville/Norton Healthcare system. Participants: A total of 41 caregivers with at least one child and 43 physicians were surveyed in this study. Results: Overall categorical agreement between reviewers was k = 0.839, indicating good agreement on assignment. Injury/violence was identified by both caregivers and physicians as the top concern for children across all age groups. Wide variation was found when analyzing specific injury/violence subcategories, with caregivers more worried about household safety (17-40%) and gangs/unsafe neighborhoods (10-50%) while physicians were more concerned about sleep safety (36%), domestic violence (8-27%), and unintentional injury (10-20%). Conclusions: Survey administration was a feasible method of comparing health and safety concerns among caregivers and physicians. We identified injury/violence as the top health and safety concern across all age groups in our community but noted variation on the specific type of injury/violence. Replication of our study methodology in other neighborhoods may allow for improved comparison of caregiver and physician concerns.
Lincoln Hospital: the decline of health care
Authors: Editors The
Published: January 2025

“Lincoln Hospital: the decline of health care”was broadcast on WBAI radio in New York City onApril 22, 1971, roughly a year after the communitytakeover of Lincoln Hospital (see Fitzhugh Mullan’sarticle “Seize the Hospital to Serve the People” onthis journal).
On Fitzhugh Mullan's: White Coat, Clenched Fist
Authors: Chowkwanyun Merlin
Published: January 2025

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Improving Maternal Healthcare Access and Neonatal Survival through a Birthing Home Model in Rural Haiti
Authors: Shaffer Stan , Fryzelka Denise , Obenhaus Cindy , Wickstrom Elizabeth
Published: January 2025

High neonatal mortality in Haiti is sustained by limited access to essential maternity services, particularly for Haiti’s rural population. We investigated the feasibility of a rural birthing home model to provide basic prenatal, delivery, and neonatal services for women with uncomplicated pregnancies while simultaneously providing triage and transport of women with pregnancy related complications. The model included consideration of the local context, including women’s perceptions of barriers to healthcare access and available resources to implement change. Evaluation methods included the performance of a baseline community census and collection of pregnancy histories from 791 women living in a defined area of rural Haiti. These retrospective data were compared with pregnancy outcome for 668 women subsequently receiving services at the birthing home. Of 764 reported most recent pregnancies in the baseline survey, 663(87%) occurred at home with no assistance from skilled health staff. Of 668 women followed after opening of the birthing home, 514 (77%) subsequently gave birth at the birthing home, 94 (14%) were referred to a regional hospital for delivery, and only 60 (9%) delivered at home or on the way to the birthing home. Other measures of clinical volume and patient satisfaction also indicated positive changes in health care seeking. After introduction of the birthing home, fewer neonates died than predicted by historical information or national statistics. The present experience points out the feasibility of a rural birthing home model to increase access to essential maternity services.
Social Aspects of Maternal Mortality: A Case Study of the State of Mexico
Authors: Karam Calderón Miguel Ángel , Bustamante Montes Patricia , Campuzano González Martha , Camarena Pliego Ángela
Published: January 2025

We now have evidence that maternal deaths result from a set of social, economic, biological and logistical problems in health services. However, the approach used to address these problems is still essentially medical.
In this study we examined some of the social determinants of maternal deaths between 2004 and 2006 in the State of Mexico. To do this we reviewed clinical files and used verbal autopsies. The medical causes of maternal death were similar to those reported in previous studies. 80% were a result of direct causes: the low socio-economic level of the deceased women was the fundamental determinant of mortality, in that it limits access to education, income, adequate nutrition, and medical care. This situation negatively affects a woman's ability to make health related decisions.
It is important to consider that when a young woman becomes pregnant, it is the beginning of a long term social and economic responsibility for which they lack appropriate resources. In conjunction with limited work opportunities, this situation perpetuates a vicious circle of poverty.
From Alma Ata to the Global Fund: The history of international health policy
Authors: Global Health Watch Italian
Published: January 2025

The paper traces the evolution of international health policies and international health institutions, starting from the birth of the World Health Organization, the setting up of the Health for All target at the Alma Ata conference in 1978 and the rise of neo-liberal policies promoted by international financial institutions from 1980 to the present. The paper looks at different issues surrounding public-private partnerships and the setting up of the Global Fund to fight AIDS, Tuberculosis and Malaria and the influence of these institutions on the health systems in poor countries.
Lessons from Semmelweis: A Social Epidemiologic Update On Safe Motherhood
Authors: Cwikel Julie
Published: January 2025

In this historical review, Ignaz Semmelweis's study of handwashing to prevent puerperal fever is described and used as a benchmark from which to identify salient issues that are informative to today's women’s health activists working for Safe Motherhood. The epidemiology of contemporary excess maternal mortality is reviewed. Using the conceptual framework of social epidemiology, the paper addresses four issues that were problematic in Semmelweis’ era. New tools in public health are presented that can help to solve critical, still challenging problems to reduce excess maternal mortality, nosocomial infections, and puerperal fever at childbirth: 1) progress in behavioral methods to promote health behavior change, 2) the introduction of participatory action research, 3) the diffusion of evidence-based public health practice and 4) understanding how politics and health interact and present challenges when trying to meet public health goals. Social exclusion and marginality are still key issues in determining who has access to safe motherhood and who risks her life in maternity. Applied social epidemiology allows practitioners to make effective use of the already accumulated evidence and translate it into effective public health practice to promote safe motherhood around the world.
Social Change and Health Policy in Venezuela
Authors: Alvarado Carlos H. , Martínez María E. , Vivas-Martínez Sarai , Gutiérrez Nuramy J. , Metzger Wolfram
Published: January 2025

This work reviews social changes occurring in Venezuela during the last two decades, examining how they led to the development of a new health policy. Initially, the political context of the nineties is examined; this was a time when the neoliberal politics of the 1980’s had a demonstrable impact on the living conditions and health status of the population. By 1999 social and political events led to a new Constitution which provided the juridical and legal framework for a new health policy. The conceptualization of health and the model of health care which arose from the constitutional process are considered, as well as the reaction of the dominant economic and political sectors to the new policies imposed by constitutional mandate. The emergence of Barrio Adentro and other social missions is analyzed as an essential factor in the initiation of structural changes within the country and its health institutions. The Barrio Adentro program is described in detail, along with key steps in the development of the Venezuelan National Public Health System. Finally, the impact of these new health policies on the quality of life of the Venezuelan population is delineated.
Alames turns 24
Authors: Granda Ugalde Edmundo Humberto
Published: January 2025

Juan Cesar García pointed out four fundamental characteristics of social medicine, as it was developed in Europe during the 19th Century. These four characteristics can guide our actions in the American Continent of today: a) political commitment to change, b) health/illness as a social fact, c) the importance of science in the construction of the discipline and d) the responsibility of the State for health.

In this paper I have tried to illustrate certain issues: 1) the historical roots and meaning of the term social medicine and b) the delineation of its particular characteristics. I have also examined three simultaneous evolutions: c) from a focus on health/illness to an emphasis on health practice, d) from the insistence on establishing differences between disciplines to the search for unity in action, and e) from the academic arena to other fields of practice.

We have been creating our identity through social medicine as a transformative political program that fights for the right to health, built with the support of different viewpoints and via consensual methods. The potential for our further development lies in the expansion of transformative experiences in the field of collective health that enable the opening spaces and paths toward the fight for health as a right through the commitment and empowerment of the people.
Health Equity: Conceptual Models, Essential Aspects and the Perspective of Collective Health
Authors: Linares-Pérez Nivaldo , López-Arellano Oliva
Published: January 2025

This paper analyzes the concept of health equity, drawing on ideas of social justice, of rights and values, and of the social and economic determinants which define living conditions and power relations among social groups. Differing schools of thought concerning health inequality and inequity in health are considered, highlighting contemporary approaches and the conceptual and operational diversity of definitions. We adopt the viewpoint of collective health and outline the elements which are essential to the understanding of inequity: the role of social, economic, political, cultural and ideological determinants on the equity of health outcomes, access to services and quality of care. We conclude that theoretical/conceptual frameworks must be formally spelled out before we can advance our understanding of health equity. The use and interpretation of terminology is made problematic by the abundance of definitions, although there appears to be a consensus on the need to further explore - in a varied, complementary and integrated manner - aspects of health care itself and of its environment. From a collective health perspective, we need to move beyond traditional approaches, a challenge which will enable better understanding of the social dynamics which, when expressed as inequalities in health, constitute social inequity.
Social Determinants of Health: Perspective of the ALAMES Social Determinants Working Group
Authors: López Arellano Oliva , Escudero José Carlos , Carmona Luz Dary
Published: January 2025

Introduction The recent discussion of the social determinants of health, which has been promoted by the WHO as a way to approach global health conditions is neither a new nor a foreign subject for Latin American social medicine or collective health. Indeed, this approach to health derives from the principles of 19th century European social medicine which accepted that the health of the population is a matter of social concern, that social and economic conditions have an important bearing on health and disease, and that these relationships should be subjected to scientific enquiry. (Rosen, 1985:81) The specific socio-historical conditions of Latin America in the 1970’s fostered the development of an innovative, critical, and socially-based based health analysis, which was seen in an evolving theoretical approach with deep social roots. (Cohn, 2003) This analysis calls for scientific work which is committed to changing living and working conditions and to improving the health of the popular classes. (Waitzkin y col. 2001; Iriart y col. 2002). From its beginning, this school of socio-medical thought recognized that collective health has two main areas of research: 1) the distribution and determinants of health and disease and 2) the interpretation, technical knowledge, and specialized practices concerning health, disease, and death. The goal is to understand health and disease as differentiated moments in the human lifecycle, subject to permanent change, and expressing the biological nature of the human body under specific forms of social organization, all this in such a way as to allow discussion of causality and determination. (Breilh y Granda,1982; Laurell, 1982). Latin American social medicine criticized biomedical and conventional epidemiological approaches for isolating health and disease from social context, misinterpreting social processes as biological, conceptualizing health phenomena in individualistic terms, and adopting the methodological procedures of the natural sciences
Autopsy on the AMA: An Analysis of Healthcare Delivery Systems in America [1970]
Authors: Woodard Joe
Published: January 2025

Prepared by: Cy Schoenfield, Janet Brown, Joe Woodard,
Jeff Brown, Martin Brown, Charles Turner, Jill Hill

Published in 1970 by Student Research Facility, Berkeley, California

Reproduced from the US Heath Activism History Collection
Rare Book and Manuscript Library, University of Pennsylvania
"The United States (has) a quality of medical care unsurpassed anywhere," said Dr. Milford O. Rouse, President of the American Medical Association (the AMA) in 1967. His position at the pinnacle of the most powerful country's most powerful medical organization certainly gave him the authority to say that with confidence.

"People respect doctors. In fact, 92% of the public feels most doctors can be trusted. People in the medical therapy professions are admired and the communities they serve reward them well for their work. Doctors averaged $31,400 a year in 1967 and their median income was $32,170 in 1968. These figures are approximately five times the average and median
incomes for the general population.

"Medically speaking, things seem to be going well. The drama of headlines about organ transplants and new medical advances in the laboratory also serve to indicate that the System that provides health care for Americans does its job splendidly.

But does it, really?"
The Economic Crisis and Public Health
Authors: Levy Barry S. , Sidel Victor W.
Published: January 2025

The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.
Lessons from Mexico’s H1N1 Influenza Outbreak
Authors: Social Medicine Association Latin American
Published: January 2025

1. Mexico needs to rebuild an efficient epidemiological monitoring system which can react in a timely manner to unusual infectious outbreaks. SINAVE, the National Epidemiologic Monitoring System, showed itself incapable of responding opportunely and effectively to the increase of pneumonia cases which was reported as early as February 2009. Nor did SINAVE pay sufficient attention to the inhabitants of Gloria, Perote, Veracruz when they complained of an outbreak of respiratory illness. 2. Priority should be given to forming teams with the technical capacity to identify the earliest cases of any new outbreak and then to immediately establish quarantine procedures. These teams should be housed within the National Public Health System and should be properly structured, well organized, and coordinated on the national level. There can be no doubt that the recent public health emergency in Mexico demonstrated the disorder and disorganization which have resulted from dismantling of Mexico’s national public health system. The deficiencies in Mexican public health result from several decades of disinvestment in the public sector and of favoring privatization and technological dependency on transnational companies. The lack of effective and consistent communication, guidance, and policies in response to the emergency made clear just how the current system reinforces social exclusion by not responding to the needs of the population. [continued...]
An Interview with Sir Michael Marmot
Authors: Editors The
Published: January 2025

In August of 2008 the WHO Commission on the Social Determinants of Health concluded its work with the publication of a report entitled: “Closing the gap in a generation: Health equity through action on the social determinants of health.” The Commission’s chair, Sir Michael Marmot, was kind enough to answer our questions about the Commission’s recommendations. This interview was conducted by email in May of this year.
XI Congress of Latin American Social Medicine & Collective Health
Authors: Torres Tovar Mauricio
Published: January 2025

The Latin American Medical Association (ALAMES) will be hosting the 11th Congress of Latin American Social Medicine and Collective Health from November 17-21 in Bogota Colombia. This meeting will coincide with the 25th Anniversary of the founding of ALAMES and its theme is the role health in the Latin American political and social agenda. Below we present an abridged version of the planning document for the conference. The complete version is available in Spanish in Medicina Social. More information can also be found on the ALAMES website (www.alames.org) The Editors The 11th Latin American Congress of Social Medicine and Collective Health is both a convocation and a celebration. It’s a convocation to create bold and innovative alternatives to the profound crisis of neoliberal globalization, a crisis that is only beginning. The response to this crisis cannot be limited to the socialization of the losses incurred by the speculators. Now is the moment for proposing and bringing about a true change in global direction.
The Ongoing Legacy of the Spanish Civil War for One Family
Authors: Angulo Menassé Andrea
Published: January 2025

This paper examines the health consequences of the Spanish Civil War for a family of Repub-lican militiamen who defended the socialist project in a divided Spain between 1936 and 1939. The consequences of the Civil War are traced in their children and grandchildren. Interviews with members of a family of socialist political exiles revealed how the war against Spanish fascism affected their lives and their bodies. As children, the adults had been forced to flee Spain for their very lives, accompanying their parents first to France and later to America. Once the war was over, those who remained in Spain were enveloped in a wave of terror which forced them to hide and then escape across the border. As socialist families in resistance, they were under constant threat of death. Based on the testimony of various generations, this paper traces the messages transmitted from grandparents to parents, from parents to children, and from grandparents to grandchildren, focusing on how those messages affected their mental health. This evidence supports my hypothesis that, in the context of war, it is not necessary to have been on the front lines to suffer the trauma caused by the material conditions of terror and persecution. Nor was it necessary to have personally suffered the experiences of exile and the persecution in 1939 to carry the burden of what the Civil War meant in terms of the loss and failure of a utopian political project. The violence was like a tattoo engraved on all generations of the family, even - and perhaps especially - on those born in the country of refuge.
Closing the Gap: Where are we one year later?
Authors: Editors The
Published: January 2025

August 28, 2009 marks the first anniversary of the WHO Commission on the Social Determinants of Health’s report: Closing the gap in a generation: Health equity through action on the social determinants of health. Noting that “Social injustice is killing people on a grand scale,” the report challenged the international community to achieve health equity within a generation.
In this editorial we offer a brief reflection on where things stand with respect to health equity one year later. Our Themes & Discussions section includes two additional commentaries. Dr. José Carlos Escudero explores the meaning of the report for the WHO and underscores the report’s limitations. A detailed critique of the report, along with an alternative approach to addressing health inequities, is offered by Dr. Anne-Emanuelle Birn. Dr. Birn’s critique is especially important for offering important historical background.
Asa Cristina Laurell receives an honorary doctorate from University of Buenos Aires
Authors: Editors The
Published: January 2025

Dr. Asa Cristina Laurell, a member of our Editorial Advisory Board received an honorary degree from the University of Buenos Aires on September 2, 2009. The editors of Social Medicine would like to congratulate her on this honor which recognizes her academic contributions, her daily labor to promote social medicine, her commitment to social justice, and her untiring political commitment to promote health as a human right. We present here a brief summary of her life and work
Declaration of Bogota
Authors: Social Medicine Association Latin American
Published: January 2025

The attendees of the XI Latin American Congress of Social Medicine, meeting on the twenty-fifth anniversary of the Association, affirm...
Historical and Contemporary Factors Contributing to the Plight of Migrant Farmworkers in the United States
Authors: Koreishi Safina , Donohoe Martin Thomas
Published: January 2025

Migrant farmworkers provide an essential service and perform jobs that many Americans are unwilling to do. Immigration practices and policies dictate the extent to which undocumented migrant farmworkers have access to governmental health and social services, and are ever-changing based on the political climate. This paper reviews historical and contemporary United States government policies relevant to migrant farmworkers. It refutes some of the common myths regarding documented and undocumented immigrants and migrant farmworkers, such as "U.S. public health insurance programs are overburdened with immigrants," "undocumented immigrants are taking advantage of the American system by 'free riding' and are a 'drain on the economy,'" and "undocumented immigrants take American jobs." Even though their jobs involve significant occupational hazards, undocumented migrant farmworkers are ineligible for government services, and employers generally do not provide these workers with health insurance. Migrant farmworkers also face food insecurity, poor housing conditions, impaired access to education for their children, and even human rights violations. These conditions, as well as the nature of their work, affect the health of undocumented migrant farmworkers and their children. This paper analyzes these inequities and calls for a more just and equitable system that treats migrant farmworkers fairly and provides them and their families with social services and health care.
Social Network Analysis in Transnational Settings: The Case of Mexico City’s AIDS CBOs
Authors: Barnes Nielan
Published: January 2025

Using a case study approach, I show how transnational civil society networks both help and hinder community-based HIV/AIDS organizations by providing opportunities for community-state partnerships that favor some local organizations over others, and (re)produce intra-organizational stratification at the local level. In the case of Mexico City, transnational ties encourage community-based AIDS organizations to develop formal organizational forms and strategies (negotiating fronts) which often enhance organizational sustainability and draw organizations into a closer relationship with the state institutionalized sphere. However, such ties also create divisions (political fronts) between outsider and insider organizations that compromise local inter-organizational collaboration and service delivery. As a result, transnational networks and resources solidify outsider-insider conflicts and balkanize service provision along political lines. The conclusions of this research are helpful to international health practitioners and social scientists seeking to understand how transnational networks and resources shape global civil society, and can both challenge and reproduce existing community-state power regimes and health inequities at local and transnational levels.
What kind of social protection for what kind of democracy? Dilemmas of social inclusion in Latin America
Authors: Fleury Sonia
Published: January 2025

It is very moving to be part of this celebration of 25th anniversary of ALAMES, the Latin American Association of Social Medicine. These many years have been filled with dreams, struggles, warmth and emotion, debates, disappointments. and hopes. Over this time we have aged and some of our dearest colleagues have passed away. Others left us. At times we grew disheartened; at others we were unable to see beyond our dogmatic positions and understand the need for change. But we regrouped, caught up with what was going on in the world, learned new things, added new partners, and built new strategies.

Our vitality arises from the very choices that define the field of social medicine. Collective Health (as it is called in its Brazilian version) examines the interrelation between the biological and social orders, in other words, the concrete, historical associations of social determinants which affect living beings and how they relate to each other. We see the “social” as a field of inquiry which combines knowledge and action, both the study and practice of social transformation.
An Overview of Latin American Health Policies and Debates
Authors: Laurell Asa Cristina
Published: January 2025

It is now 15 years since the publication of Investing in Health (World Bank, 1993), a report which set the course for health care system reform in Latin America and around of the world. Since that time a great many studies about the reforms have been published and new reforms have been launched to “correct” the defects of the earlier ones. The objective of this paper is to call into question the entire current political debate over health care, as well as to clarify key concepts and practices. To this end I will analyze the current vogue of interrelated proposals for a second reform of the state. I will examine debates over insurance as a way of grant universal coverage; the separation between the regulation, financing and provision of health services; and the public private partnerships for the construction, financing, and management of hospitals. This paper will also examine the development of a new scientific discourse around “evidence-based policies” and academic referral networks. The goal of this paper is not to offer a comprehensive treatment of these issues, but rather to question some assumptions and contribute to the larger debate.
Health Care Reform: a Socialist Vision
Authors: Livingston Martha , Capps Linnea
Published: January 2025

At first glance, it doesn't seem as though socialism and health-care reform have a whole lot to do with each other. After all, the most visible "left" position in the current discussion of health-care reform merely advocates for the government to assume the function of national insurer, leaving the delivery of health care - from its often-questionable content to its hierarchical relationships - firmly in place. As such, a single payer, Medicare-for-All insurance program is a modest, even tepid reform.

Those of us on the left who have been active in the single payer movement have always seen it as a steppingstone toward health-care justice: until the question of access to care is solved, how do we even begin to address not only health care but also health inequities? How, for example, can working-class Americans, Americans of color, and women demand appropriate, respectful, humane, first-rate care when our ability to access any health-care services at all is so tightly constrained?
The Effects of Public Infrastructure and Household Characteristics on Inequality and Infant Mortality in Mexico: What Has Changed Between 1990 and 2005?
Authors: Meindl Richard S. , Roldán Amaro Jose Antonio , Thompson Cynthia , Gregory Tremaine L. , Álvarez Izazaga Marcela , Saucedo Arteaga Gabriel
Published: January 2025

The reduction of infant mortality (IM) continues to be a primary goal throughout much of the developing world, and a suite of methods have been proposed with which to achieve it. However, most attempts at IM reduction have taken place within the context of an almost bewilderingly complex regimen of simultaneous changes occurring in the physical environment, sociopolitical structure, and health care. Which of these various elements is truly causal in reducing IM and which may be merely a correlated but nonprimary agent? During the past two decades Mexico has constituted an extraordinary field laboratory with which to decipher the roles of these various potential agents of IM reduction. Health resources include community access to proper drainage, safe drinking water, electrical power, as well as a suite of individual, if highly intercorrelated, family and household characteristics. Despite considerable demographic and socioeconomic heterogeneity, dramatic reductions in IM have been achieved, and additional ones are certainly possible. We weigh the factors that have reduced infant mortality in this country. Particular infrastructure improvements in the Pacific South, the Gulf, and the Yucatan peninsula must be continued. This would impact both inequality and, in turn, infant health and survival in this country.
Sleeping With the Enemy: "More Doctors Smoke Camels” Revisited
Authors: Anderson Matthew
Published: January 2025

In this issue of Social Medicine we offer readers two “classic” papers on tobacco activism which originally appeared in the New York State Journal of Medicine in 1983. These papers are introduced by Dr. Alan Blum who was editor of the journal at the time. This editorial will examine the modern equivalents of cigarette advertising and their connections with several of our most important medical associations: the American Academy of Pediatrics (AAP), the American Academy of Family Practice (AAFP), and the American Medical Association (AMA).
Cigarette smoking and its promotion: Editorials are not enough
Authors: Blum Alan
Published: January 2025

This article was originally published in The New York State Journal of Medicine, Volume 83, Number 13, pp. 1245 – 1247, 1983. It is reprinted here with permission. This article should not be reproduced without permission of the Medical Society of the State of New York.

-- INTRODUCTION --

This issue of the Journal marks the 20th anniversary of the first report on smoking and health by the Surgeon General of the United States Public Health Service. Preparations for the issue began one year ago with a letter to the present Surgeon General, C. Everett Koop, MD, requesting an interview on the subject of juvenile-onset cigarette smoking. Dr Koop's encouraging reply inspired other letters to individuals around the world who have been deeply committed to ending the cigarette pandemic.