Políticas públicas de saúde e determinantes sociais de saúde: relação saúde e doença na comunidade rural do município de Barreiras, Bahia

Abstract

The Social Determinants of Health must directly influence the formulation of public health policies for the rural population, which will be related to other public policies. An adequate and contextualized health policy takes into account the difficulties that pervade the rural environment, valuing community participation and improving health services, it benefits living conditions in rural communities. The general objective of the thesis was to investigate the relationship between social determinants of health and public health policies in a rural community in Barreiras, Bahia, Brazil. The specific objectives were: to identify the socio-demographic and economic characteristics of the participants; analyze practices in disease prevention and health promotion, as manifestations of public health policies, related to social determinants of health; to verify the perception of the impact of the DSS on diseases recognized in the community. The structure of the thesis consists of: presentation, introduction, chapter of methodological path, three final products in the form of an article and general final considerations. The first article is a systematic review of the literature that aimed to analyze the relationship between social determinants of health and public health policies in rural areas. The rural population is at a disadvantage in relation to public health policies because it does not consider their peculiarities. The second empirical article aimed to understand the relationship between social determinants of health and public health policy in a rural community in Barreiras, Bahia, Brazil. The research is characterized by being qualitative and descriptive. Data collection was carried out through semi-structured interviews at home. The results, based on the social determinants of health, demonstrate the majority presence of women, elderly and with disease prevention practices at the expense of health promotion. There is also a precariousness in community activities, a high sense of community, appreciation of the family, need for investments in infrastructure, presence of tranquility, pain related to work, insufficient food production on the property and use of traditional practices. It is concluded that rural communities based on social determinants of health need public health policies that encourage popular participation to create strategies in order to promote health. Therefore, research is proposed with people linked to the field, so that the population, professionals and managers know the important aspects of social determinants of health to improve quality. of this public's life. The third empirical article aimed to analyze the social determinants of health and its relationship with public health policies in the rural community of Barreiras, Bahia. The study was qualitative and descriptive, data collection took place through semi-structured interviews in the homes of three rural villages in Barreiras, Bahia. Data analysis was based on deductive categories created through social determinants of health and the subcategories were built with the aid of the ATLAS.ti program. The results of the subcategories were: predominance of women, overvaluation of the biomedical model, lifestyle close to nature, religiosity and spirituality, family and neighborhood, relationship between work versus health / illness, unemployment, housing beyond housing, insufficient income, feeling of social exclusion and the social role of rural women. From the data of this research, the relationship between social determinants of health and public health policies in the rural community of Barreiras points to a neglect, in which the living and working conditions of the population do not match the planning and actions that occur in that context. In summary, public health policies in the rural area of Barreiras do not take into account the social determinants of health that are present. For this reason, the living conditions of the rural population in the municipality may be impaired. In addition, strategies involving disease prevention are more prevalent, while actions for health promotion are little or not recognized