Objective: To analyze changes in the concept of health-illness, from the perspective of epidemiology and in light of the economic, political, and social changes that occurred during the decade of the 1980s.
Methodology: Analytical and interpretive.
Results: Traditional concepts of health and illness have had to confront more integrated conceptual and methodological developments. These developments manifest greater capacity to capture the real complexity of processes of determination, to advance beyond a simple and unilateral vision, to describe and to explain the relations between more general processes of a society and the health of individuals and social groups. At the same time, this change represents the challenge to demonstrate that these developments really present greater potential to mobilize resources of power, to obtain favorable changes in life conditions and health profiles of different groups in the population, and to articulate through developments in strategic planning that would permit greater efficiency and effectiveness of health actions.
Within these conceptual transformations, epidemiology also is redefining itself. The author defines epidemiology in the following manner: Epidemiology has as its object the study of problems of health-illness at a collective level. The collective, the grouping, or the social is not the mere sum of individual processes, but in turn not only express itself at the level of groups but also at the level of the individual.
Castellanos reinterprets the concept of social situation and analyzes in detail the dynamic processes of determination in the context of health. He differentiates determination of cause, the singular space, the particular, and the general in defining of problems, explanation, and transformative action.
Conclusions: This article represents an advance in the understanding of the differences between the more traditional currents of public health and social medicine, and between classical epidemiology and critical epidemiology.
Copyright 2007 University of New Mexico