Breilh J, Granda E. Epidemiología y contrahegemonía. [Epidemiology and counter-hegemony]. Social Science & Medicine 1989;28:1121-1127.

Objective: To analyze the scientific output of different Latin American groups and their contribution to the task of transforming the sciences related to public health.

Methodology: Analytical and interpretive, based on critical thinking in Latin American social medicine.

Results: The authors examine different tendencies and perspectives in the social sciences, as applied to the study of healthcare in Latin America . They demonstrate the heterogeneous nature of the scientific output and analyze it in terms of the different structural conditions within countries (different levels of development of productive forces and relations of production). In this manner, the authors note that varying social conditions in different countries pattern the epidemiological studies produced by various groups. The authors also point out the differences between the studies pursued by social scientists interested in healthcare and studies pursued by other scientists connected to the health sciences who focus on the question of social determinants.

Lastly, the authors point out the importance of understanding the real situation or problem from which epidemiological work flows: the concrete conditions of workers (male and female) in industries; of those living in urban neighborhoods; and of peasants and ethnocultural groups within the rural economy.

Work in Latin American critical epidemiology occurs in the face of conceptual obstacles. These obstacles include the influence of empirical functionalist thought, the technocratic outlook, and the conservative psycho-cultural tendencies that tend to disregard the historical context, social structure, and the exercise of power.

Conclusions: The authors conclude that critical epidemiology must make a radical break from conventional empirical epidemiology. A simple juxtaposition between them is not possible. If this break is not made, the conservative elements of functionalist scientific tendencies will remain in force and work against the social purposes of critical epidemiologists.

Copyright 2007 University of New Mexico