Promoção da saúde em espaços sociais da vida cotidiana

Abstract

The present study holds as premise that day-to-day life is fraught with norms and rationalitythat limit health promotion as a possibility for subjects and their choices on ways of life. Thegoal of this study was to analyze the way of life in social spaces of day-to-day life, graspingthe meaning and sense of health-promoting practices. The referential of Sociology of day-todaylife was adopted as theoretical and methodological framework. The study was performedon the territory covered by the Health Center São José, in the Northwest Sanitary District inthe municipality of Belo Horizonte. Seven spaces were chosen for the analysis of day-to-dayhealth-promoting practices: school, health service, neighborhood association, elderly citizensgroup, gymnastics group, recreation club and jogging track. In these spaces, the developeddiscourses and practices were revealing of the sense and meaning of health promotion invectors that are articulated in the macro-social way-of-life and micro-social routine spheres,and which pose health promotion as a political issue. The results indicate that way of life inthe study scenario is stained with deprivations. In this context, dependence vis-à-vis publicpolicies and social networks give meaning to day-to-day routine. In the participantsdiscourses, health and quality of life are regarded focally, with an emphasis on the capacityto live (or survive), not reaching the broader meaning of relation with structuralmacrodeterminants. Health-promoting practices in different social spaces reveal mechanismsof social control and management of vulnerable populations. There is a preponderance offocal practices on disease, risks or deviations from normality, which contribute little to theinterruption of medical socialization. Thus, there is a feedback of the biomedical paradigm,materialized in different practices and spaces (beyond traditional health services), which,together with the sense and meaning generated by people regarding health, configure a newrationality. The analysis of practices made evident the logic behind the organization ofregulating discourses of health promotion, which repeat patterns, rules and regulations inday-to-day life spaces. Hence, the forces of circulation of power, centered on evokingknowledge-power from the State and organized movements of civil society confer on thepractices their character of maintenance of medical socialization, as they becomemechanisms of social regulation and control. With that, autonomy-granting possibilitiesprovided by the practices identified in the territories are less expressive than their regulatingand medicalizing potential. It is concluded that health promotion in social spaces of day-todaylife poses the challenge of widening the autonomist potential in the actions of individuals,albeit without relieving from the State and organized civil society the responsibility ofproviding structural conditions that favor the creation of new habits. Thus, one has tobroaden the synergistic relationship of each individual with oneself, with others from thesame context and with the State, in a way that guarantees health promotion as a citizen right.Hence, promoting health implies in sealing social pacts and creating strategies for promotingcitizenship; overcoming focal and fragmented practices; implementing inter-sector actions;and developing co-responsibility between the government and communities, thusguaranteeing political sustainability, effectiveness and resolution capacity of localdevelopment propositions.