Vivências de narrativas do processo saúde-doença em um contexto de transformações urbanas: um estudo no Morro das Pedras, Belo Horizonte

Abstract

Urban transformation interventions aim to improve residents' living conditions and promote more equitable and healthy environments. However, they can also lead to unintended harmful consequences. Understanding the effects of urban interventions in favelas on residents' health and well-being is mediated by a general comprehension of health and illness. Qualitative information, such as exploring the meanings attributed to the health-disease process, is important for deepening the understanding of the interventions' effects on the individual and collective experiences associated with them. Objectives: To understand the perceptions of the health-disease process among residents of the Morro das Pedras favela, which participated in urban transformation interventions under the PAC Vila Viva Program (PVV) in Belo Horizonte. Specifically, to identify conceptions of health and illness, neighborhood dimensions related to the health-disease process, and possible differences in residents' perceptions, in order to contribute to studies on the effects of urban transformation interventions on health. Methods: This is a qualitative study that utilized Reflexive Thematic Analysis (RTA) to analyze 37 semi-structured interviews conducted in 2018 with residents of the Morro das Pedras favela. The theoretical framework adopted was that of Social Determination of Health and Urban Health. Results: Residents' conceptions of health go beyond the presence or absence of diseases, encompassing psycho emotional aspects - such as emotional suffering, depression, and anxiety—and functionality, that is, the ability to perform daily activities and fulfill social roles even while living with illnesses. The perceptions proved to be heterogeneous, influenced by factors such as gender and generation. The neighborhood dimensions identified as affecting the health-disease process were basic sanitation, access and mobility, housing conditions, neighborhood relations, and multiple forms of violence (structural and symbolic), with ambivalent effects on health. Residents' health perceptions shaped the understanding of the effects of urban interventions on health, which, in turn, presented paradoxical effects. Conclusion: The study highlights the importance of considering the multidimensionality of the health-disease process, as well as the paradoxical effects of urban interventions, in studies and evaluations of their impacts on health.