Social determinants and possibilities for participation in public policy

ALEJANDRA SÁNCHEZ CABEZAS, NATALIA CASTELNUOVO Y CLAUDIA BALENZANO

JOURNAL OF URBAN HEALTH

SPRINGER

Lugar: Springer US; Año: 2009 vol. 86 p. 415 - 416

1099-3460

Background: Our paper examines factors that facilitate or impede access to avenues of participation in the public policy process. We propose to present the analysis of selected representations of community participation and organization that various social actors expressed in regards to the clientele of health services at different sites where we provide community health promotion programs. Methods: Our study draws on surveys, in-depth interviews, and focus groups carried out with educators, residents, and healthcare personnel in northern Argentine provinces between 2003 and 2005. In these cases, residents themselves identified social determinants relating to the role of the state, forms of participation, health and access to healthcare services. Results: An in-depth look at these determinants allows us to examine?on the one hand?underlying assumptions regarding groups that are often labelled as ?in need,? ?vulnerable,? ?marginalized groups? or ?poor.? And, on the other, it allows us to increase our understanding of how a reliance and emphasis on concepts such as ?marginality,? and ?exclusion? tend to create a disregard for the kinds of relationships that they produce on a day-to-day basis. Conclusions: In this sense -and in light of the data collected- it is possible to show that the representations made by doctors, educators and other service providers regarding their clientele as being ?passive,? ?dependent,? ?liable,? and ?lazy? are in fact closely tied to concepts that, in turn reproduce the conditions which they ought to be changing.