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巴西统一卫生系统中工人健康的简史:进展与挑战

A brief history of worker's health in Brazil's Unified Health System: progress and challenges.

作者信息

Gomez Carlos Minayo, Vasconcellos Luiz Carlos Fadel de, Machado Jorge Mesquita Huet

机构信息

Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.

Núcleo de Promoção da Saúde, Ambiente e Trabalho, Diretoria Regional de Brasília, Fiocruz. Brasília DF Brasil.

出版信息

Cien Saude Colet. 2018 Jun;23(6):1963-1970. doi: 10.1590/1413-81232018236.04922018.

Abstract

This article draws on current understandings of workers' health in Brazil that emerged concomitantly with advances in the field of public health. It describes the institutional trajectory of the field of workers' health within the Unified Health System (SUS), emphasizing the challenges faced in developing actions in the sphere of workers' health surveillance. It synthesizes the often tortuous path taken over the last 30 years between multiprofessional training processes, coordination between different levels of the SUS, interinstitutional support, especially from public universities, and interaction with participatory processes. It provides an overview of progress and challenges in the face of continuous changes in working conditions and work organization and the limited effectiveness of government policies designed to address occupational health risks. Finally, it suggest that progress has come out of the intertwining of social and academic movements, with the opening up of institutional spaces that transform the SUS, reviving the underlying principles of participation and health promotion in broad vision of state policy.

摘要

本文借鉴了巴西当前对工人健康的理解,这些理解与公共卫生领域的进步同步出现。它描述了统一卫生系统(SUS)内工人健康领域的制度轨迹,强调了在开展工人健康监测行动中面临的挑战。它综合了过去30年在多专业培训过程、SUS不同层级之间的协调、机构间支持(特别是来自公立大学的支持)以及与参与性过程的互动之间常常曲折的道路。它概述了面对工作条件和工作组织的持续变化以及旨在应对职业健康风险的政府政策效果有限的情况下所取得的进展和面临的挑战。最后,它表明进步源于社会和学术运动的交织,以及制度空间的开放,这些空间改变了SUS,在国家政策的广阔视野中复兴了参与和健康促进的基本原则。

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