Maria Cecília de Souza Minayo

Qualidade de vida e saúde: um debate necessário

This paper discusses the relationships between quality of life and health by applying the discourses emerging in the health sector to other fields and other disciplines. These relationships constitute social representation based on subjective parameters (well-being, happiness, love, pleasure, personal satisfaction), and on objective ones such as satisfaction of basic needs and of the needs created by the degree of economical and social development of a given society. The text presents the main instruments which have been constructed during the last years for measuring quality of life, as well as the debate they cause. It also debates the semantic field where the representations and actions in favour of quality of life - such as the concept of development, democracy, quality, way and conditions of life - develop. In relation to the field of health, this article discusses the tendency to restrict the concept of quality of life to the biomedical area, associated with an economic assessment. It shows the variety of instruments created for measuring quality of life in accordance with the concept. Health promotion is considered one of the most relevant strategies in this field in order to avoid medical reductionism and to develop an interdisciplinary dialogue. It is argued that this proposal, however, still needs to be refined and tested in sanitary practices.

Quantitativo-qualitativo: oposição ou complementaridade?

Este trabalho resume um debate metodologico em processo na Escola Nacional de Saude Publica, Brasil, sobre as duas formas de abordagem mais correntes nas investigacoes da area de saude: o metodo quantitativo e o metodo qualitativo. Os autores - uma antropologa sanitarista e um bioestatistico - demonstram, com argumentacoes teoricas e praticas, que esses metodos sao de natureza diferenciada, mas se complementam na compreensao da realidade social. Num mundo onde o que distingue o ser humano e a linguagem comunicativa, o acento deste debate recai sobre a possibilidade, o significado e os limites da linguagem matematica e da linguagem de uso comum na experiencia cotidiana.

Violência social sob a perspectiva da saúde pública

Este artigo tem a finalidade de introduzir o leitor na tematica da violencia social, sob a perspectiva da Saude Publica. Desenvolve-se analisando o tema no âmbito da sociedade, no campo da saude expressa na mortalidade e morbidade. Termina refletindo sobre as propostas possiveis, setoriais, intersetoriais, interprofissionais e articuladas com a sociedade e os movimentos sociais.

Violence and injuries in Brazil: the effect, progress made, and challenges ahead

Although there are signs of decline, homicides and traffic-related injuries and deaths in Brazil account for almost two-thirds of all deaths from external causes. In 2007, the homicide rate was 26·8 per 100,000 people and traffic-related mortality was 23·5 per 100,000. Domestic violence might not lead to as many deaths, but its share of violence-related morbidity is large. These are important public health problems that lead to enormous individual and collective costs. Young, black, and poor men are the main victims and perpetrators of community violence, whereas poor black women and children are the main victims of domestic violence. Regional differentials are also substantial. Besides the sociocultural determinants, much of the violence in Brazil has been associated with the misuse of alcohol and illicit drugs, and the wide availability of firearms. The high traffic-related morbidity and mortality in Brazil have been linked to the chosen model for the transport system that has given priority to roads and private-car use without offering adequate infrastructure. The system is often poorly equipped to deal with violations of traffic rules. In response to the major problems of violence and injuries, Brazil has greatly advanced in terms of legislation and action plans. The main challenge is to assess these advances to identify, extend, integrate, and continue the successful ones.

Fatores de risco e de proteção para o uso de drogas na adolescência

Este artigo apresenta uma visao compreensiva da complexidade dos fatores de risco e de protecao para o uso de drogas na adolescencia. Discorre sobre a interdependencia dos diversos contextos - individual, familiar, escolar, grupo de pares, midiatico e comunidade de convivencia - propicios tanto ao risco quanto a protecao ao uso das drogas licitas e ilicitas, fornecendo, por ultimo, algumas estrategias de prevencao.

A complexidade das relações entre drogas, álcool e violência

This article discuss the complex relations between drugs and violence. Drawing on empirical studies and current forms of discourse, it analyzes conceptual and methodological problems related to the establishment of causal nexuses, risks, and associations. By demonstrating the theoretical and practical difficulties in such associations, it also points to the need for a debate in the field of public health and social policies. The article expresses concern that programs and prevention not be contaminated by fallacies, contributing nothing to an understanding of (or action related to) the social issue of drugs.

É possível prevenir a violência? Reflexões a partir do campo da saúde pública

As autoras discutem sobre as possibilidades e dificuldades de prevenir as diferentes formas de violencia a partir do campo da saude publica. Conceituam as nocoes de prevencao, promocao da saude e o complexo conceito de violencia. Situam o contexto brasileiro diante dos graves problemas que a violencia social significa para o setor saude e apresentam propostas de prevencao em diferentes paises, inclusive no Brasil, algumas ja em andamento, outras ainda em fase de elaboracao. Concluem que, por se tratar de um fenomeno historico-social, construido em sociedade, a violencia pode ser desconstruida. Dada a sua complexidade, qualquer processo de intervencao deve abranger questoes macro-estruturais, conjunturais, culturais, relacionais e subjetivas, bem como focalizar a especificidade dos problemas, dos fatores de risco e das possibilidades de mudanca.

Violência para todos

This paper investigates the problem of social violence based on the situation for mortality from external causes in Brazil, particularly in the city of Rio de Janeiro. Mortality data from the Brazilian Ministry of Health (consolidated by the Department of Epidemiology of the National School of Public Health in the period 1980-1988) are used in this study. Proportional mortality and mortality rates from external causes are given according to sex, age, specific groups of external causes, types of homicides, and traffic accidents. Despite being basically a descriptive study, this paper also studies homicides as the most significant cause of death in the configuration of violence in Brazil today.

A implicação da família no uso abusivo de drogas: uma revisão crítica

Este artigo apresenta uma revisao critica da literatura sobre a relacao entre adolescencia, familia e uso abusivo de drogas. Discorre sobre a importância da insercao do sintoma drogadiccao no contexto familiar e sociocultural para o entendimento de sua complexidade. A familia e vista como uma das fontes de socializacao primaria do adolescente, juntamente com a escola e o grupo de amigos. As praticas educativas e os estilos de criacao da familia, com seus tres diferentes tipos de controle parental, sao ressaltados porque podem facilitar, ou nao, o uso abusivo de drogas. Os resultados das pesquisas apontam para a importância de se engajar a familia no tratamento do adicto e alguns estudos ampliam o foco para engajar contextos sociais multiplos - familia, amigos, escola, comunidade e sistema legal - no tratamento do adolescente que faz uso abusivo de drogas.

Suicide among young people in selected Brazilian State capitals

This study analyzes suicide among young Brazilians (15-24 years old) in nine metropolitan areas. Mortality data for 1979-1998 were obtained from the Mortality Information System of the Ministry of Health. External causes are the main causes of death among youth, and suicide is the sixth most frequent of these causes. The distribution is heterogeneous, varying according to the social stratum, specific age group, sex, and means used to commit suicide. All cities analyzed showed increased suicide rates from 1979 to 1998 (from 3.5 to 5.0 per 100,000 inhabitants 15-24 years old). Salvador and Rio de Janeiro had the lowest suicide rates, while Porto Alegre and Curitiba had the highest. The principal means used by youth to commit suicide were hanging, strangling, and suffocation (Porto Alegre), followed by firearms and explosives (Belo Horizonte).