Social determination, no! Why?

Abstract

The article aims to provoke a discussion on the acritical use of the expression “social determination of health” and demonstrate the concept’s impropriety for representing the phenomenon’s complexity and the health/disease situations and all the questions involving the Collective Health field given the context of profound changes in postindustrial society. The article is organized as follows: the history of the term’s adoption and the vast scientific production that uses it in Latin America, including in Brazil; a description of determinism as a historical concept originating in Physics and Biology with reflections in the Social and Human Sciences; and a focus on contemporary sociological knowledge on determination and freedom, performing a critique of the concept. The article emphasizes the need for the Collective Health field to review some of its concepts based on the model of thinking in industrial society on which it was based. And it concludes: social determination, no! To accept that things are determined means to disdain the power of nature and the creativity and autonomy of the individual and society to act, ignoring the centuries-old experience that everything which is historically constructed can be deconstructed by human action and by reality’s randomness. Thus, any kind of libertarian work needs to take into consideration, among the given conditions, the personal, community, social, and self-organizing forces that interact for the preservation of the environment and individual and collective health.