PRIMARY CARE AND THE SOCIAL DETERMINATION OF HEALTH: (IM)POSSIBILITIES FROM COMMUNITY PROCESSES

Abstract

Primary Health Care actions are referenced by the territory in which they operate and must be organized based on local needs and demands. In this context, it is important to highlight that in peripheral areas and areas of extreme poverty, serious, complex, and urgent situations involving the social determinants of health in capitalism are quite explicit. This social study in health, based on Historical Dialectical Materialism, focused on understanding community processes in confronting the social determinants of health in a highly vulnerable occupied territory and the possibilities of articulation with Primary Health Care. To this end, semi-structured interviews were conducted with local residents. The analysis was based on the core meanings of the discourse. Three main themes emerged: social inequality in capitalism, community and collectivization, and the role and place of the State. The study revealed a lack of coordination between the local health service and the specific needs of that population, with the primary health care unit being viewed by participants as a place for physical health care based on established symptoms. The study showed the difficulty of services in considering the social determinants of health and the expanded concept of health in comprehensive care, especially in vulnerable regions.