OPACIFICATION AS AN ANALYTICAL CATEGORY IN PUBLIC HEALTH: PROCESSES OF CARE PRODUCTION, INSTITUTIONAL POWER, AND THE CONSTRUCTION OF SUBJECTIVITIES IN THE BRAZILIAN UNIFIED HEALTH SYSTEM (SUS)

Abstract

This study analyzes opacification as an analytical category in Public Health, understanding it as an effect of the institutional modes of organization of the Unified Health System (SUS) that make the rules, decision criteria, and recognition regimes that structure the production of care difficult to understand. It starts from the observation that power relations, epistemic hierarchies, and colonial legacies permeate the daily life of the system, producing invisibilities, silences, and restrictions on the agency of users, workers, and communities. The research adopts a narrative review method, allowing for the articulation of theoretical and empirical contributions from different fields, such as care in multidisciplinary teams, health education, collaborative research, indigenous health, emerging conditions, and digital technologies in health. The analysis shows that opacification operates transversally, simultaneously affecting the construction of subjectivities, the circulation of knowledge, and participation in decision-making processes, reproducing inequalities even in a system guided by principles of universality and equity. It is concluded that understanding opacification broadens the critical horizon of Public Health, offering an interpretative key to consider the limits of the Brazilian Unified Health System (SUS) and pointing out paths aimed at increasing institutional transparency, recognizing situated knowledge, and promoting effective participation in care.