The social nature of human health: re-readings of social determination in a historical-territorial key

Abstract

Since its emergence, public health has been marked by strong disputes over how to understand and intervene in the health processes. The biomedical and multicausal epidemiological perspective have occupied a hegemonic position; however, in the 1970s, the Latin American critical perspective of social determination began to question the ontoepistemological assumptions underlying health interventions and research. This recognition made it possible to move beyond discussions focused on specific diseases or isolated therapeutic developments, fostering a conceptual and political shift toward a collective health approach. Within this framework, efforts to illuminate the interdependence between historicity and territoriality in health, the political intentionality underlying health actions, and the complexity of the health-diseasecare- death processes have converged in what has come to be known as the critical historicalterritorial perspective. This essay examines the onto-epistemological and praxiological disputes within the field of public health, recovers the Latin American tradition of social determination characteristic of collective health, and presents an initial formulation of key categories of the critical historical-territorial perspective as a theoreticalpolitical project committed to emancipatory and transformative praxis.