Social determinants or processes of determination? Anthropological reflections based on the experiences of women in the Brazilian Federal District during and after the COVID-19 pandemic

Abstract

Drawing on anthropological theory and a longitudinal qualitative study, this essay analyzes the social shaping of health, emphasizing its processual and dynamic nature. To this end, it presents different interpretations of the concept of the social determinants of health, contextualizes its emergence within the health field, and discusses contemporary critiques in Collective Health. It foregrounds the experiences of marginalized women in the Federal District during and after the COVID-19 pandemic, showing their agency and reflexivity regarding their living conditions. I argue that this agency and reflexivity demonstrate that living conditions do not operate as mere externalities; rather, they are actively recognized and mediated by the meanings that guide these women’s actions. Thus, countering a deterministic approach to the social determinants of health, this paper proposes understanding these determinants through theoretical frameworks that privilege the processual nature of social practices.