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RESUMOS EXPANDIDOS DE APRESENTAÇÕES DE CONVIDADOS

NATIONAL POLICIES FOR WORKERS' AND ENVIRONMENTAL HEALTH

POLÍTICAS NACIONAIS DE SAÚDE DO TRABALHADOR E SAÚDE AMBIENTAL

Daniela Buosi1, Luiz Belino Ferreira Sales1

DOI: 10.5327/Z16794435201816S1007

Brazil needs to overcome complex challenges to adjust the need for promotion of economic growth and social inclusion of a significant part of the population to environmental balance. In a country with highly diverse geographical areas, biomes, populations and patterns of social organization, such challenges are substantial. Sustainable development anchored in social justice, economic growth and environmental sustainability represents an option for the required transformation.

It is worth observing that the health of individuals, communities and populations is not dissociated from production processes, land use patterns, and individual and collective consumption. The negative impacts of such complex network of interactions are responsible for countless diseases and health problems which fall under the scope of environmental health surveillance and workers' health surveillance. The social determination of the health-disease process should be approached from the work and environment perspectives.

However, the complexities brought by new social and economic models in Brazil, including precarious working conditions and employment relationships, changes in the labor legislation, a weaker and more flexible role of the government in environmental preservation and care of the population's health, represents a new challenging scenario to the fields of environmental and workers' health.

Pollution, biome and land degradation, which in recent decades reached alarming levels, together with a model of goods and services production in which archaic and modern work processes conflictingly coexist, and flexibilization of rights with low economic sustainability - at a time when a demographic transition is consolidating in Brazil - are social and environmental determinants of health with strong impact on the deterioration of the quality of life of the Brazilian population, and point to the urgent need to develop a sustainable path.

It is no longer possible to analyze individuals and populations separately. Possible answers should have their point of departure in the social and environmental determinants of health. Health governance should develop broader views on the causes for the loss of the quality of life of populations, which invariably results in disease and death. It should understand that these issues are the consequence of economic models which impose degrading working and living conditions with poor social sustainability, and of the historical process of appropriation of nature, which has been predatory, as is known.

Although one might find support for workers' health actions and the role of the Unified Health System (SistemaÚnico de Saúde – SUS) in regard to the determinants of health - including the environment, labor, income, housing, sanitation and transport, among others - in the Federal Constitution (FC), the right to health - as maximum expression of quality of life - has been neglected in political decision-making and the legislation. If on the one hand the 1988 FC made health a right, on the other fundamental rights are being violated in association with economic recession and health budget freeze.

Although the current scenario in environmental and workers' health surveillance is adverse, a significant conquest in terms of public health policies was achieved with the recent publication of the National Policy of Health Surveillance. This achievement signals a process of resistance not only of health care within SUS, but also within social control. This policy embodies the ideal that the government is the single responsible for the management of health surveillance, which reinforces its universal and transversal role as guide of care delivery in the country.

The need for health sector, embodied by SUS in Brazil-agency, is crucial to ensure the right to high-quality public health. Vasconcellos, Gomez and Machado1 conclude their reflections on "what has been established and what remains to be done" in workers' health surveillance (vigilância em saúde do trabalhador–VISAT) by asserting "workers' health is at the center of a conflict arena, and VISAT is the ethical, political, technical and methodological tool to reinforce the side which usually losses its health, and even its life, in such arena."

 

REFERENCE

1. Vasconcellos LCF, Gomez CM, Machado JMH. Entre o definido e o por fazer na Vigilância em Saúde do Trabalhador. Cien Saude Colet. 2014;19(12):4617-4626.


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