Classes sociais e a desigualdade na saúde

Abstract

A presente investigação pretende analisar a relação entre a estrutura de classes sociais e as desigualdades na saúde, procurando explicar os mecanismos mediadores que convertem o social no biológico. Sustenta-se como hipótese central que as desigualdades inscritas na ordem social se traduzem numa incorporação individual da desigualdade sob a forma de disparidades perante a doença e a morte, ou seja, que as relações que os indivíduos têm com os seus corpos e sintomas, com os sistemas de saúde e com as possibilidades de tratamento são condicionadas pela posição e trajectória social. No plano teórico recorre-se a contributos das áreas disciplinares da sociologia das classes sociais, da sociologia da saúde e da epidemiologia. Projecto assente numa estratégia de investigação de tipo extensivo-quantitativo, tendo por base a informação presente nos processos clínicos individuais dos óbitos ocorridos em 2004, em duas instituições hospitalares, uma localizada em Lisboa e a outra em Beja (N = 1935).

The main objective in this investigation is to analyse the effects of the social structure on the unequal patterns of morbidity and mortality in Portugal. The unequal distribution of the diseases and the causes of death in the social space, reveals a structure of social inequalities based in the differentiated possibilities in the access and in the use of health resources. The research was placed in two different regions of Portugal: one, in an urban region, the Portuguese capital, Lisbon, and the other, in a poorer and rural region, Beja. The purpose was also to compare different social structures, under the hypothesis that the geographical inequalities in health are a reflex of social geographic inequalities. The empirical methodology was located on the individual level and was based on a complementary of quantitative and qualitative strategies. The main information was based on the analyses of the “Hospital Individual Clinical Files” of people who died in 2004 from two hospitals (N = 1935). In each clinical file social and health dimensions were collected. Life trajectories, as well as illness trajectories were built regarding each patient, to demonstrate in the end, that over the life course, individuals positioned in different social classes experience different health and diseases trajectories.