Medidas de salud pública y estigma

Fernando García; Miguel Ángel Royo Bordonada

doi:10.1344/rbd2019.0.27795

Autors/ores

Fernando García Instituto de Salud Carlos III https://orcid.org/0000-0002-4802-2650
Miguel Ángel Royo Bordonada

DOI:

https://doi.org/10.1344/rbd2019.0.27795

Paraules clau:

salut pública, classes socials, estigma, discriminació, deliberació democràtica, supervisió ètica, ètica en la salut pública, tabac

Resum

Moltes mesures de salut pública poden tenir un impacte important en determinades classes o grups socials desfavorits. Això pot atenuar, almenys temporalment, les desigualtats socials en salut, en la mesura en què aquests grups tenen una prevalença major de les condicions que les mesures de salut pública volen afrontar, però també pot estigmatitzar-los, la qual cosa a la llarga conduiria a exacerbar de nou les inequitats en salut. Es descriuen els conceptes de classe social, classisme i estigma. S'analitzen diferents corrents de pensament que han concebut el paper de l'estigma dins de la salut pública. S'accepta que en condicions excepcionals es poden defensar algunes mesures de salut pública amb certs efectes estigmatitzadors com una conseqüència indesitjada, però mai de forma deliberada, com a component nuclear o exclusiu de la intervenció. Finalment, es comenten diverses condicions que han de complir-se per evitar o minimitzar l'estigma en les actuacions de la salut pública: la participació de les classes i grups socials involucrats en la presa de decisions; la supervisió ètica independent; defugir la individualització dels problemes de salut pública i posar l'èmfasi en què són problemes predominantment col·lectius; la compensació suficient a les persones i grups perjudicats; i l'esforç per afrontar i corregir les causes profundes i estructurals de les desigualtats en salut.

Biografies de l'autor/a

Fernando García, Instituto de Salud Carlos III

Médico epidemiólogo, Doctor en Medicina. Máster en Bioética y Derecho. Miembro del Observatorio de Bioética y Derecho, UB.

Email: fjgarcial@isciii.es

Miguel Ángel Royo Bordonada

Escuela Nacional de Sanidad, Instituto de Salud Carlos III; Sinesio Delgado, 8, 28029 Madrid;

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