A saúde é social? representações de profissionais da estratégia de saúde da família no contexto (pós)pandêmico

Abstract

Since December 2019, the health crisis caused by the COVID-19 pandemic, which began in China, has exposed many social inequalities and weaknesses in territories and health systems, especially in countries of the Global South. In Brazil, the records have shown the heterogeneity of cases, revealing infected people and deaths among people of different age groups and places, but with a greater focus on vulnerable territories and situations where health services are poorly structured or in territories where negligence and trivialization have been observed in the fight against COVID-19. The pandemic has challenged the formulation of strategies to overcome the impacts caused by the new coronavirus, whether in health services, communities, home or work environments, representing a sudden threat to the usual flow of everyday practices. The general aim of this dissertation is to understand the representations of Primary Health Care (PHC) professionals, who worked at this level of care during the pandemic, about health and illness as social phenomena. This was a qualitative, descriptive and comprehensive study carried out in three Basic Health Units (BHUs) in a medium-sized municipality in Minas Gerais. The study population consisted of 16 health professionals linked to the UBS. The fieldwork was carried out using individual semi-structured interviews. The information obtained from the interviews was analyzed using the thematic analysis technique proposed by Braun and Clarke (2006). The results revealed aspects related to: (I) the impact on physical and mental health, with reports of anxiety, depression, desire for suicide and chronic and communicable diseases; (II) social inequalities, exacerbating the difficulty of access to basic resources; (III) changes related to work processes and organization to ensure care and safety at the same time; (IV) health measures and local responses to the crisis; (V) vaccination against COVID-19; and (VI) the consequences on education and the economy, including unemployment and loss of income and the closure of schools and businesses. The interconnection between the results leads to an understanding of how difficult it is to completely separate these domains, as they interact and influence each other, and provokes reflection on the pandemic from a social practice perspective. The experience of the pandemic is not just a matter of individual subjectivity, but involves relationships and interactions between different social actors. This approach reconceptualizes health, broadening the view beyond the mere normality of organs. Instead of focusing exclusively on physical health and the absence of pathological conditions, this perspective sees health as a state of integral well-being that includes social, emotional and psychological aspects. It recognizes that social factors such as inequalities, working conditions and access to resources have a significant impact on people's health.