QUAL É O PESO REAL DOS ESTILOS DE VIDA NA SAÚDE DAS PESSOAS?

"When we just target the individual behaviours, we're neglecting to look at these systemic factors."

Em entrevista ao sítio na internet da Upstream: Institute for a Healthy Society, organização sem fins lucrativos, com sede no Canadá, Denis Raphael Professor de Health Policy and Management at York University em Toronto, investigador na área dos determinantes sociais da saúde e editor dos “Canadian Facts” chama à atenção para importância de uma abordagem sistémica centrada nos determinantes sociais da saúde, recusando a abordagem centrada nos estilos de vida "When we just target the individual behaviours, we're neglecting to look at these systemic factors."

Ao longo da entrevista o Professor Denis Raphael, fala sobre os determinantes sociais da saúde, defendendo uma abordagem sistémica uma vez que o enfoque numa abordagem centrada nos estilos de vida apenas representam, na melhor das hipóteses 10 a 15% da variação dos resultados em saúde.

“What they should be doing is recognizing, as Randolph Virchow pointed out, that medicine is actually a political activity, and that certainly, all things considered, you don't want people, if they have some control, to smoke. We much prefer that people have a balanced diet, and certainly all things considered, we'd want people to be more active than less active, but these factors themselves play a rather small role in health outcomes. The danger to all of this is that what it does is diverts attention from these far more important issues of living and working conditions. Also, the evidence that these so-called lifestyle approaches will actually improve the health of the most vulnerable is completely lacking.

What actually happens, with all this attention to the so-called lifestyle approach, all it really does is actually increase health inequalities, because the people that are in the best condition to actually make these changes in their lives are already the ones that are going to live longer anyway, and it's an insidious process whereby even when governmental and other agencies recognize the broader determinants of health, what they do is in their practical recommendations they drift, such that the term "lifestyle drift" has come to refer to the tendency of all of these public health, health agencies and governmental agencies, to rather than raise the issues of income and democracy and political control and power, they end up ignoring all of those and telling and implying that the causes of disease and illness are people's adverse behaviours.”