The Social Studies for Health Working Group is organized around health problems in Latin America in two main dimensions: the health conditions of the population and the institutional and non-institutional responses for their resolution. The issue of population health is characterized by a demographic process in recent decades of growth of the so-called demographic dividend, made up of a young population, while at the same time the population is aging through the lengthening of life expectancy for those over sixty, while the supporting population, the economically active one, is gradually reduced to levels that call into question the solidarity systems that require significant adjustments for their maintenance; at the same time, it is a population affected in its living conditions where 60% are in conditions of poverty. In terms of health problems, Latin America has changed significantly over the last three decades, and currently chronic-degenerative diseases account for 60 percent of mortality, while life expectancy in the countries is increasing. The dominant explanation for this change is that it is due to an epidemiological and demographic transition, an interpretation that is repeated in all official documents and in many academic studies. The approach from critical health thinking is that this is an epidemiological polarization in which the popular classes continue to get sick and die from infectious and nutritional causes as well as from chronic-degenerative diseases. Thus, a marked inequality in the face of illness and death continues to exist. At the same time, an emerging issue in collective or public health is the explosive growth of violence in its various forms. Although gender-based violence has received increasing attention, including from academic circles, the same cannot be said for homicidal violence against young men, as it is considered a public safety issue. This violence is becoming the leading cause of death among these men in several countries such as Mexico, Brazil, El Salvador and Venezuela, and it remains a major problem in Colombia. This violence is even reflected in a decrease in life expectancy. In Mexico, for example, it has reached the extreme in Cd. Juárez, where this indicator decreased in four years. For the GT, the problem of systemic violence is an area of ​​urgent exploration given that it is mainly directed against the poor population in marginalized urban areas and where repressive state forces frequently participate. Regarding the second area of ​​concern, the institutional response, which is the most widespread, but also the non-institutional response used by specific groups in the face of a lack of access to care for health and disease processes, the last decades have been characterized by reform processes that can be summarized in two major orientations and processes: countries whose subordination to the project of large international capital has meant the redesign of health systems, especially the public and social security sectors, through a privatizing reconfiguration. Since the late eighties, the World Bank has defined the reduction of the state's presence in social spheres and the reduction of its action towards the poor through basic actions. These processes have had different levels of progress depending on the political and institutional conditions of the countries. Their results in the most advanced cases, such as those of Chile and Colombia, indicate both strengths and weaknesses. The best and most important result has been a significant contribution to the processes of capital accumulation and concentration, which is expressed in an almost doubling of the share in GDP that must be deeply analyzed but is not expressed in the field of its substantive function, the resolution of health-disease problems. These processes, on the contrary, are increasingly deteriorated in terms of access, quality and comprehensiveness of care, as well as the availability of the human resources necessary for their care and their increasing flexibility. In this sense, health systems show, on the one hand, a profound disarticulation between levels of care and the deepening of the segmentation of the public sector, the emergence of various forms of commodification within it as well as the emergence of the private sector, without yet managing to establish a permanent alternative project or put an end to its readjustment. This has complicated the problems of access, care especially at the second level, and the problem-solving capacity and quality of both. On the other hand, there are the countries that have maintained the universalist conception in the organization of health services. The oldest surviving case is Cuba, which ranks among the countries with the best health indicators; Brazil, which, starting with the 1988 Constitution, opened the possibility of creating a Unified Health System and has made significant progress in its health, organizational, and participatory challenges; also, the emergence in the last two decades of alternative progressive governments, which, under new constitutions and other founding principles, have expanded access, participation, and training based on the development of existing or parallel public systems at the primary level, within the framework of projects of political and economic sovereignty and the construction of a decolonizing identity and recognition of indigenous peoples. Social and health policy has universalized rights and promoted social inclusion. In this complexity, the field of health requires ongoing recognition and monitoring of its characteristics as a social issue in its various dimensions, expressions, and levels of analysis, always within the framework of changes derived from the already established or emerging conditions of economic, political, institutional processes and the development of social struggles in each country.

The theoretical relevance of this topic lies in recognizing this field of health as definable by its object of study as part of the social question, whose characteristics, such as health-disease processes and the social response as both object of study and action, are socio-historically determined. This analytical perspective has been synthesized through the construction of what is known as social medicine and/or Latin American collective health, which originated as an academic concern and among organized groups in the 1970s. This current or perspective has drawn conceptually from the critical thinking available at any given time to clarify the general function of so-called medical practice as a hegemonic model within the framework of capitalist production and reproduction processes, especially since the 1980s in its neoliberal phase. Among these sources, one can cite 19th-century social medicine, which defined health and disease processes as a consequence of unhealthy environments and miserable living conditions, in contrast to the emerging biomedical thought that summarized the cause of disease as the relationship between agent, host, and environment, and grounded it in the isolation of Koch's bacillus as the causal agent, which could be targeted through medical intervention or vaccination. Social medicine and public health have drawn from critical social sciences, including authors such as Marx and Engels, who contributed the relationship between living conditions and health while also describing the first forms of intervention in the construction of the capitalist state; the Frankfurt School and its contribution of instrumental reason (Horkheimer); the analytical theory of science versus dialectics (Habermas); and the limits of legitimacy and accumulation (Offe). French post-structuralism and the contributions of Foucault, Bourdieu, and Passeron to the field of education and the reproduction of ideas are significant. Among Latin American thinkers, there is already a vast body of theoretical work that has identified problems surrounding economic, political, and ideological relations in the field of health. Thus, health in general, and its two objects of study—health-disease processes and the social response—are understood within their social determinants. That is, the characteristics of the intrinsic object or essential function are determined by the specific and long-term context, based on the functions of capitalist production and reproduction in general, and in this case, in dependent societies.

The defining characteristic of these health-disease processes in the current neoliberal period has been the weakening of the state's role and the introduction of economic reproduction models that have significantly transformed living conditions. This transformation has occurred through the imposition of free trade agreements, which have established the rules of operation for both international and domestic markets. These agreements have impacted labor processes, leading to increased flexibility, longer working hours, precarious wages, a high degree of technological dependence, and the existence of a parallel economy of drug and human trafficking, among other contributing factors. Simultaneously, neoliberalism has freed or reduced state controls on businesses. These companies, along with the use of networks and media operating under market models, have bombarded the population to intensify the consumption of manufactured goods. The results have included the loss of productive capacity, a lack of public oversight, unemployment, and processes of domestic and social violence that have deteriorated the health of populations. On the other hand, healthcare systems have become increasingly commodified, with varying degrees of intensity in each country. This has led to the erosion and discrediting of public and social security institutions, fostering and stimulating the development of a healthcare industry through the use of workers' contributions, state-funded private insurance, public procurement from private entities, and many other mechanisms. Simultaneously, this has meant a shift in the operation and characteristics of the medical-biological model, replacing medical criteria with economic ones and changing the central actors from physicians to economists, among other issues. Overall, we are facing deteriorating health conditions and dysfunctional healthcare systems.

On the other hand, we are witnessing the rise of progressive governments that have improved the living and health conditions of their people, as in the cases of Bolivia and Venezuela before the end of the boycott, while also exploring the difficult path towards decommodification and universal healthcare in local, regional, and national governments.