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Howard Waitzkin, MD, PhD, Celia Iriart, PhD, MPH, Alfredo Estrada, MD and Silvia Lamadrid, MA

Howard Waitzkin and Celia Iriart are with the Division of Community Medicine, Department of Family and Community Medicine, University of New Mexico, Albuquerque. Celia Iriart is also with the Central Organization of Argentine Workers (Central de Trabajadores Argentinos), Buenos Aires, Argentina. Alfredo Estrada and Silvia Lamadrid are with the Group for Research and Training in Social Medicine (Grupo de Investigación y Capacitación en Medicina Social), Santiago, Chile. Silvia Lamadrid is also with the University of Chile, Santiago.

Correspondence: Requests for reprints should be sent to Celia Iriart, PhD, MPH, University of New Mexico, 2400 Tucker Ave NE, Albuquerque, NM 87131 (e-mail: iriart{at}unm.edu).

ABSTRACT

The accomplishments of Latin American social medicine remain little known in the English-speaking world. In Latin America, social medicine differs from public health in its definitions of populations and social institutions, its dialectic vision of "health–illness," and its stance on causal inference.

A "golden age" occurred during the 1930s, when Salvador Allende, a pathologist and future president of Chile, played a key role. Later influences included the Cuban revolution, the failed peaceful transition to socialism in Chile, the Nicaraguan revolution, liberation theology, and empowerment strategies in education. Most of the leaders of Latin American social medicine have experienced political repression, partly because they have tried to combine theory and political practice—a combination known as "praxis."

Theoretic debates in social medicine take their bearings from historical materialism and recent trends in European philosophy. Methodologically, differing historical, quantitative, and qualitative approaches aim to avoid perceived problems of positivism and reductionism in traditional public health and clinical methods. Key themes emphasize the effects of broad social policies on health and health care; the social determinants of illness and death; the relationships between work, reproduction, and the environment; and the impact of violence and trauma.

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