Interdisciplinaridade e Intersetorialidade: Desafios nos Processos de Formação e Trabalho Profissional

Interdisciplinaridade eIntersetorialidade: Desafios nos Processosde Formação e Trabalho Profissiona

Salud urbana, ambiente y desigualdades

Os ambientes psicossocial, econômico e físico, nos quais se nasce, cresce, vive e trabalha, afetam a saúde e a longevidade, tanto quanto o fumo, o exercício e a dieta. A atenção individual à saúde não é suficiente para prevenir ou controlar os efeitos das más condições ambientais. Evidências históricas e atuais apontam para o agravamento das condições de saúde das populações mais pobres, acompanhando processos de urbanização rápida. Esperadamente, o envelhecimento populacional num ambiente urbano de desigualdade social deverá agravar a situação de saúde da população mais pobre, resultando em mais sofrimento e em perdas econômicas para o país. Com base nestas justificativas, um grupo de professores da Universidade Federal do Rio Grande do Sul se organizou, via extensão universitária, para contribuir com a discussão e as iniciativas nacionais de intervenção sobre a saúde urbana. Os projetos do grupo abarcam: o debate sobre o impacto potencial de iniciativas privadas e políticas públicas setoriais (de habitação, saneamento, transporte, educação, inovação tecnológica, sustentabilidade ambiental etc.) na saúde urbana; a produção e divulgação de conteúdos sobre determinantes sociais e ambientais da saúde; a produção e disseminação dos indicadores de desigualdade social dos determinantes da saúde; a formação de recursos humanos; e a participação em redes sociais. A apresentação pública deste projeto cumpre o objetivo de contribuir desde já com essa discussão.The psychosocial, economic, and physical environment where we were born, and now are growing, living, working, and reproducing affect health and longevity as much as do smoking, exercise, and diet. Individual attention to health is not enough to prevent or control the effects of bad environmental conditions. Historical and current evidence show that a decline in the health condition of the poorest is associated with rapid urbanization. Population aging in an urban environment of social inequalities is expected to make the health situation of the poorest even worse, resulting in more human suffering and economic losses for the country. Based on these observations, a group of professors from the Universidade Federal do Rio Grande do Sul (UFRGS) organized themselves, through an extension program, to contribute on the discussion and national initiatives of intervention in urban health. The group’s projects are comprised of: discussions about the potential impact of private initiatives and sector public policies (housing, sanitation, transportation, education, technological innovation, environmental sustainability, and so on) on urban health; the production and dissemination of information about social and environmental determinants of health; the production and dissemination of new indicators of inequality as determinants of health; human resources development; and the participation in social networks. The public presentation of this project satisfies the objective of initiating the group’s contribution to this discussion.Los ambientes psicosocial, económico y físico en los cuales nacemos, crecemos, vivimos, trabajamos y nos reproducimos afectan la salud y la longevidad, tanto como el tabaco, el ejercicio y la dieta. La atención individual a la salud no es suficiente para prevenir o controlar los efectos de malas condiciones ambientales. Evidencias históricas y actuales muestran el agravamiento de las condiciones de salud de las poblaciones más pobres acompañando procesos de urbanización rápida. Previsiblemente, el envejecimiento de la población en un ambiente urbano de desigualdad social deberá agravar la situación de la salud de la población más pobre, resultando en más sufrimiento y en pérdidas económicas para el país. Con base en estas justificativas, un grupo de profesores de la Universidade Federal do Rio Grande do Sul (UFRGS) se organizó, a través de la extensión universitaria, para contribuir con la discusión y las iniciativas nacionales de intervención sobre la Salud Urbana. Los proyectos del grupo abarcan: el debate sobre el impacto potencial de iniciativas privadas y políticas públicas sectoriales (de habitación, saneamiento, transporte, educación, innovación tecnológica, sustentabilidad ambiental, etc.) en la Salud Urbana; la producción y divulgación de contenidos sobre determinantes sociales y ambientales de la salud; la producción y diseminación de indicadores de desigualdad social como determinantes de la salud; la formación de recursos humanos; y la participación en redes sociales. La presentación pública de este proyecto cumple con el objetivo de contribuir desde ya con esta discusión

Connections : can the 20th century coronary heart disease epidemic reveal something about the 1918 influenza lethality?

This essay proposes that the ecologic association shown between the 20th century coronary heart disease epidemic and the 1918 influenza pandemic could shed light on the mechanism associated with the high lethality of the latter. It suggests that an autoimmune interference at the apoB-LDL interface could explain both hypercholesterolemia and inflammation (through interference with the cellular metabolism of arachidonic acid). Autoimmune inflammation, then, would explain the 1950s-60s acute coronary events (coronary thrombosis upon influenza re-infection) and the respiratory failure seen among young adults in 1918. This hypothesis also argues that the lethality of the 1918 pandemic may have not depended so much on the 1918 virus as on an immune vulnerability to it, possibly resulting from an earlier priming of cohorts born around 1890 by the 1890 influenza pandemic virus

Spanish flu and early 20th-century expansion of a coronary heart disease : prone subpopulation

According to Stephen Jay Gould, “we have a strong preference for seeing trends as entities moving somewhere.” However, trends may instead be the product of relative expansions and contractions of different subpopulations constituting the system. Variation in attributes of coronary heart disease cases during the decline in coronary heart disease mortality suggests a change in the primary source-subpopulation of cases over time. It is proposed that an early 20th-century expansion of a coronary heart disease–prone subpopulation, characterized by high serum-cholesterol phenotype and high case-fatality—which contributed to most of the coronary heart disease cases and deaths during the 1960s—may have been a late result of the 1918 influenza pandemic. The same unusual immune response to infection that in 1918 killed preferentially men, whites, and those born from 1880 to 1900 (20–40 years old) may have “primed” survivors of those birth cohorts to late coronary heart disease mortality. Ecologic evidence in favor of a birth cohort and geographic association between both epidemics is presented. Cross-reactive auto-immune response upon reinfection could explain the excess coronary heart disease deaths reported during influenza epidemics from the late 1920s onward. Mimicry between the viral hemagglutinin and the apolipoprotein B or the low-density lipoprotein receptor could be the link between infection and hypercholesterolemia. The extinction of those birth cohorts would result in a relative increase in cases coming from a 2nd subpopulation, which was characterized by insulin resistance and chronic expression of low-grade inflammation markers and was comparatively less vulnerable to die acutely from coronary heart disease