Individualization in the Context of Contemporary Social Changes: The Challenges for Public Health in Brazil

Public health involves social action, scientific thinking and political practice, being also framed by individual-societal relations. Its landmark is the protection of life and, since its institutionalization in the nineteenth century, it held diverse political-institutional forms.

The reflexivity of modernity is characterized by the radicalization of the individualization phenomenon. This process produces new political and institutional challenges to both health and social protection, which is radically different from those established by the first modernity pact.

In a society like Brazil where there are great diversity of structures, forms, processes and social relations, the individualization phenomenon triggers a number of challenges for public health. Brazil, characterized as a developing country, coexists with classical structures and social forms of a modern capitalist industrial society, as well as, incorporates new contemporary dynamics that can be characterized as second modernity, as instance of individualization. These dynamics combine and intersect themselves, forming the Brazilian social fabric.

In this context, new challenges are addressed to the Brazilian Public Health: intensification of health medicalization and pharmaceutilization, increasing judicialiazation to access health goods and services, current impasses on the psyciatry reforrm and de-hospitalization, etc., all phenomena that compromise institutional structures and the country's public policies, requiring new protection arrangements to health and life. The pressure of individual interests, which is socially produced, also confronts the social and public role of the state, promoting and even changing the notion of health as a right, which is present in the Brazilian constitution and in the institutional model of the national health system. The right to health is transformed into a consumer good.

Apart from the fact that the complexity of individualization-public health relation in Brazil is extremely pertinent and challenging, it also allows us to reflect upon issues of strategic interests towards actions and health policies at global scale.