Ciudad, salud y participación

Resumen

espanolLa ciudad de la Grecia clasica fue el escenario en el que surgio la medicina hipocratica, adquiriendo en su ambiente social democratico y racional una dimension especial la relacion de dialogo entre el medico y el enfermo. La ciudad a partir de la Edad Media se convierte en la suministradora de experiencias para luchar socialmente contra la enfermedad. La higiene publica y la patologia social deben su configuracion al analisis que proporciona su variada realidad. La Revolucion Industrial transforma profundamente el escenario urbano y sanitario, y plantea a la poblacion, mayoritariamente obrera, contradicciones y necesidades de participacion de caracter eminentemente politicas. Precisamente la cuestion de la participacion popular en materia de salud en un contexto de crisis del Estado de Bienestar lleva a desvelar su intima naturaleza politica, por encima de las apariencias tecnocraticas o filantropicas. EnglishThe paper explains how the cities of classical Greece saw the birth of hipocratic medicine and gave to it, thanks to the democratic and rational milieu that reigned in them, a special slant: patient and doctor discussed the case. It goes on the explain how from the Middle Ages onwards, the city became a hot bed for diseases that had to be counteracted civically. Public Hygiene and Social Pathology were both born of and shaped by this their nursery. The Industrial Revolution altered both the city and its health requirements beyond recognition and faced new population, for the main parte workers, with contradictions and a need for participation, in both cases of a decidedly political nature. The paper concludes that this question of popular participation in Public Health, within the overall context of a crisis of the Wellfare State, has brought out more clearly than ever the deeply political undertow of the issue despite its usual trappings of philanthropy and mere expertise.