A territorial turn in research on health inequities
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Federal University of Minas Gerais (UFMG), Brazil
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1857
ABSTRACT
Background: Research on health inequities mostly focuses on describing different levels of exposure to (social) factors that influence health outcomes. While this overcomes still dominant biomedical and lifestyle approaches, it does not sufficiently engage with the processes that (re)produce health inequities and shape processes of embodiment. Territory and its correlates are increasingly being considered to explore such processes. Nonetheless, there remains a problematic ambivalence between notions of territory that broadly correspond to localization and an acknowledgement of territory as a relational, dynamic, and inherently conflictual appropriation of space. We make a case for a critical territorial turn in health inequity research. Methods: On the basis of theoretical insights from Critical Geography, Ecosocial Theory and Latin American Social Medicine and Collective Health, case studies on processes of health-disease and death in territories shaped by urban violence in Bogotá and Rio de Janeiro are analyzed with a territorial lens, revealing ways in which territorial dynamics shape processes of embodiment and health inequities. Results: The case examples underline the importance of understanding and systematically integrating a territorial lens in health inequity research as the territorial dynamics provide insights and reveal pathways of embodiment that results from direct and indirect territorial (un)making of both emancipatory and dominating, state-centered and bottom-up political projects that shape unequal exposure, susceptibility, experience and impact of what compromises health and wellbeing at multiple levels. In the case examples this is illustrated by mostly violent territorial (dis)ordering imposed by militarization of urban space, state violence, militias and globalized drug trade and its implications for well-being, ill-being and death in urban Latin America. Conclusions: A territorial turn is necessary to inform more sensitive and complex readings of health inequities and to reveal pathways of embodiment that challenge essentialist and individualistic approaches to population health (inequities), including urban violence and violent death.