Território-ambiente-saúde: análises do processo saúde-doença, e seus determinantes ambientais e sociais, em Buritirana, Palmas/TO

Abstract

The World Health Organization (WHO) posits that the health-disease process of individuals and populations is shaped not only by individual characteristics but also by socioeconomic, cultural, and environmental factors that act as health conditioners and determinants. Based on this premise, and considering the spatio-temporal variability of the health-disease process in a given territory, this thesis aimed to analyze the environmental and social factors that condition and determine the health-disease process of residents in the Buritirana District, in Palmas/TO. Methodologically, the research was conducted in three main stages. First, an epidemiological survey of the illness and mortality profile among the population attended at the Mariazinha Rodrigues Family Health Unit (USF) — the district's main health facility — was carried out by reviewing medical records from January 2019 to December 2023. Next, a questionnaire was applied, and a focus group was held with the 04 Community Health Agents (ACS) to understand these professionals' perspectives on the health and illness conditions of the district's population. To complement the analyses, a semi-structured interview was conducted with 10 residents/users of the USF services, living in the urban center, to survey their socio-environmental, health, and housing conditions. The entire field research journey was enriched by the technique of systematic observation. The qualitative and quantitative data collected in the research were submitted to content analysis and descriptive statistics techniques. The results indicate that the population's health-disease process (illness and mortality) is determined, especially, by the population's age group, which is predominantly composed of elderly individuals; by the fragility of access to more effective public health policies, a reflection of the territorial location being far from the municipal administrative center; and by the impacts of agribusiness. The intense agricultural activity, being the main economic base, structures the economic, social, and environmental aspects of the territory, directly influencing local living and health conditions. Therefore, this research has a significant social impact by exposing health inequities and the specific vulnerabilities of rural populations distant from urban centers. By linking the illness profile to socio-environmental determinants — notably the fragility of public policies and the impacts of agribusiness — the study provides a diagnosis that can subsidize the formulation and implementation of more adequate, territorialized, and equitable public health policies for the Buritirana District.