Este curso fue sugerido al Programa de Estudios Latinoamericanos de San Diego State University en 1999.
Luis A. Avilés
Health Policy, Power and Inequality in Latin America and the
San Diego State University
Department of Latin American
This is NOT a course about prevalent diseases and their risk factors in Latin
America and the Caribbean. The purpose of this course is to examine historical
and contemporary health policy debates and their relation to social, economic,
military, cultural, and development policies and practices. The course reviews
the history of health policies in Latin America and the Caribbean since the 19th
Century age of imperialism, up to the current World Bank-sponsored health care
reform in the region.
The course pays particular attention to the theoretical and methodological
potential and limitations of different academic disciplines, such as medical
sociology, medical anthropology, epidemiology, bioethics, and policy studies.
Course readings and class discussions will emphasize critical perspectives that
challenge the orthodox/ humanitarian approach to medicine and public health, in
order to consider the social forces that shape health policy.
In order to contextualize class discussion within a particular historical and
geographical situation, course readings will focus on the specific situation of
a particular country or area. The readings encompass a variety of countries
aiming to be as representative as possible of the diversity of the region,
including the Hispanic and non-Hispanic Caribbean, Mexico, Central America, and
the Spanish, Portuguese and English speaking South America.
The design of the course aims to appeal to students with a public health
background as well as those with a social sciences/Latin American studies
background. Those students with a health-related background will learn about the
broader social determinants of health policy. Those with a social sciences/Latin
American studies background will learn about the public health implications of
economic and development policy. The course aims not just to increase the
intellectual knowledge on public health issues in Latin America and the
Caribbean but also intends to promote a practice of advocacy for social justice
To be able to contextualize a specific health policy or practice within the
broader historical, economic, political, social, and cultural situation of the
country or region.
To be able to identify public health consequences of social, economic,
military, cultural, and development policies and practices.
To be able to identify the potentials and limitations of different
disciplinary approaches to the study of public health problems.
1. Germs and Conquest
Oldstone, Michael B. A. Viruses, Plagues, and History. (Chapter 1:
Introduction). Oxford University Press, New York. 1997.
Noble, David Cook. Born to Die: Disease and New World Conquest, 1492-1650.
Cambridge University Press, Cambridge. 1998.
2. Militarism and the Origins of Tropical Medicine
Delaporte, Francois. History of Yellow Fever: An Essay on the Birth of
Tropical Medicine. MIT Press, Boston. 1991
3. Rockefeller Medicine in the Americas
Brown, E. Richard. Rockefeller Medicine Men: Medicine and Capitalism in
America. The University of California Press, Berkeley, 1979. Cueto, Marcos.
Missionaries of Science: The Rockefeller Foundation and Latin America. Indiana
University, Indianapolis. 1995.
4. Banana Medicine (Costa Rica)
Langley Lester D., and Thomas D. Schoonover. The Banana Men: American
Mercenaries and Entrepreneurs in Central America, 1880-1930. Kentucky
University Press. 1995. (Chapters 1: The World of the Banana Men, and Chapter 2:
Morgan, Lynn. Community Participation in Health: The Politics of Primary
Care in Costa Rica. Cambridge University Press. 1993. (Chapter: Banana
5. Population Policy and Reproductive Rights (Puerto Rico)
Hartman, Betsy. Reproductive Rights and Wrongs: The Global Politics of
Population Control. South End Press, Boston. 1995. (Chapters 6 The Birth of
an Ideology; and Chapter 7: The Population Establishment Today)
Ramírez de Arellano, Annette. and Seip, Conrad Seipp. Colonialism,
Catholicism, and Contraception: A History of Birth Control in Puerto Rico.
University of North Carolina, Chapell Hill, 1983. (Chapter 6: An Answer to the
6. The Social Production of Health and Disease: Epidemiologies from the
North and the South
Waitzkin, Howard. The social origins of illness: A neglected history.
International Journal of Health Services. 11(1) 77-103, 1981.
Krieger, Nancy. and Zierler, Susan. What explains the public's health? - A
call for epidemiological theory. Epidemiology. 7(1) 107-109, 1996.
Rothman, KJ; Adami, HO; Trichopoulos, D. Should the mission of
epidemiology include the eradication of poverty? Lancet, 352(9130):810-3.
Breilh, Jaime. Epidemiology's role in the creation of a humane world:
convergences and divergences among the schools. Social Science and Medicine
7. Critical Medical Sociology and Anthropology (Cuba and Haiti)
Navarro, Vicente. The underdevelopment of health and the health of
underdevelopment: An analysis of the distribution of human resources in health
in Latin America. In Vicente Navarro (editor) Imperialism, Health and
Medicine. Baywood Publishing Company, Farmingdale, New York, 1981.
Morgan, Lynn. Dependency theory in the political economy of health: An
anthropological critique. Medical Anthropology Quarterly. (N.S.) 1(2)
Farmer, Paul. AIDS and Accusation: Haiti and the Geography of Blame.
University of California Press, Berkeley, 1992.
Feinsilver, Julie M. Healing the Masses: Cuban Health Politics at Home and
Abroad. University of California Press, Berkeley, 1993.
8. Prostitution and Sexually Transmitted Diseases (Argentina)
Guy, Donna J. Sex and Danger in Buenos Aires: Prostitution, Family, and
Nation in Argentina. University of Nebraska Press, Lincoln. 1991. (Chapters
2: Dangerous Women; and Chapter 3: Venereal Disease, Public Health and
9. Cold War Medicine: Insurgency and Counterinsurgency in Health (El
Vázquez, Norma. Motherhood and sexuality in times of war: The case of
women militants of the FMLN in El Salvador. Reproductive Health Matters.
Fish, Joe and Christina Sganga. El Salvador: Testament of Terror. Zed
Books LTD, London, 1988. (Chapter 10: Welfare as Warfare).
Smith-Nonini, Sandy. "Popular" health and the state: dialectics of the
peace process in El Salvador. Social Science and Medicine, 1997 Mar,
Smith-Nonini, Sandy. Healing the wounds of war. The New Physician.
July-August 20-24, 1993.
Clements, C. Witness to War: An American Doctor in El Salvador. Bantam
Books, New York, 1984.
10. Clandestine Abortion - Contrasting Realities (Chile and Guyana)
The Alan Guttmacher Institute. Clandestine Abortion: A Latin American
Reality. New York. 1994.
Casas-Becerra, Lidia. Women Prosecuted and imprisoned for abortion in
Chile. Reproductive Health Matters (9) 29-36. 1997
Nunes, Frederick E. and Ivetter M. Delph. Making abortion law reform
works: Steps and slips in Guyana. Reproductive Health Matters. 9:139-146.
11. Health and Human Rights (The San Diego-Tijuana Border)
Amnesty International. United States of America: Human Rights Concerns in
the Border Region with Mexico. May 1998
Gross, Gregory. Death in the dessert: Finding them before they die.
The San Diego Union Tribune (Street Final) Monday, August 31, 1998.
12. Neoliberalism in Health (Chile and Mexico)
Reichard, S. Ideology drives health care reform in Chile. Journal of
Public Health Policy. 17(I) 80-98, 1996.
Collins, J. and Lear, J. Chile's Free-Market Miracle: A Second Look.
The Institute for Food and Development Policy, Oakland, California, 1995.
(Chapter: Marketing Health)
Laurell, A. Cristina. Crisis, neoliberal health policy, and political
processes in Mexico. International Journal of Health Services. 21(3)
Laurell, A. Cristina and López-Arellano, Olivia. Market commodities and
poor relief: The World Bank proposal for health. International Journal of
Health Services. 26(1) 1-18, 1996.
13. Foucault, Bio-Politics and Health Education (Brazil)
Lupton, Deborah. The Imperative of Health: Public Health and the Regulated
Body. Sage Publications, London. 1995. (Chapter 2: Technologies of Health:
Contemporary Health Promotion and Public Health)
Gastaldo, Denise. Is health education good for you? Rethinking health
education through the concept of Bio-Power. In Alan Petersen and Robin
Burton (editors), Foucault, Health and Medicine. Routledge, London. 1997
14. Summary and Conclusions: Social Justice in Health
Drane, James F. Bioethical Perspectives from Ibero-America. The Journal of
Medicine and Philosophy. (21) 557-569. 1996
dos Anjos, Marcio Fabris. Medical Ethics in the Developing World: A
Liberation Theology Perspective. The Journal of Medicine and Philosophy.
(21) 629-637. 1996.