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Models of social determination of chronic non-communicable diseases

This essay critically revises theoretical frameworks and models of social determination of chronic non-communicable diseases. Functionalist sociology generated sociocultural models of health that influenced the field of epidemiologic investigation of so-called "new morbidity" (basically chronic and degenerative illnesses), later contained under the generic label of stress theory. Neo-durkheimian approaches of social inequalities, based on the social capital concept, are analyzed and theoretical uses of the lifestyle notion in the health field are criticized. Models derived from the dialectical materialism, grounded on the concepts of labor and social class, are also discussed as they have turned quite influential in Latin-American social epidemiology. Finally, considering theoretical and conceptual gaps of such partial theories in what concerns the symbolic space of the social life, the conceptual bases of an alternative theoretical focus: the theory of mode of life and health. As a possible synthesis of the models object of this critical review, it is considered as especially suitable for the elaboration of epidemiologic models of social determination of non-transmissible chronic diseases.

Chronic diseases; Social determination; Stress; Mode of life; Health inequities


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