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Ciênc. saúde coletiva vol.9 n.3 Rio de Janeiro Jul./Sep. 2004
As a conceptual and practical field, Health Promotion has received substantial attention from health managers and professionals in recent years, all over the world, due to the creative and innovative possibilities it offers in the approach to individual and collective health problems. At least this is the opinion of those immersed in the so-called field of Health Promotion.
However, what one observes is that numerous initiatives of various types have been labeled as "health promotion". This has advantages and disadvantages. On the one hand, it represents a break in the monopoly of curative care in the health field's conceptual debate and practices, which is very good, because it questions the hegemony established over the course of nearly the entire social history of medicine and health, a trend that deepened in the 20th century; on the other, by encompassing such diverse experiences, it challenges the professionals involved in the process to seek greater precision in the conceptualization and work methods utilized in the self-d Health Promotion field.
Therefore, this issue of Ciência & Saúde Coletiva is highly appropriate in conducting a conceptual debate and presenting concrete experiences in the evaluation of self-d Health Promotion programs.
Corroborating our opening statement, this issue discusses the evaluation of Health Promotion initiatives with such diverse experiences as: healthy cities and communities in Cali, Colombia; health-related activities with the elderly; a communication and information network; two initiatives focused on Development with Local and Integrated Sustainability (DLIS) in Rio de Janeiro; a healthy housing proposal; a proposal for a national Health Promotion program; a Health Promotion project in an academic health center; and articles that explore conceptual and methodological aspects in the evaluation of Health Promotion itself, including the "Debate", which is the cornerstone article in this issue of the journal.
This diversity of experiences finds a common denominator in this issue, namely the question of their evaluation. As stated in the Debate, at a time when public policy evidence is increasingly demanded by managers, political representatives, and taxpayers (who, after all, pay the bill) and when it is simultaneously claimed that Health Promotion is capable of actually promoting health and reducing overall health system costs, the journal is making an excellent contribution to the debate.
The conclusions are stated quite prudently as preliminary and call for further research efforts, as expected in all responsible scientific work, particularly in a new conceptual and practical field, which nevertheless has consolidated itself as a space for hope in the face of such glaring inequalities and all-too-often fruitless and expensive efforts to improve individual and collective health in contemporary societies.
Paulo M. Buss