Public health in a society at risk
In the setting accompanying expectations produced at the end of the last century and the beginning of the 21st century, the western world was overwhelmed by a mishmash of academic-political and theoretical-sociological production attempting to explain the changes caused in fin-de-siècle society, seeking to find the best way of understanding the social dynamics of the vertiginous present.
Multiple formulations were proposed for naming and understanding the reality of a complex society called post-industrial society by some and post-modern society by others. The work of the German sociologist Ulrich Beck, who participated in this debate with his work entitled, "The Society at Risk," passed almost unnoticed, at least in our particular area, in the middle of such heated debate during the last decade.
This author's fundamental hypothesis can maybe be summed up by saying that the great movement suffered by modern society at the end of the 20th century was due to a fracture within modernity and a progressively expanding sense of danger overcoming any of the previously protected areas. In the unavoidable relationship between the production of wealth and risk being produced, the balance towards the former became changed towards the latter.
The tragic events of 11th September 2001 led to the notion of global risk capturing the interest of imperial ideologists and becoming assumed in terms of a battle against the menace of terrorism. However, this only led to distracting thoughts away from more suitable understanding of the deep implications which the notion of a society at risk has for public health.
Such loss led to many of the challenges which public health must face remaining hidden within the context of growing complexity and systematic social production of menaces to people's health. For example, menaces such as permanent radiation (now multiplied by more serious sources from high voltage cables to cell phones), risks arising from the wasteful consumption of natural resources, colossal environmental contamination and mass consumption of processed food and domestic articles, all subject to the unknown action of potentially toxic agents.
Our societies are confronting a mixture of situations leading to a multiplicity of different types of risks being produced. Such drama imposes the task of simultaneously confronting secular problems of hunger, exclusion and misery on us, as well as current problems regarding unhealthy habits becoming generalised and the globalised deterioration of the environment. This is the complex framework within which public health, and those working in it, must perceive and imagine alternative ways of responding to the great objectives imposed by its knowledge and action, improving the conditions of people's lives and helping them to enjoy social wellbeing at a level which is possible today.
Juan Carlos Eslava C.
Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia