One Health of Peripheries: biopolitics, social determination, and field of praxis

Amid the urgency to solve countless and severe health problems, asking what is health or who can and must have it may seem like a waste of time. However, some responses can reveal prevailing practices that divert attention from fundamental problems, thus maintaining privileges and deepening health inequities. One Health of Peripheries arises from these questions and takes three interdependent senses. The first refers to attributes determining the well-being and suffering of peripheral multispecies collectives: a state, a process, the realization of capacities. The second problematizes marginalizing apparatuses that define health and who can and should have it. The third encompasses practices in more-than-human social spaces in which, and through which, One Health is experienced, understood, and transformed. The qualification of health as “one” does not refer to the lack of plurality, nor to the simple aggregation of health fragments (human + animal + environmental), but to the complexity of health in a field with peripheral places, ensuing from margins to privilege those who are inside and legitimize the exploitation of those who are outside. The interaction among margins creates degrees and kinds of privilege and vulnerability that materialize epidemiologic profiles while articulating different peripheral strengths and needs supports a collective resistance to break margins. Social determination, a key concept in the (Latin American) collective health movement, underlies such profiles. However, this movement overlooks the more-than-human dimension of social determination; that is to say, One Health of Peripheries is a blind spot of collective health. The cartography of One Health of Peripheries has unique needs regarding participation, research, and inclusive policies for the decolonial promotion of healthy lifestyles. Professor Oswaldo Santos Baquero is the author of the study.

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From modern Planetary Health to decolonial promotion of One Health of Peripheries.

The concept of Planetary Health has recently emerged in the global North as a concern with the global effects of degraded natural systems on human health. It calls for urgent and transformative actions. However, the problem and the call to solve it are far from new. Planetary health is a colonial approach that disregards alternative knowledge that over millennia have accumulated experiences of sustainable and holistic lifestyles. It reinforces the monologue of modernity without realizing that threats to “planetary health” reside precisely in its very approach. It insists on imposing its recipes on political, epistemological, and ontological peripheries created and maintained through coloniality. The Latin American decolonial turn has a long tradition in what could be called a “transformative action”, going beyond political and economic crises to face a more fundamental crisis of civilization. It deconstructs, with other decolonial movements, the fallacy of a dual world in which the global North produces epistemologies, while the rest only benefit from and apply those epistemologies. One Health of Peripheries is a field of praxis in which the health of multispecies collectives and the environment they comprise is experienced, understood, and transformed within symbolic and geographic peripheries, ensuing from marginalizing apparatuses. In the present article, the authors show how the decolonial promotion of One Health of Peripheries contributes to think and advance decentralized and plural practices to attend to local realities. They propose seven actions for such promotion. The study was made by Oswaldo Santos Baquero, Mario Nestor Benavidez Fernández (Universidad de San Buenaventura, Colombia) e Myriam Acero Aguilar (Universidad Nacional de Colombia).

Inverted Map of South America. Joaquim Torres Garcia.

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Pandemic experiences in São Remo: a collective discourse.

Jardim São Remo is a favela in the West Zone of the city of São Paulo, where the experience of the Covid-19 pandemic is similar to that of other urban peripheries in some aspects and differs in others. In São Remo, the experiences comprise elements common to all its members and particularities of each group, family and individual. Between January and April 2021, there was a collective construction to portray the experiences of some residents, considering various experiences and memories recorded in interviews or during the application of a photographic method of community research known as Photovoice.

The following text is a collective discourse composed of several of these records, which we built with the support of some ideas of a method called “collective subject discourse”. We did not use all the records, and the way of articulating them was one among many. The result brings nuances, affections and portraits that reinforce what seems obvious, remains neglected, and exposes a chronic contradiction: marginalized communities continue to suffering most of the collective damage, which deepens marginalization and intensify crises. However, result also brings lessons and points of view necessary to overcome chronic malady.

We modified some text fragments mainly to concatenate ideas, added implicit terms in the original context, and increaseed the number and gender agreement between sentences from different registers. These modifications are in gray.

It is worth noting that although we have used some elements of Photovoice and the “collective subject discourse”, this document does not report the application of these methods or what would result from their application. Other documents will address methodological aspects and their respective results, using additional records and reusing some of those used here.

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Feline sporotrichosis: social vulnerability and prioritization of areas with the highest incidence of cases in the city of Guarulhos, SP, Brazil.

Over the past two decades, many Brazilian cities have been reporting an increasing incidence and spread of feline sporotrichosis. The disease is neglected, and little is known about the causal processes underlying its epidemic occurrence. This study characterized the spatiotemporal dynamics of feline sporotrichosis in Guarulhos. Moreover, it proposed and tested a causal explanation for its occurrence and zoonotic transmission, giving a key role to social vulnerability. A direct acyclic graph represented the causal explanation, while Bayesian spatial models supported its test as well as the attribution of a risk-based priority index to the census tracts (geographic divisions) of the city. Between 2011 and 2017, the disease grew exponentially, and the spatial spread increased. The model findings showed a dose-response pattern between an index of social vulnerability and the incidence of feline sporotrichosis. This pattern was not strictly monotonic, so some census tracts received a higher priority index than others with higher vulnerability. According to our causal explanation, there will no be effective prevention of feline and zoonotic sporotrichosis as long as social inequalities continue imposing precarious lifestyles. The study was developed in the Laboratory of Epidemiology and Biostatistics of the Department of Preventive Veterinary Medicine and Animal Health of the Faculty of Veterinary Medicine and Animal Science (LEB-VPS-FMVZ-USP), by Ligia Scuarcialupi, Fernando Pereira (Zoonoses Control Center of Guarulhos), and Oswaldo Santos Baquero made the study.

Picture: Fernando Pereira.

Picture: Folha de São Paulo, Rivaldo Gomes.

Causal process compatible with the higher frequency of sporotrichosis in urban peripheries. See the details in the study.

Cases of feline sporotrichosis reported between 2011 and 2017 in the city of Guarulhos.

The census tracts (geographic divisions) are grouped by degree of vulnerability (IPVS from 1 to 6). The higher the IPVS, the greater the vulnerability. The density and total of reported cases of feline sporotrichosis are systematically higher in the most vulnerable tracts. Guarulhos, 2011 – 2017. IPVS: São Paulo State Social Vulnerability Index.

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Interpersonal violence, animal abuse, and social vulnerability in São Paulo city.

Multiple studies relate human-to-human violence with human-to-animal violence, and this relationship is known as “the link” (the Link). Most of such studies attribute violence to individual characteristics of the perpetrator (use individuals as the unit of analysis), ignoring or neglecting the sociocultural context in which violence occurs. We have learned a lot from this approach, but it is far from being comprehensive. For this reason, this research investigated, on a geographic scale, the effect of the degree of social vulnerability on the relationship between the number of reports of interpersonal violence and animal abuse in the city of São Paulo. In addition to identifying the most affected administrative districts, the research found that the greater the vulnerability, the greater the quantity and strength of the association between the two types of notifications, always taking into account the population size of the districts. Therefore, one can think of one variable as a red flag of the others: greater social vulnerability indicates a greater probability of occurrence of both types of violence, while a greater occurrence of one type of violence indicates a greater probability of the occurrence of the other type in a more vulnerable social context. The recommendation to use violence against animals as a warning signal of interpersonal violence and vice versa at the individual level is already known, and the novelty of this research is the extension of the recommendation to geographic levels, also considering social vulnerability. It is important to emphasize that the findings of this research do not allow us to say how often the perpetrators of violence against animals are the same as those of interpersonal violence, nor do they allow us to say whether these perpetrators had individual attributes of social vulnerability. A district as a whole may be vulnerable, while some of its geographic subdivisions are not. Furthermore, the vulnerability of the geographic context accounts only for a fraction of the vulnerability of its residents. The study was developed in the Laboratory of Epidemiology and Biostatistics of the Department of Preventive Veterinary Medicine and Animal Health of the Faculty of Veterinary Medicine and Animal Science (LEB-VPS-FMVZ-USP), by Oswaldo Santos Baquero, Fernando Ferreira, José Soares Ferreira Neto and Jason Ardila, and by the Captain of the São Paulo State Military Police, Marcelo Robis Francisco Nassaro.

Reports of interpersonal violence and violence against animals in the administrative districts of the city of São Paulo, 2011-2012. The panels differ in the degree of vulnerability (IPVS from 1 to 4). The higher the IPVS, the greater the vulnerability and the number of both types of reports. The blue line and gray envelope show the trend of the positive relationship. IPVS: São Paulo Social Vulnerability Index.

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Spatiotemporal dynamics and risk factors for human Leptospirosis in Brazil.

Between 2000 and 2016, there were 63,302 reported cases and 6,064 reported deaths from human leptospirosis in Brazil. This research identified the Brazilian states to be prioritized based on the number of cases and deaths in that period. Additionally, it evaluated the influence of climatic and socioeconomic factors on the disease dynamics, using satellite images and measures related to waste management, illiteracy, and poverty. The State of Acre was systematically the most affected, demanding a much larger allocation of resources than the remaining States. Professors Oswaldo Santos Baquero, and Gustavo Machado (North Carolina State University) made the study following an approach that gave almost all attention to statistical issues and did not discuss the implications of the proposed hypothesis and findings. They made the study before the beginning of OHP theorization.

Spatiotemporal dynamics of excess risk of human leptospirosis cases, in the Brazilian States between 2000 and 2016. The excess risk [Pr(RR > 1)] represents the probability of States having more cases than the average number of cases in Brazil, considering the respective population sizes.

Priority index (PI) of States, according to the relative number of cases. A state with a PI of 100 has twice as much priority as a state with a PI of 50.

Causal process compatible with the occurrence of cases and deaths of human leptospirosis. See the details in the study.

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