Covid-19, causas fundamentais,classe social e território / COVID-19, fundamental causes, social class and territory / Covid-19, causas fundamentales, clase social y territorio

Resumo A teoria que considera as condições sociais como causas fundamentais da saúde, em articulação com as noções de classe social e território, é usada em reflexões acerca da trajetória e da distribuição dos efeitos da pandemia da Covid-19 no país. Parte-se de sínteses teóricas, abordagens e evidências de trabalhos do autor sobre desigualdade de saúde no Brasil. Entende-se que o 'meio social', de natureza relacional e estruturada, afeta a propagação e a distribuição da doença entre os grupos. As diferenças de classe em circunstâncias de trabalho, localização e moradia são referidas. No tocante às diferenças sociais no risco de desenlace fatal da doença, são consideradas a distribuição prévia de condições adversas e as diferenças no modo como as instituições de saúde processam as pessoas. Como proposto pela teoria, as desigualdades de recursos, informações, disposições e capacidade estariam afetando a distribuição social dos efeitos da pandemia no Brasil.

Abstract The theory of social conditions as fundamental causes of health, in conjunction with the notions of social class and territory, is used in reflections about the trajectory and distribution of the effects of the Covid-19 pandemic in the country. It starts with theoretical syntheses, approaches and evidences from the author's works on health inequality in Brazil. It is understood that the 'social environment', of a relational and structured nature, affects the spread and distribution of the disease among the groups. Class differences in circumstances of work, location and housing are mentioned. Regarding social differences in the risk of fatal outcome of the disease, the previous distribution of adverse conditions and differences in the way health institutions process people are considered. As proposed by the theory, inequalities in resources, information, dispositions and capacity would be affecting the social distribution of the effects of the pandemic in Brazil.

Resumen La teoría de las condiciones sociales como causas fundamentales de la salud, junto con las nociones de clase social y territorio, es utilizada en reflexiones sobre la trayectoria y distribución de los efectos de la pandemia de Covid-19 en el país. El punto de partida son síntesis teóricas, enfoques y evidencias de los trabajos del autor sobre la desigualdad en salud en Brasil. Se entiende que el "entorno social", de naturaleza relacional y estructurada, afecta la propagación y distribución de la enfermedad entre los grupos. Se mencionan las diferencias de clase en circunstancias de trabajo, ubicación y vivienda. Con respecto a las diferencias sociales en el riesgo de desenlace fatal de la enfermedad, se considera la distribución previa de condiciones adversas y las diferencias en la forma en que las instituciones de salud procesan a las personas. Según lo propuesto por la teoría, las desigualdades en recursos, información, disposiciones y capacidad estarían afectando la distribución social de los efectos de la pandemia en Brasil.

Classe Social, território e desigualdade de saúde no Brasil / Social class, territory and health inequality in Brazil

Resumo O estudo analisa como classe social e território se combinam na produção de padrões de saúde na população. Considera em particular as variações e as convergências espaciais da relação focal entre classe social e saúde no Brasil. Nas análises foram usadas probabilidades preditas e medidas tanto absolutas quanto relativas de desigualdade de saúde. Foram estimadas as probabilidades de não ter boa saúde para a capital e o interior de cada um dos estados brasileiros. Localização espacial e classe social se combinam para acentuar dramaticamente as discrepâncias de saúde. Como regra geral, as discrepâncias relativas de classe social são maiores nas regiões mais desenvolvidas e nas capitais de todos os estados. Os melhores níveis de saúde em territórios menos adversos favorecem mais os grupos com recursos e capacidades de potencializar os ganhos de saúde. A desigualdade absoluta é maior nas áreas menos desenvolvidas. As adversidades territoriais se combinam a maior densidade das categorias mais vulneráveis, impondo um enorme fardo populacional de saúde nas regiões menos desenvolvidas.

Abstract This study analyzes how social class and territory are combined to produce health patterns in the population. Particular and converging spatial variations of the focal relationship between social class and health in Brazil were considered. Predicted probabilities and both absolute and relative health inequality measures were used in the analyzes. The probabilities of not having good health were estimated for the capital city of each Brazilian state and in its hinterland. Spatial location and social class are combined to dramatically accentuate health discrepancies. In general, the relative discrepancies of social class are greater in more developed regions and in the capitals of all states. Better levels of health in less adverse territories favor groups with the resources and capabilities to increase health gains. Absolute inequality is greater in less developed areas. Territorial adversities are combined with the greater density of the most vulnerable categories, imposing a huge populational burden in health in less developed regions.

Desigualdade racial de saúde e contexto de classe no Brasil / Health inequality by race and class context in Brazil / Inégalité raciale dans la santé et contexte de classe au Brésil

This study focuses on social patterns, socioeconomic mediations, and conditional relations characterizing racial inequalities in health in Brazil. Multiple logistic regression models were used to assess the association between racial division and poor health status. Socioeconomic factors explain a high proportion (84 percent) of racial inequality in health, which depends heavily on asymmetries in resources, power, and valuable contexts. When social class contexts interact with race, they reveal nonequivalent (conditional on class) health advantages or disadvantages between racial groups. Racial divisions affect the actors' capacities and opportunities to achieve their ends by mobilizing the available means.

Dans ce travail, on cherche à connaÎtre les modèles sociaux, les médiations socioéconomiques et les rapports de contrainte qui marquent les écarts entre races concernant la santé. Des modèles de régression logistique multiple ont été examinés afin de déterminer le rapport entre une division raciale et un état de santé "pas bon". Les composants socioéconomiques représentent une part très importante (84 percent) de l'inégalité raciale dans la santé, qui dépend plutôt des asymétries de ressources, pouvoirs et contextes de valeurs. Quand les contextes de classe sociale interagissent avec la race, ils révèlent des avantages ou désavantages dans la santé qu'on ne retrouve pas entre groupes raciaux. Les divisions raciales affectent les capacités et les réelles opportunités des acteurs d'arriver à leurs fins par les moyens dont ils disposent.

Classe social e desigualdade de gênero no Brasil / Social class and gender inequality in Brazil / Classe sociale et inégalité des sexes au Brésil

This article investigates the hypothesis that gender inequality in income in Brazil is influenced by the social class context. Class order and occupational segregation act as relevant factors in gender inequality. The effect of social class on the gender wage gap, although less pronounced as compared to interactions between class and race, plays an important "moderating" role on gender disparity, particularly by accentuating the gap in the case of capitalists, managers, and holders of professional qualifications (as assets) and attenuating them in the case of ordinary workers. The study identifies sharp inequality in gender treatment that appears to supersede the inequality in access to valuable contexts and resources, representing a direct effect of gender.

Dans cet article, on cherche à savoir si l'inégalité de revenu selon le sexe au Brésil serait liée à l'appartenance à une classe sociale donnée. L'ordre de classe et la ségrégation professionnelle agissent comme d'importants facteurs médiateurs de l'inégalité selon le sexe. L'effet de la classe sociale sur les écarts selon le sexe, bien que moins aigu lorsqu'on le compare aux interactions entre classe et race, joue un rôle "modérateur" important sur l'inégalité de revenu selon le sexe, en particulier chez les détenteurs de capital, les cadres et ceux qui diposent d'actifs de qualification, dans le sens de leur approfondissement, et les travailleurs primaires, dans le sens de leur allègement. Dans cette étude, on constate une forte inégalité de traitement selon le sexe, qui semble prédominer sur les inégalités d'accès à de considérables contextes et ressources, ce qui représente un effet direct de l'appartenance à l'un des sexes.

Efeitos de classe na desigualdade racial no Brasil / Class effects on racial inequality in Brazil

This article analyzes the conditioning exercised by class inequality on racial inequality in income between whites and non-whites (the latter including both pardos, or mixed race, and pretos, or blacks) in Brazil. The study uses linear regression techniques aimed at unveiling the "moderating" effect of class categories in the attenuation or exacerbation of race effects on personal income. There is a racial gap favoring whites in nearly all class categories, but its effect is significantly moderated by class condition. The racial gap in income is higher among middle-class positions and especially among managers. The proletarian segments per se display the lowest racial gaps in income.