Dialectic Approaches and Public Policy Interactions for Social, Environmental and Health Problems: Challenges for Health Promotion across Territorial Scales

Abstract

A constant reproduction of environmental injustices and health iniquities has demanded the employment of participatory/dialectic approaches to research and to intervene in the reality making possible the involvement of social actors in healthy public policies. On this framework, the aim of this paper is to analyse scientific production with dialectic approaches associated with public policies in the context of social, environmental and health problems, considering territorial scales of intervention and the correspondence with some relevant strategies of health promotion. A systematic bibliographic review was applied on a wide pan-disciplinary scientific data base and 36 papers were analysed and classified by their territorial scales of approach. The amount of papers found and their spread through a variety of journals showed a modest, but increasing production which has been dispersed in terms of knowledge areas. Within the classification of territorial approaches, 14 papers were classified as local, 5 as expanded and 17 as a multi-level. Although the papers classified as local approaches were in a good structure of stakeholders’ participation, they are limited to dealing with the global driving forces that reproduce the environmental injustices. Regarding this limitation, the multilevel approaches were identified as more opportune to jointly deal with social, environmental and health problems by means of allowing interaction through multiple territorial scales, fomenting the strengthening of community action, creating supportive environments, and building healthy public policies.