Analysis of public policies to combat COVID-19 in the state of Paraná, Brazil.

Introduction: The COVID-19 pandemic had a great impact on several public sectors worldwide, requiring the implementation of public policies in an organized way to contain and control the disease. Thus, this study aimed to analyze public policies to face the COVID-19 pandemic in the State of Paraná, Brazil. Methods: This was a cross-sectional, retrospective, quantitative survey carried out with data from March 2020 to March 2022 in the twenty-two municipalities that host the local health regions. Data collection was documentary, carried out from the municipal Portal da Transparência website, which is dedicated to making public all expenditures, and epidemiological bulletins released by the Health Department of the state of Paraná. The variables analyzed were New Cases and Deaths, Mortality and Lethality Coefficient, Incidence Rate, Vaccination Coverage, Number of Hospital and ICU beds exclusive to COVID-19, Settled Expenses destined for COVID-19 and coping measures, namely, the Declaration of Public Health Emergency, Curfew, Mandatory use of masks, Businesses closure, Teleworking of risk groups, and Suspension of activities with crowds and of classes. After collection, data underwent descriptive analysis, and subsequently, the correlation of variables was analyzed using the Spearman test. Multiple linear regression was applied using the variable selection method called best subset selection (BSS). The dependent variables listed were incidence rate, new cases and new deaths. Results: The results showed that coping measures, as well as the application of resources for the pandemic, were implemented heterogeneously in the municipalities studied, and the progression of the disease, the distribution of beds and vaccination occurred unevenly and may be a reflection of the limited Brazilian national governance. An important correlation was observed between the incidence rate and new deaths with vaccination coverage. In addition, the regression model showed that measures such as mandatory use of masks, closure of shops, suspension of classes, and curfew showed important correlations with the variables incidence rate, cases, and new deaths. Discussion: The study highlighted the importance of carrying out a robust analysis of public policies to face emergencies of global importance so that government entities are prepared for future crises of great repercussions, such as the COVID-19 pandemic.

Hidden Hate, Hidden Violence: Dismantling Myths and Identifying Fresh Challenges for Research and Policy.

Hate crime has become an increasingly familiar term within global scholarship, with advancements in conceptual understanding and empirical knowledge helping to generate improved policy responses across many parts of the world. However, the continued demonization of 'other' identities, the escalating volume of hate incidents worldwide and the prevailing climate of rising tensions, decreasing resources and political de-prioritization all suggest that many urgent challenges remain. Contributors to this special issue have dismantled common stereotypes and misperceptions which hamper our collective capacity to address contemporary expressions of hate and violence. In doing so, they draw from their research evidence to identify "hidden" challenges which should be at the forefront of attempts to address the causes, effects, and prevention of all forms of violence. This call for reconfiguration is the unifying theme which runs through each article, and which paves the way for more nuanced analyses that offer new frameworks for responding to the diverse and changing patterns of violence. These are challenges which straddle disciplinary boundaries, geographical borders, and the physical/digital world, and which demand the international, intersectional, and interdisciplinary perspectives evident within this special issue.

Nuclear energy acceptance in Poland: From societal attitudes to effective policy strategies-Network modeling approach.

Poland is currently undergoing substantial transformation in its energy sector, and gaining public support is pivotal for the success of its energy policies. We conducted a study with 338 Polish participants to investigate societal attitudes towards various energy sources, including nuclear energy and renewables. Applying a novel network approach, we identified a multitude of factors influencing energy acceptance. Political ideology is the central factor in shaping public acceptance, however we also found that environmental attitudes, risk perception, safety concerns, and economic variables play substantial roles. Considering the long-term commitment associated with nuclear energy and its role in Poland's energy transformation, our findings provide a foundation for improving energy policy in Poland. Our research underscores the importance of policies that resonate with the diverse values, beliefs, and preferences of the population. While the risk-risk trade-off and technology-focused strategies are effective to a degree, we advocate for a more comprehensive approach. The framing strategy, which tailors messages to distinct societal values, shows particular promise.

[Public policies and right to sexuality of the elderly in Chile]. / Public policies and right to sexuality of the elderly in Chile.

People over 65 years of age will constitute the majority of the world's population in the short term, but in precarious living conditions: more years in a worse condition of vulnerability and fragility. Societies and development models would not be prepared, generating high personal, family and collective costs. In Chile, fragility would be highly prevalent in this population, impacting the full development of their lives; with sexuality as one of the aspects that are invisible and little studied. This work makes a critical approach, based on the review and analysis of context, public policies and legislation in force in Chile, evidencing atomization and biomedical orientation of public policies, collaborating in the understanding of the relationship between fragility and sexuality in old people; and revealing pending training and research tasks for the generation of public policies for an active and healthy life.

Las personas mayores de 65 años constituirán la mayoría de la población mundial en corto plazo, pero en condiciones de vida precarias. Esto quiere decir que vivirán más años en peor condición de vulnerabilidad y fragilidad. Las sociedades y modelos de desarrollo no estarían preparados, generando altos costos personales, familiares y colectivos. En Chile la fragilidad sería altamente prevalente en esta población, impactando el desarrollo pleno de su vida. La sexualidad es uno de los aspectos que son invisibilizados y poco estudiados. Este trabajo realiza una aproximación crítica, a partir de la revisión y análisis de antecedentes de contexto, políticas públicas y legislación vigentes en Chile. En estos aspectos se evidencia atomización y orientación biomédica de las políticas públicas, colaborando en la comprensión de la relación fragilidad y sexualidad en personas mayores. Además, se revelan tareas de formación e investigación pendientes para la generación de políticas públicas para una vida activa y saludable.

Replication guide. Applying the human security approach to advance an integrated response to health and migration in El Salvador, Guatemala, Honduras, and Mexico

In 2022, the program on Applying the Human Security Approach to Advance an integrated response to Health and Migration in the Northern Triangle of Central America and Mexico was jointly launched by the Pan American Health Organization/World Health Organization (PAHO/WHO) and the International Organization for Migration (IOM). The program grant was sponsored by the United Nations Trust Fund for Human Security (UNTFHS). Among its main goals was the intention of raising awareness of the human security approach and how it can be used as a successful operational tool to advance universal access to health and universal health coverage, as well as the Sustainable Development Goals (SDGs), by contextualizing the added value of human security to health and migration in the four countries in which it was implemented: El Salvador, Guatemala, Honduras, and Mexico. Sustainability and replicability of the program were specifically integrated in the program’s design to promote continuity and scale-up of the activities, ensuring that knowledge obtained on the ground be disseminated and used to mainstream the human security approach throughout the region and beyond. This guide is part of those activities to facilitate the process of further replicating the program and its outcomes, taking into consideration lessons learned through its implementation also this publication is crucial in promoting the human security approach as an operational tool in health and migration, demonstrating its effectiveness in improving universal health access and advancing the SDGs. It also provides a practical guide for replicating the program in other regions, ensuring the sustainability and expansion of its benefits.

Understanding Local Alcohol Control in Wisconsin: Building a Database of Local Municipal Alcohol Policies.

In Wisconsin, many alcohol policies are regulated at the local level. To examine the relationship between local policies, alcohol use and health outcomes, our team developed a database to collect local alcohol policies. Initial results highlight differences in how policies are defined, enforced, and made available to the public.

The protective and destructive critical processes of female labor in small-scale fishing in coast Pernambuco, Brazil. / Processos críticos protetores e destrutivos no trabalho das pescadoras artesanais do litoral Pernambucano, Brasil.

This study aims to analyze the protective and destructive critical processes of 34 water women in the municipalities of Cabo de Santo de Agostinho and Ipojuca, Pernambuco, Brazil, from February/21 to August/22. The work process stages were systematized by the work flowchart, and we employed Breilh's critical processes matrix to organize the data. The destructive processes identified in the general domain were injustice and socio-environmental vulnerability, such as the economic development model, the Suape Industrial Port Complex, the 2019 oil spill crime disaster, the COVID-19 pandemic, and the difficult access to public policies; in the particular domain: overloads and extended working hours, use of rudimentary equipment and tools, and unequal gender, class, and race relationships; in the singular domain: physical and mental illnesses and deaths. The protective processes identified in the general domain were sustainable development objectives, public health, and social assistance policies; in the particular domain, group work and processing, consumption for subsistence; in the singular domain, fishing as a therapeutic, pleasurable, and sharing process. The study highlighted the central issues of the water women and the need to establish public policies targeting their care.

Objetivou-se analisar os processos críticos, protetores e destrutivos do trabalho de 34 mulheres das águas nos municípios de Cabo de Santo de Agostinho e Ipojuca (PE), de fevereiro de 2021 a agosto de 2022. As etapas do processo de trabalho foram sistematizadas pelo fluxograma do trabalho e organizadas na matriz de processos críticos de Breilh. Os processos destrutivos, no domínio geral, foram: injustiça e vulnerabilização socioambiental como modelo de desenvolvimento econômico, o Complexo Industrial Portuário de Suape, o desastre-crime de petróleo ocorrido em 2019, a pandemia de COVID-19 e dificuldade de acesso às políticas públicas; no particular: jornadas e sobrecargas de trabalho, uso de equipamentos e ferramentas rudimentares e relações desiguais de gênero, classe e raça; no singular: adoecimentos físicos, mentais e mortes. Os processos protetores, no domínio geral: os objetivos de desenvolvimento sustentável, políticas públicas de saúde e assistência social; no particular: trabalho e beneficiamento em grupo, consumo para subsistência; no singular: a pesca como processo terapêutico, prazeroso e de partilha. O estudo destacou os problemas centrais das mulheres das águas e a necessidade do estabelecimento de políticas públicas voltadas ao seu cuidado.

Perspectives for Primary Health Care public policy in South America. / Perspectivas para las políticas públicas de Atención Primaria en Salud en Suramérica.

We aim to conduct a comparative analysis of the implementation of PHC in nine South American countries. Three dimensions were highlighted from documentary sources: political commitment, leadership, and governance; care model; and engagement of communities and other stakeholders. The results indicate a formal commitment that places PHC at the center of efforts to achieve universal access. The following can be observed: revitalization processes in public subsystems, based on guaranteeing preventive, promotional, curative and rehabilitation actions; PHC as gatekeeper; emphasis on family and community; assigned population and territory; multidisciplinary teams; and, in some cases, the accent on interculturality expressed in the concept of "buen vivir" (good living). The PHC revitalization processes were affected by political changes. Between progress and setbacks, the segmentation of coverage was not overcome. The current moment seeks to recover more inclusive and broad public policies in the context of the return of the progressive and democratic fields. The dissemination of country experiences can contribute to the development of a comprehensive, integrated, and quality approach to PHC in the Region.

El objetivo es realizar un análisis comparativo de la implementación de la APS en nueve países de Suramérica. A partir de fuentes documentales fueron destacadas tres dimensiones: compromiso político, liderazgo y gobernanza; modelo de atención; involucramiento de comunidades y otros actores. Los resultados indican la existencia de compromiso formal que localiza la APS en el centro de los esfuerzos para lograr el acceso universal. Se observan procesos de revitalización en los subsistemas públicos, basados en la garantía de acciones preventivas, promocionales, de cura y rehabilitación; puerta de entrada; enfoque familiar y comunitario; población y territorio adscriptos; equipos multiprofesionales, y, en algunos casos, énfasis en la interculturalidad expresada en la concepción de "buen vivir". Los procesos de revitalización de la APS fueron afectados por cambios políticos. Entre avances y retrocesos, no se logró superar la segmentación de cobertura. El momento actual es de rescate de políticas públicas más inclusivas y amplias, en el contexto de recomposición de los campos progresistas y democráticos. Difundir experiencias de los países puede contribuir para el desarrollo de un enfoque de APS integral, integrada y de calidad en la Región.

Mexican-origin women's individual and collective strategies to access and share health-promoting resources in the context of exclusionary immigration and immigrant policies.

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.

The role of nurses in implementation of public policy on adolescent health in Colombia, Ecuador, and Peru.

BACKGROUND: In Latin America, interventions aimed at adolescents' health suffer from a shortfall of investment and lack of sustainability. Nurses, as an integral part of health services and systems, can lead the implementation and development of public health policies to improve adolescent health. OBJECTIVE: To identify and analyze the role of nurses in the development and implementation of public policies and in the provision of health care to adolescents in Colombia, Ecuador, and Peru. METHODS: The research was carried out in three phases: a documentary analysis, an online survey, and semi-structured focus groups. A total of 48 documents were analyzed, 288 nurses participated in the survey, and 29 nurses participated in the focus groups. RESULTS: State policies aim to guarantee rights, with special protection for children and adolescents. It is an incremental process, with greater involvement of civil society and governments. Participants reported a lack of synergy between law and practice, as well as differences in regulatory compliance in rural areas and in populations of different ethnicities and cultures. Their perception was that the protection of adolescents is not specifically enshrined in the legal bases and regulatory structures of the countries, meaning that there are both protective factors and tensions in the regulatory framework. While nurses are highly committed to different actions aimed at adolescents, their participation in policy development and implementation is low, with barriers related to a lack of specialized training and working conditions. CONCLUSIONS: Given nurses' involvement in different actions aimed at adolescents, they could play a fundamental role in the development of policies for adolescents and ensure their effective implementation. Policymakers should consider revising the budget to make compliance viable, incorporating and using monitoring indicators, and increasing the involvement of educational institutions and the community.

Introduction to the special issue on the consequences of immigration policies on children, youth, and families who experience migration-related trauma.

We are excited to introduce this special issue on the consequences of immigration policies on children, youth, and families who experience migration-related trauma. International migration has increased over the last 5 decades. Recent estimates suggest that 281 million people live in a country other than the one in which they were born (McAuliffe & Triandafyllidou, 2021). These migratory patterns are complex and present both challenges and opportunities for trauma psychologists and professionals from diverse disciplines who approach their work with immigrants from a trauma-informed perspective. In this 21st century, a variety of stressors and crises continue to propel the movement of children, youth, and families across the globe. Trauma often pervades the experiences that cause people to leave their homes. They may need to escape oppressive political systems; criminal gangs, war, or disasters; or simply to survive. Migration itself can lead to exposure to additional traumatic events, such as physical and sexual violence, kidnapping, and trafficking. Finally, upon arrival in a host country, individuals may experience further stressors as they struggle to navigate immigration systems with discriminatory processes and inadequate resources. In this special issue, 14 articles illustrate various ways by which migration-related traumatic experiences can inform assessment and treatment, public health policy, and human rights advocacy. Focusing primarily on children and families, unaccompanied youth, and adult migrants from Latin America and other regions, the authors explore premigration, migration itself, and postmigration issues that arise when individuals migrate to survive. The articles highlight how the resiliency and strength of individuals and families can be called upon to empower them in their journey toward healing and the critical need for cross-disciplinary treatment and advocacy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Regional variation in social norm nudges.

Public support is crucial for the effectiveness of ambitious climate policies, and social norm interventions have been proven effective in fostering support. An open question is which norms should be communicated if support and estimated support for climate policies differ substantially between regions. In two studies, we investigate whether individuals accurately assess the existing support and then explore the impact of national and regional norms on public support. Our results show that the norm on climate policy support is generally misperceived, i.e., the norm is higher than expected. This misperception increases with policy ambition and varies substantially between sub-national regions. Information about the national norm increases support, mainly in regions with below or above-average support. In contrast, interventions with regional norms are ineffective and even backfire in low-support regions. This demonstrates that norm nudges need to consider the regional aspects of the reference and target groups.

State Policies Regulating Firearms and Changes in Firearm Mortality.

Importance: Despite high social and public health costs of firearm violence in the United States, the effects of many policies designed to reduce firearm mortality remain uncertain. Objective: To estimate the individual and joint effect sizes of state firearm policies on firearm-related mortality. Design, Setting, and Participants: In this comparative effectiveness study, bayesian methods were used to model panel data of annual, state-level mortality rates (1979-2019) for all US firearm decedents, with analyses conducted in October 2023. Exposures: Six classes of firearms policies: background checks, minimum age, waiting periods, child access, concealed carry, and stand-your-ground laws. Main Outcome and Measures: Primary outcomes (total firearm deaths, firearm homicide deaths, and firearm suicide deaths) were assessed using the National Vital Statistics System. Bayesian estimation was used to estimate the partial association of changes in firearms policies with subsequent changes in firearm mortality. Results: The estimated effect sizes of individual policies 5 or more years after implementation were generally small in magnitude and had considerable uncertainty. The policy class with the highest probability of reducing firearm deaths was child-access prevention laws, estimated to reduce overall firearm mortality by 6% (80% credible interval [CrI], -2% to -9%). The policy class with the highest probability of increasing firearm deaths was stand-your-ground laws, estimated to increase firearm homicides by 6% (80% CrI, 0% to 13% increase). Estimates of association of implementing multiple firearm restrictions with subsequent changes in firearm mortality yielded larger effect sizes. Moving from the most permissive to most restrictive set of firearm policies was associated with an estimated 20% reduction in firearm deaths (80% CrI, 10% to 28% reduction), with a 0.99 probability of any reductions in firearm death rates. Conclusions and Relevance: In this comparative effectiveness study of state firearm policies, the joint effect estimates of combinations of firearm laws were calculated, showing that restrictive firearm policies were associated with substantial reductions in firearm mortality. Although policymakers would benefit from knowing the effects of individual policies, the estimated changes in firearm mortality following implementation of individual policies were often small and uncertain.

"It's changing our lives, not for the better. It's important that we have a say". The role of young people in informing public health and policy decisions about gambling marketing.

BACKGROUND: Marketing has a significant impact on the normalisation of gambling for youth across the globe. This has included shaping positive attitudes towards gambling, as well as increasing the social and cultural acceptance of gambling - particularly aligned with valued activities such as sport. Because of this, public health experts argue that gambling marketing poses a significant risk to the health and wellbeing of youth. While young people are increasingly exposed to, and impacted by marketing for gambling products, they are rarely consulted about policy issues and options. This study aimed to explore young Australians' perceptions of current policy responses to gambling advertising, whether they thought young people should be involved in discussions and decisions about gambling marketing regulations, and their perceptions of the duty of governments to protect young people from gambling industry marketing strategies. METHODS: Qualitative focus groups (n = 22) were held with n = 64, 12-17 year olds in the Australian states of Victoria and New South Wales. Participants were asked to reflect on current gambling policies, particularly relating to marketing, what they thought should be done about gambling marketing, and if and how young people should be included in public health responses to gambling. An interpretivist 'Big Q' approach to reflexive thematic analysis was used. RESULTS: Young people highlighted the need for more effective regulations around the content and frequency of gambling marketing. They also wanted to see more realistic representations of the negative impacts of gambling to counter persistent positive commercial marketing messages. Most thought that young people should be given an opportunity to have a say about responses to gambling due to their unique experiences. Participants identified mechanisms to increase young people's engagement in decision making, such as direct lines of communication to different levels of government, involvement in research, and diversifying ways of engagement. Specific recommendations included more regulatory action such as bans on gambling advertising. CONCLUSIONS: Creating formal structures that facilitate the inclusion of young people's perspectives in decisions made about gambling can result in more innovative and effective strategies to prevent the harms from gambling industry products, promotions, and practices.

Cannabis policy liberalization is only associated with increased blunt use if states lack strong tobacco control.

INTRODUCTION: Co-use of tobacco and cannabis has long been an issue for prevention and intervention efforts targeting these substances. Blunt use-cannabis inside a cigar wrapper-has been a consistent mode of cannabis consumption since the 1990s. Since then, both tobacco control and cannabis policies have changed considerably. This paper examines the influence of tobacco taxes and smoke-free policies as well as medical and recreational cannabis policies on blunt use among young people. METHODS: Combining state-level tobacco control and cannabis policy data with the restricted-access youth cohort of the Population Assessment of Tobacco and Health (PATH) study, we use multilevel logistic regression models to examine the impact of these policies on past-year blunt use. RESULTS: While we found a main effect whereby both legal medical and recreational cannabis policies are associated with higher odds of blunt use among youth, interaction effects demonstrate that this association only emerges in states lacking a comprehensive tobacco smoke-free policy. In states with smoke-free policies, we found no significant associations between cannabis policy and odds of blunt use. CONCLUSIONS: Denormalization through smoke-free policies may mitigate the effects of recreational and medical cannabis policies on blunt use. Smoke-free policies represent a possible cost-effective mechanism to curb the co-use of tobacco and cannabis in the form of blunts. States with medical and recreational cannabis policies may benefit from greater prevention efforts for young people specifically focused on blunt use, especially in states that do not have strong tobacco control.

Public opinion on alcohol policies in Sri Lanka.

Background: Alcohol imposes a significant burden on health, social and economic systems in Sri Lanka. In the present economic crisis taxes on alcohol provides necessary revenue increases. Yet, the perception of the public on alcohol policies in Sri Lanka is not well explored. Objectives: This opinion survey was conducted with the aim to understand the public's awareness on alcohol harm, alcohol industry influences, barriers and facilitators for implementing alcohol control policies in Sri Lanka, and the level of public support for alcohol policies, particularly taxes on alcohol products. Methods: A street intercept survey among 997 participants (with a ratio of 2:1 for males and females) selected through a cluster sampling method responded to an interviewer administered questionnaire. Bivariate and multivariate analyses were conducted to determine associations and a p < 0.05 was considered significant. Results: Among the respondents, 36.1% have consumed alcohol at least once in their lifetime and 29.1% have consumed alcohol during the past 12 months with a significant gender difference (females - 2.8%; males- 43.4%; p < 0.001). Significant proportions of both men (81.4%) and women (71.8%); p < 0.017 agreed that policy measures to reduce alcohol consumption would benefit the government including a significant proportion (73.8%, p < 0.008) of alcohol users. The vast majority -72.8%- agreed that increasing alcohol prices would help address the alcohol consumption problem in Sri Lanka. Moreover, only 30.8% of men and 44.3% of women agreed that the government's alcohol laws are currently strong enough to protect people from alcohol harm. The regression analysis revealed that men are 2.43 times more in agreement with the statement that "policy measures aimed at reducing alcohol consumption can benefit the public" as compared to women. However, individuals aged 50-64 years are 40% less likely to agree with this statement as compared to 18-33 years. Conclusion: The majority of the public, including people who consume alcohol, are supportive of improving alcohol related policies, including taxes, and acknowledge negative impact of alcohol consumption on the country. This presents a clear opportunity for Sri Lanka to strengthen and enforce the alcohol related policies to protect and improve public health.

Popular education in the SUS: current challenges from the perspective of the Observatory of Popular Health Education and the Brazilian Reality. / Educação popular no SUS: desafios atuais no olhar do Observatório de Educação Popular em Saúde e Realidade Brasileira.

This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.

Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.