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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La epidemiolog&#237;a ocupa ya un papel relevante en la definici&#243;n de pol&#237;ticas p&#250;blicas y corporativas&#44; tanto en Espa&#241;a como en otros pa&#237;ses desarrollados&#44; especialmente en los &#250;ltimos a&#241;os&#44; en que como consecuencia de la entronizaci&#243;n por la Organizaci&#243;n Mundial de la Salud de la noci&#243;n de determinantes sociales de la salud&#44; la conexi&#243;n entre la salud y lo construido socialmente se ha hecho m&#225;s evidente&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">El uso de la epidemiolog&#237;a&#44; sin embargo&#44; suele verse restringido al desarrollo y la evaluaci&#243;n de pol&#237;ticas originadas en burocracias sanitarias y con la mejora de la salud como &#250;nico objetivo social&#59; son las llamadas pol&#237;ticas directas de salud&#46; Esto supone una visi&#243;n reduccionista del tema&#44; ya que la salud se gana y se pierde por pol&#237;ticas extrasanitarias primordialmente&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Para ampliar el papel de la epidemiolog&#237;a como herramienta para las pol&#237;ticas&#44; necesitar&#237;amos tener una visi&#243;n de las exposiciones y los efectos m&#225;s all&#225; de la esfera sanitaria y de los factores de riesgo &#8211;biol&#243;gicos y conductuales&#8211;propuestos por el paternalismo m&#233;dico&#46; Hay que tener una actitud m&#225;s participative que prescriptiva&#44; desarrollar m&#225;s estudios de evaluaci&#243;n del impacto en salud y empezar a valorar tambi&#233;n el efecto sobre la salud de las decisiones de las instituciones que derivan del poder pol&#237;tico&#46; Es decir&#44; construir una epidemiolog&#237;a pol&#237;tica&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Para esta tarea&#44; quiz&#225;s clave para desarrollar la salud p&#250;blica que necesitamos&#44; los salubristas deber&#237;an ser m&#225;s visibles y m&#225;s cre&#237;bles&#44; tender m&#225;s a la independencia del poder pol&#237;tico&#44; y suministrar informaci&#243;n directamente a la poblaci&#243;n y otros interesados &#40;transparencia&#41;&#44; desarrollando su profesionalizaci&#243;n plena &#40;competencia&#41; m&#225;s como redes de profesionales que como pir&#225;mides burocr&#225;ticas&#46;</p>"
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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Epidemiology already plays a substantial role in the definition of public and corporate policies in Spain as well as in other developed countries&#46; The World Health Organization reinforced the position of epidemiology by enshrining the notion of social health determinants and&#44; as a result&#44; the connection between health and social constructs has become more visible&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">However&#44; the use of epidemiology is usually restricted to the development and evaluation of policies originating in health bureaucracies with health improvement as the only public objective&#59; these are called direct health policies&#46; This view is somewhat reductionistic insofar as health gains and losses occur mainly due to policies outside the health sector&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">To expand the role of epidemiology as a tool to shape policies&#44; we need a view of exposures and effects beyond healthcare and the biological and behavioral risk factors proposed by medical paternalism&#46; Also required are an attitude that is more participative than prescriptive and the development of more health impact assessments&#46; In addition&#44; the health effects of the decisions taken by politically-empowered institutions should be included in the epidemiologist&#39;s tool kit&#46; In other words&#44; a political epidemiology should be constructed&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">For this endeavor&#44; which may be crucial to attain the public health required&#44; public health practitioners should be more visible and credible&#44; have greater independence from political power&#44; provide information directly to the public and other stake holders &#40;greater transparency&#41;&#44; and further develop the professionalization of public health &#40;greater competence&#41; by working increasingly in networks of professionals rather than in bureaucratic pyramids&#46;</p>"
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