Social determination, sustainable development, and popular education

(re)thinking human and planetary health

Abstract

On the eve of the 2025 United Nations Climate Change Conference (COP 30), the trajectory of the implementation of the 2030 Agenda and its Sustainable Development Goals (SDGs) shows only subtle progress. The unfavorable global political climate has had a negative impact, culminating in the breaking of multilateral agreements and pacts by conservative governments, hindering progress in achieving some goals and leading to setbacks in others. Therefore, achieving the SDGs depends on a profound change in the current mode of production. Transformations of this magnitude are complex, demanding educational actions in different social spaces capable of promoting the decolonization of knowledge, thus preventing the perpetuation of socio-environmental tragedies resulting from neoliberal policies as if it were a natural process. This work aimed to discuss the relationship between achieving the SDGs of the 2030 Agenda and the process of social and environmental determination of health in the context of the structural crisis of capitalism, focusing on Popular Health Education as an alternative for mobilization towards the necessary decolonization of Latin American thought and consequent social transformation. To this end, a theoretical essay was conducted, exploratory in nature and anchored in a qualitative research perspective, understanding that these works are based on arguments and debates on a theme, drawing on theories – here, critical ones – about a specific subject (relations between the capitalist mode of production and global health). The social determination of health constitutes an essential theoretical elaboration for the construction of a critical and politically relevant science, involving processes characterized by interdependence and autonomy, expressing the contradiction between health-promoting and unhealthy factors. Here, health is understood as a multidimensional and complex object, realized in the general dimension of society (involving education, income, basic sanitation, transportation, food, etc.), in the particular dimension of social groups, and in the singular dimension of individuals in their daily lives. Thus, the determination of human health is made through the analysis of the prevailing mode of production in a given location and historical period, as well as the degree of development of the productive forces and the social relations established between subjects. It is no coincidence that historical inequalities resulting from the actions of the Global North persist, shaping health policies and practices often disconnected from local realities and those of other regions of the world. This process is translated into the colonization of knowledge and power, insofar as the Western biomedical model, built on Eurocentric foundations, has been universalized as the sole standard of rationality and care. This colonization is not restricted to the political or economic dimension, but also to the epistemic dimension; that is, it affects how health is defined, who produces valid knowledge, and which practices are recognized as legitimate. In this sense, epistemologies from the South propose the recognition of popular, traditional, and community knowledge as fundamental to the construction of fairer, more dialogical, and contextualized health policies. From this perspective, it is urgent to value local knowledge, critically analyze structural processes, and build public health policies that articulate social justice, equity and decoloniality, in order to overcome capitalist exploitation. If, for capitalist society, it is vital to promote the exploitation of labor, generating inequality and misery, it is possible to affirm that what capitalism needs to survive and progress is exactly the opposite of what is advocated for health. For this reason, we understand that the realization of the SDGs is absolutely linked to overcoming the capitalist mode of production. Based on Marxist thought, the health-disease process translates into the expression of the contradictions between capital and labor, where environmental crises are not natural, but consequences of the capitalist production model that generates inequalities and degrades life. Thus, social determination broadens the debate by articulating health, environmental justice, and sustainability, indicating the need to transform the economic and political structures that produce both illness and environmental destruction. To produce a theory of transition to a new social order requires a collective effort, which we believe is possible through Popular Education (PE) focused on problematizing health inequities. PE is conceptualized as a dialogical and participatory pedagogy, with a class perspective and valuing different types of knowledge, as well as being a political, social, and cultural movement of mobilization and awareness-raising. Thus, it understands the reading of the world – and of life – as a political act of practice Popular Education in Health (EPS) is an educational approach aimed at recovering the humanity stolen from the oppressed. In this way, it is reaffirmed that EP is carried out with the intention of fighting for humanization, for free labor, for de-alienation, and for the affirmation of people as persons. EPS constitutes a theoretical-methodological and ethical-political perspective, present in different experiences of Latin American social movements, qualifying the political nature and pedagogical power of popular education in the health sector. It is a decolonial, critical, dialogical, and participatory educational perspective that stimulates the development of critical thinking, so that individuals seek to understand their reality, problematizing and reflecting on the resolution of the problems that oppress them. The colonialist structures present in the policies and narratives on health and well-being in the SDGs of the 2030 Agenda render local knowledge invisible, marginalizing historically excluded populations, such as Black people, Indigenous peoples, and the LGBTQIAPN+ community, disregarding their cultural and community experiences. Paradoxically, they cite poverty eradication, gender equality, and the reduction of inequalities as goals. It is urgent to value local epistemologies, recognize the political and cultural territory of health, and (re)build policies that are truly sensitive to Latin American realities. Within these reflections, we defend EPS as an educational movement of resistance, strengthening the fight against the dehumanization imposed by the logic of capitalist production and the social inequities it produces. Thus, we believe in education – of popular origin – in diverse contexts as an instrument of critical, dialogical, and participatory construction so that the population – including ourselves – can overcome, through popular struggle, the atrocities of which we are victims of this perverse, cruel, and exploitative system.