Perspectivas críticas de salud y hegemonía comunicativa: aperturas progresistas, enlaces letales

Abstract

This essay argues that dominant ideologies and practices of communication, which it refers to as communicability, operate much like the “Hegemonic Medical Model” (Menéndez y Di Pardo, 1996). Hegemonic ideologies envision communication as a linear, unidirectional process in which messages are produced by experts –medical researchers, epidemiologists, etc.–, are circulated by health education specialists and reporters, and received by “the public”. Rather than being mere mechanical processes, spheres of communicability in health –or biocommunicability– constitute a form of governmentality that creates and ranks subjectivities and social locations. The article creates a dialogue with Latin American critical epidemiology and social medicine, particularly with the work of Jaime Breilh and Eduardo Menéndez, comparing how the frameworks proposed by these authors and the one outlined in this article analyze power, social inequality, state institutions, and neoliberal policies. At the same time that critical epidemiologists and practitioners of social medicine can provide important theoretical and political insights for informing research on biocommunicability, they have generally failed to identify and challenge hegemonic ideologies of communication and their effects on public health. The essay thus hopes to show that both epistemological and political facets of critical epidemiology and social medicine can be significantly strengthened by adding “communication” to the set of hegemonic concepts and practices that researchers evaluate critically and seek to transform. Specifically, communicability constitutes an important set of tools for constructing and naturalizing neoliberal ideologies and practices.