Why did VMS die? Sentinels of the de-velopment under the critical social environmental approach of the social determination of health

ABSTRACT We start from a transnational company worker who died of liver disease caused by pesticides, to discuss limits of the biomedical paradigm that guides the actions of the Unified Health System. Based on the critical and transformative social environmental approach, we seek to expand the understanding of this and other deaths of workers 'included' through precarious jobs and unequally protected by public policies. It features a vulnerability process mediated by the neo-liberal state and its extrativist policies of development, and enhance the theoretical-methodological bases of public health to advance critical and emancipatory perspective, in dialogue with the knowledges of other epistemic and political subjects.