Indigenous territories and socio-environmental determination of health: discussing exposure by pesticides

ABSTRACT The stages involving the agricultural supply chain produce different possibilities of vulnerability in populations, affecting the health situation of indigenous peoples. The use of pesticides is an activity intrinsic to monocultures. The exposure to these substances generates acute and chronic negative outcomes in human health and contamination in the environment. In order to contribute to the debate in Public Health, the text directs the discussions to the state of Mato Grosso, where are several indigenous peoples, facing the production of commodities and health outcomes associated to pesticides. For that, we resort to the socio-environmental determination of the health-disease process, organizing a matrix of indicators that emphasize the choices and omissions of the State in environmental issues, incorporating historicity in the processes of illness. The impacts of the agricultural commodities chain and exposures by pesticides in indigenous territories are an intersectoral problem that is linked to the violation of basic social rights, such as the right to land, health, and food and nutritional security. The responses must be considered in an articulated perspective between the economic, political, environmental, and health sectors, with participation and decision by the indigenous population in the stages of the processes.

摘要 农业供应链各环节会为不同人群带来脆弱性风险，进而影响原住民的健康状况。农药使用是单作种植模式的固有生产活动。接触此类农药会对人体健康造成急性与慢性不良影响，同时引发环境污染。为推动公共卫生领域的学术讨论，本文聚焦马托格罗索州（Mato Grosso），该州分布有多个原住民群体，正面临大宗商品生产及与之相关的农药暴露健康后果问题。为此，本文援引健康-疾病过程的社会环境决定论，构建一套指标矩阵，用以凸显国家在环境议题上的决策取向与疏漏之处，并将历史性维度纳入疾病发生过程的分析。农业大宗商品供应链的影响以及原住民领地内的农药暴露问题属于跨部门议题，其与土地权、健康权、粮食与营养安全等基本社会权利的受侵害息息相关。相关应对方案需从经济、政治、环境与卫生部门的协同联动视角出发，且需让原住民群体参与各环节的决策与执行。