Health paradigms shifts in the 20th Century

  • Jose Miguel De Angulo MAP International
  • Luz Stella Losada Map International
Keywords: health paradigms, paradigm shifts, complex systems, community health, Alma Alta, primary health care

Abstract

The application of systems theory and the study of complexity to medicine and human health allows for a more comprehensive understanding and a more holistic view of what it means to be human.  Such application overcomes the limitations of the traditional, fragmented understanding of phenomena and problems based on the mechanistic or Newtonian worldview.  It recognizes that phenomena are interrelated, and that individual parts cannot be understood by only focusing on the analysis of their individual qualities.  Rather, the individual parts can only be understood in relation to the whole and by being analyzed in the context of their interaction with the whole. The door is opened to previously unimagined models of thinking.

There have been shifts in the paradigms that have governed medicine and human health in the modern western world.  There has been a shift from the focus on specific biological analysis and pathological diagnostics to complex human interactions with the environment and with sociopolitical and economic processes.  There are complex models of systems in immunology, in neuroscience, and in genetics, as well as complex ways of understanding interactions as in epidemic modeling, in social media technologies, socioeconomic factors, and artificial intelligence. 

In this paper we describe three paradigms of the health-disease process that in some degree correspond to the historical development of modern medicine and healthcare over the previous century.  The oldest paradigm focused on specific disease mechanisms and treatment.  This gave way to paradigms that historically were broader and more inclusive, such as “international health”.  The international health paradigm focused primarily on the control of epidemics across national borders and considered government as the only health actor.  However, this perspective has come to be seen as excessively reductionist and excluded many critical components essential to a robust understanding. The old “international health” has in turn been replaced by the paradigm of “global health” that exercises more comprehensive claims.

Author Biographies

Jose Miguel De Angulo, MAP International

Dr. De Angulo established MAP International’s Bolivian Community Health Promoter Training Center in 1988 in which 1,000 men and women from urban and rural areas have participated.  His community health experience, combined with his medical credentials qualifies him as a good consultant on the topics of health education, holistic development, management, human rights, and sexual abuse issues.  With his wife, Luz Stella Losada de De Angulo, he has authored over a dozen books on these subjects. Dr. De Angulo, Colombian born, received his medical degree in 1978 from the Universidad del Cauca in Popayán, Colombia.  He then pursued a Master of Public Health degree from the Johns Hopkins University School of Hygiene and Public Health in Baltimore, MD and a Master of Arts in Religion from the Eastern Baptist Seminary in Philadelphia, PA. While studying in the United States, he participated in public health programs, community health promotion, and grass-roots community organization efforts in both Baltimore and Philadelphia. His most recent accomplishment is co-founding, with his wife, the Support Center for Victims of Sexual Abuse in Cochabamba, Bolivia. In the last decade he has focused his work on healthy early child development programs.  Dr. De Angulo has served on multiple boards and actually is a member of the international board of World Vision International.

 

Dr. De Angulo established MAP International’s Bolivian office in 1988. During this period, with his wife Luz Stella Losada, has facilitated multiple community health programs with emphasis on gender equity and comprehensive child protection and development. They both have authored over two dozen books on the subjects of community health, sexual violence against children, community development education, and comprehensive early child development. Dr. De Angulo, Colombian born, received his medical degree in 1978 from the Universidad del Cauca in, Colombia.  He then pursued a Master of Arts in Religion from the Eastern Baptist Seminary in Philadelphia, and a Master of Public Health from the Johns Hopkins University School of Hygiene and Public Health in Baltimore. With his wife co-founded the Support Center for Victims of Sexual Abuse in Cochabamba, Bolivia. In the last decade he has focused his work on comprehensive early child development programs with special consideration to their brain architecture development as the foundations for physical and mental health they will have during their lifespan.

Luz Stella Losada, Map International
Along with her husband, Dr. José Miguel De Angulo, Luz Stella helped established MAP International’s Bolivian Community Health Promoter Training Center in 1988 in which more than 1,000 men and women have participated from urban and rural areas throughout the Department of Cochabamba.  She regularly consultants to PVOs, and NGOs, universities around the world on the topics of health education, holistic development, management, human rights, and sexual abuse issues.  With her husband, she has co-authored over a dozen books on these subjects. Luz Stella, Colombian born, graduated from the Colegio Mayor de Cultura in Popayan, Colombia in 1976. In 1997 she received a Masters Degree in Health Education from Limburg University, Maastricht, The Netherlands. She and her husband co-founded The School for Life in Chilimarca, Bolivia, a pre-school and early education school patterned on Montessori, Problem Based Learning and Cooperative Learning education principles.  In 2004 she co-founded The Centro Una Brisa de Esperanza in Cochabamba, Bolivia for child victims of sexual abuse. She has been intensively involved supporting comprehensive early child development programs and training of health promoters on early infancy and parents on child rearing practices.  Her work is focused on Program Quality and Resource Development. With her husband, Jose Miguel, have five children, four of them already married.

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Published
2015-05-28
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