Notes on the notion of territory in the field of collective health: determination, identities, and territorialities

Abstract

This theoretical essay explores different conceptions of territory within the field of collective health. We aim to elucidate how territory contributes to the historical and organizational constitution of healthcare systems and services, as well as its fundamental role in the field of collective health. The landscapebased epidemiological approach of social preventive medicine, which conceives territory as an environment of disease exposure within nation-state boundaries, is overcome by the ideas of risk and multicausality inherent in the model of the health field. This model expands the understanding of health-disease processes by integrating the environment, access to services, lifestyles, biological determinants with ecological, cultural, and symbolic aspects, as well as social responsibility. Therefore, collective health is enhanced by concepts such as territoriality, identity, and social reproduction, which are important for the districting and organization of democratic healthcare systems, for understanding the social determination of health, and for implementing effective care networks and strategies, particularly in primary care. Ultimately, the notion of territory is fundamental to understanding the structuring conditions of life processes and illness, as well as to the commitment to social transformation.