Health Policies and Social Conditions in the Republic of Laborers

Drawing attention to the fact that the concept of health is shaped beyond hospital and treatment facilities by social determinants such as working conditions, poverty, housing, and nutrition, the article discusses public health policies and marketization processes.

Although hospitals, treatment facilities, and new technologies are the first things that come to mind when health is mentioned, the fundamental factors determining a society's health level are mostly shaped outside hospital walls. People's diet, housing, working conditions, access to clean air and water, and poverty levels can be more decisive on health than treatment services. This situation, which is one of the fundamental premises of social medicine, reveals that disease cannot be explained solely by biological processes, but is a reflection of social relations and inequalities. Pneumoconiosis seen in miners, exposure of agricultural workers to chemical substances, shift work conditions, and the relationship between poverty and chronic diseases demonstrate that health is socially determined.

In the early years of the Republic, combating epidemics, developing preventive medicine, establishing the Public Health Institution (Hıfzıssıhha Kurumu), and spreading health services across the country were among the examples of treating health as a public responsibility. In subsequent years, efforts were made to provide preventive and curative services comprehensively through the health center model. However, with the Health Transformation Program during the AKP government, health services were drawn into market relations, hospitals were turned into enterprises, patients into customers, and healthcare workers into employees dependent on performance indicators. This transformation has brought along problems such as performance pressure and job insecurity.