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Urban health is strongly linked to mental illness, being overweight, smoking behaviors, diabetes mellitus, hypertension, and coronary disease; most of these are chronic diseases/conditions. Healthy...

The global health scenario shows an epidemic of non-communicable diseases that lead to long-term chronic conditions, some of which are incurable. Many infectious diseases, owing to their development and length, also generate chronic conditions. Similarly, non-morbid states, such as pregnancy, and some life cycles such as adolescence and ageing, follow the same logic. Among all these chronic conditions there is a significant interrelationship with oral health, both in parallel events and common risk factors. This article presents cross-sectional qualitative research into World Health Organisation recommended health policies to address chronic conditions. Several documents published by the organisation were analysed to verify the presence of references to oral health in relation to chronic conditions, particularly cardiovascular diseases and diabetes as these most frequently have oral manifestations. The analysis showed no significant references to oral health or its indicators within the published texts. The study recognises the value of the work developed by the World Health Organisation, as well as its worldwide leadership role in the development of health policies for chronic conditions. This article proposes a coalition of dentistry organisations that could, in a more forceful and collective way, advocate for a greater presence of oral health in drafting policies addressing chronic conditions.

This research has a theoretical approach based on the stoic principle that happiness and self-fulfillment are natural consequences of right attitudes. It is possible to change the will to suit the world and live sick and happy, in peril and yet happy, stating an individual desire completely autonomous and deterministic. This presupposes not an apathetic fatalism, but a moral resistance to better face the hardships of life. When faced with setbacks of destiny a stoic believes in an extreme personal freedom to ally with this almost absolute determinism. These are congruent principles to health care models for strengthening and supporting people in chronic conditions. A literature review of three important works of the Stoic School (Encheiridion and The Discourses, by Epictetus, and Moral Letters to Lucilius, by Seneca) was performed. The search words "health, disease, choice, discipline," with its English correspondents, were utilized for the selection of texts, interpreted by discourse analysis. It was sought a contribution to Public Health towards the management of chronic conditions, the silent epidemic of XXI century. As results some principles are presented converging to notions of selfcare and shared care for chronic conditions, primarily focused on the autonomy and discipline of users to manage their health. It is proposed the application of these principles to treatment planning in programs for chronic conditions, whether for ill patients or in special conditions of health, such as adolescence, disabilities, pregnancy, etc. Under this point of view these principles could be extended to health professionals because their work routine also features a chronic condition. That could benefit individuals, healthcare systems and society as a whole. RESUMO Esta pesquisa tem um enfoque teorico, baseada no principio estoico de que felicidade e realizacao pessoal sao consequencias naturais de atitudes corretas. E possivel alterar a vontade para se adequar ao mundo e viver doente e feliz, em perigo e ainda assim feliz, afirmando um desejo individual completamente autonomo e determinista. Isto nao pressupoe um fatalismo apatico, mas sim uma resistencia moral para melhor enfrentar as agruras da vida. Ao deparar-se com os revezes do destino um estoico acredita em sua extrema liberdade pessoal para aliar-se a esse determinismo quase absoluto. Tais principios sao coerentes com modelos de atencao a saude para o fortalecimento e apoio as pesso-as em condicoes cronicas. Foi realizada uma revisao bibliografica de tres importantes obras da Escola Estoica (En-cheiridion e The Discourses, de Epicteto, e Moral Letters to Lucilius, de Seneca). Foram utilizadas as palavras de busca “saude, doenca, escolha, disciplina”, com suas correspondentes em ingles, para a selecao dos textos, interpreta-dos por analise do discurso. Buscou-se uma contribuicao para a Saude Coletiva, direcionada para o manejo das condi-coes cronicas, a epidemia silenciosa do seculo XXI. Como resultados sao apresentados alguns principios convergentes com nocoes de autocuidado e cuidado compartilhado, focados principalmente na autonomia e disciplina da pessoa usuaria para monitorar a sua saude. Propoe-se a aplicacao desses principios aos programas de atencao as condicoes cronicas, seja para portadores de doencas ou pessoas em condicoes especias de saude, tais como adolescencia, inca-pacidades, gravidez, etc. Sob este ponto de vista esses principios poderiam ser estendidos aos profissionais de saude, pois sua rotina de trabalho tambem caracteriza uma condicao cronica. Disso poderiam beneficiar-se individuos, siste-mas de saude e a sociedade como um todo.

Tradicionais modelos biomédicos de assistência à saúde, voltados para condições agudas e episódicas, não têm respondido adequadamente às Condições Crônicas que requerem cuidado diferenciado, longitudinal e proativo. Esta pesquisa avaliativa sobre atenção a Condições Crônicas buscou identificar, em abordagem quantitativa, a percepção de usuários e equipes de saúde sobre inovações, com a implantação de um novo modelo de atenção. Os resultados demonstram associação entre a implantação do modelo e as mudanças ocorridas, tais como o cuidado compartilhado e o autocuidado. A forma como é dispensado o cuidado mostra relação direta com o nível de satisfação das equipes de saúde e pessoas usuárias.

This study deals with public health management in small Brazilian municipalities with low HDI-M through analysis of financial resources. Findings indicated some innovations, but not enough, with managers needing specific administration learning, although they state their desire to improve services. Unstructured reports do not contribute to health planning, showing no relationship between the scope of health actions and financial resources. Management needs to evolve to intersectoral decisions, with social participation in planning. This would make it possible to solve more health problems and provide a universal and equitable service to the population in the process of National Health System decentralisation.