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espanolLas Inequidades Sociales en Salud (ISS) continuan representando un gran reto para la salud publica en los diferentes paises del mundo. Por su parte, el estudio, analisis y generacion de conocimiento en esta materia ha sido reconocida como prioritaria para la Organizacion Mundial de la Salud desde 1991. La investigacion de las ISS debe basarse en fundamentos teoricos y conceptuales solidos, pues son estos las que guiaran las decisiones metodologicas en terminos de diseno de investigaciones, formulacion de intervenciones y politicas publicas en salud. En Latinoamerica, los estudios realizados se han basado primordialmente en experiencias que se han llevado a cabo en paises industrializados. Esto ha fomentado que el analisis de las ISS reproduzca posturas teoricas y metodologias, sin necesariamente presentar una perspectiva critica de los posibles estratificadores sociales que aproximan de la mejor forma los determinantes sociales de la salud en los contextos particulares. Por esta razon, se expone que las aproximaciones teorico-metodologicas deben ajustarse a los contextos especificos de los paises; que la estratificacion social de la salud debe ser evaluada de forma prioritaria; que los determinantes de la salud individuales y estructurales deben ser considerados dentro de las mediciones; y que la justificacion teorica de las decisiones metodologicas realizadas en los estudios y las medidas seleccionadas deben ser explicitas y responder a hipotesis concretas. Esto con el fin de proveer un analisis critico y herramientas utiles tanto para la investigacion como para la toma de decisiones en salud. Este estudio inicia con una sintesis de los principales antecedentes historicos que han permitido la evolucion del concepto de ISS. Seguidamente, se presentan los principales conceptos subyacentes relativos a la definicion de ISS (determinantes sociales, equidad, justicia, estratificacion y gradiente social en salud) y como estos deben guiar las decisiones practicas y metodologicas. Finalmente, se concluye con algunas recomendaciones para la generacion de esta evidencia cientifica para Latinoamerica. EnglishSocial health inequalities (or inequities) continue to represent a great challenge for public health research worldwide. Since 1991, the World Health Organization established that the study and analysis of health inequalities represented a priority for all countries. To better guide methodological and practical implications of health inequalities, research on this topic should present a solid theoretical model, able to impact future public health policies. Previous studies of health inequalities in Latin America are often inspired from abroad experiences, encouraging the reproduction of mainly European theoretical positions and methodologies. However, especially when it comes to this topic, it is known the important role of the social context and culture, playing an important role in promoting differences in health outcomes. From this perspective, to operationalize the different social determinants in health, a critical perspective and thoughtful analysis of the context is mandatory. In order to provide a critical analysis and useful tools for both research and health decision making, we recommend that the theoretical and methodological approaches used in social health inequalities research must be well adapted to the specific contexts; that health social stratification must be assessed as a priority; that individual and the wider health determinants must be well characterized; and that the theoretical justification of the methodological decisions made in the studies and the selected measures must be explicit and should answer specific hypotheses. This research provides a brief historical background, to share the basis for the conceptual evolution of social health inequalities; the main underlying concepts related to the definition of health inequalities (social determinants, equity, justice, stratification and social gradient in health); and some recommendations for the future perspectives of health inequalities research in Latin America.

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TheorTheoretical Implications for the Analysis of Social Health Inequalities: A Discussionetical Implications for the Analysis of Social Health Inequalities: A Discussion