The Construction of Social Health Systems: History and Self-Reference of Medicine and Public Health

Despite governmental and international funding as well as numerous publications on health systems, questions remain. João Costa offers new insight into health systems thinking by emphasizing the social nature of health systems. He traces health systems back to their origins in Ancient Greece and investigates their development throughout history, focusing on the notion of systems’ self-reference, a constitutive feature of social systems. The study is built on Luhmann’s Social Systems Theory and his outline of health as social system. Valuable for health professionals, it discusses communication as lifeblood for making health systems self-referential.

João Costa is a public health specialist and health economist. He has a doctorate degree from the London School of Hygiene and Tropical Medicine, where he also worked as research fellow. He is also an independent consultant and associate researcher of the Swiss Tropical and Public Health Institute. He has approximately 45 years of working experience in development projects in several countries, always focusing on strengthening health systems. His international profile includes project management, research, teaching, consultancy, and high-level advisory positions - working with academic institutions, consultancy companies, international development banks, international development agencies, and others.