Upload
naomar-almeida-filho
View
230
Download
0
Embed Size (px)
Citation preview
7/31/2019 Social determination and health inequities in Brazil today
1/40
Socialdeterminationandhealthinequities
inBraziltoday
7/31/2019 Social determination and health inequities in Brazil today
2/40
7/31/2019 Social determination and health inequities in Brazil today
3/40
1964-1985
Military dictatorship US dependent foreign policy External debt (economic
miracle)
Political repression National security ideology
7/31/2019 Social determination and health inequities in Brazil today
4/40
1986-2002
1988 Constitution
Hyperinflation Economic crisis External debt explosion Political freedom Neoliberal ideology
7/31/2019 Social determination and health inequities in Brazil today
5/40
2003-present
Reconstruction of the State Economic growth Environmental challenges Technological dependency Independent foreign policy Expanded social policies
7/31/2019 Social determination and health inequities in Brazil today
6/40
PARADOX:
More political participation Reduction of economic
inequality
Increasing social inequityin health
7/31/2019 Social determination and health inequities in Brazil today
7/40
7/31/2019 Social determination and health inequities in Brazil today
8/40
Between 2006 and 2012, the middle-income social
segment (class C)* increased from 36% to 55%
mainly because of upward mobility from thelower-level classes . Today, this social segment
represents the majority of Brazilian population,
accounting for 104.5 million people.
* Social classification: class A/B: monthly income > R$ 7,500; class C: income > R$1,500;
class D: income > R$850; class E: income < R$850. Source: IPEA
Social mobility of the Brazilian population
7/31/2019 Social determination and health inequities in Brazil today
9/40
Evolution of Social Class Profile.
Brasil 1992-2009
7/31/2019 Social determination and health inequities in Brazil today
10/40
0,559
0,552
0,548
0,534
0,530
0,524
7/31/2019 Social determination and health inequities in Brazil today
11/40
0,5590,552
0,548
0,534
0,530
0,524
0,571
0,551
0,557
0,539
0,539
0,535
0,5
0,51
0,52
0,53
0,54
0,55
0,56
0,57
0,58
2004 2005 2006 2007 2008 2009
Brasil
Nordeste
EvolutionGiniCoef:icient.Brasil2004-2009
7/31/2019 Social determination and health inequities in Brazil today
12/40
Source: Brazil - IPEA; other countries - Central Intelligence Agency's WorldFactbook
7/31/2019 Social determination and health inequities in Brazil today
13/40
EvolutionGiniCoef:icient.Brasil1960-2009
7/31/2019 Social determination and health inequities in Brazil today
14/40
EvolutionoftheSocialPyramid
Brasil2003-2011
7/31/2019 Social determination and health inequities in Brazil today
15/40
7/31/2019 Social determination and health inequities in Brazil today
16/40
7/31/2019 Social determination and health inequities in Brazil today
17/40
7/31/2019 Social determination and health inequities in Brazil today
18/40
7/31/2019 Social determination and health inequities in Brazil today
19/40
Brasil health system structure
7/31/2019 Social determination and health inequities in Brazil today
20/40
FamilyHealthProgram(PSF) PrimaryHealthCare/healthpromotion CommunityHealthAgents(>200,000) multi-professionalhealthteams(>60,000)
SpecialPrograms
HIV/AIDS EpidemiologicalSurveillance PharmaceuticalCare
HighComplexityCareManagement
Pro-Sade(healthprofessionstrainingprogram)
SUS highlights
7/31/2019 Social determination and health inequities in Brazil today
21/40
7/31/2019 Social determination and health inequities in Brazil today
22/40
7/31/2019 Social determination and health inequities in Brazil today
23/40
7/31/2019 Social determination and health inequities in Brazil today
24/40
7/31/2019 Social determination and health inequities in Brazil today
25/40
complexdialectic
7/31/2019 Social determination and health inequities in Brazil today
26/40
socialinequity
Dynamics of SUS-induced inequity
failure of
integrality unequalaccess
unequal
quality
low
SocialValue
financialinstability
Complexregressivetax system
biased
educationofhealthworkforce
7/31/2019 Social determination and health inequities in Brazil today
27/40
HowtounderstandBrazils20-yearexperienceinbuildingauniversal-access,state-funded,sociallycontrolledHealthSystemfromwithin,andmostlyincontradictionto,thesocialcontextofinequalitywhichwelivein?
7/31/2019 Social determination and health inequities in Brazil today
28/40
Most approaches currently proposed
for analyzing health inequities
take for granted (or neglect)
7/31/2019 Social determination and health inequities in Brazil today
29/40
Neo-Durkheimian Model of Health Determinants
?
7/31/2019 Social determination and health inequities in Brazil today
30/40
SocialResources HealthCare
LifeConditions
MODELING HEALTH INEQUITIES
7/31/2019 Social determination and health inequities in Brazil today
31/40
SOCIAL INEQUALITIES >======> HEALTH INEQUITIES
Social
Resources
Health
Care
Life
Conditions
SocialHealth
Situation
MODELING HEALTH INEQUITIES
?
7/31/2019 Social determination and health inequities in Brazil today
32/40
MODELING HEALTH INEQUITY
SOCIAL INEQUALITY >>>>>>>>> HEALTH INEQUITY
Social
Resources
Health
Care
Life
Conditions
Health Practices
Socio-economic determination
Mode
of Life
7/31/2019 Social determination and health inequities in Brazil today
33/40
DISTRIBUTION
CONSUMPTIONSURPLUS
VALUE
LABOR
PROCESS
HEALTH
PRACTICES
SOCIAL
CONSTRUCTION
RISK CONFIGURATIONS
WORK
HEALTH-DISEASE-CARE
SIGNS &
MEANINGS
CULTURAL
CONTEXT
SOCIAL
PRODUCTION
SOCIAL
DETERMINATION
CLASSSTRUCTURE
7/31/2019 Social determination and health inequities in Brazil today
34/40
7/31/2019 Social determination and health inequities in Brazil today
35/40
Jaime Breilh
7/31/2019 Social determination and health inequities in Brazil today
36/40
Gilles Bibeau Juan Samaja
7/31/2019 Social determination and health inequities in Brazil today
37/40
7/31/2019 Social determination and health inequities in Brazil today
38/40
7/31/2019 Social determination and health inequities in Brazil today
39/40
7/31/2019 Social determination and health inequities in Brazil today
40/40
ObrigadoThank you