Health, development and equity

Abstract

Brazil, a country of continental proportions, shares this paradox along with other dynamics of a developing and dependent country. It is a country with great natural wealth, and major energy and raw material potential, each of which has not been properly exploited and used. Few segments of the population have been incorporated into the global economy and a large proportion are marginalized from the process of development and, more specifically, from the distribution of its wealth. Within its territory, there remain large islands of unequally distributed deprivation, destitution, and oppression, due to the longstanding economistic — and not distributive — development model, recently imbued with neo-liberal elements. Government efforts aimed at economic aspects, and not at human needs, have produced growing impoverishment accompanied by the inability of the overwhelming majority of the population to participate equitably in the production, management, and consumption of material and cultural goods and services. While it is not low in comparison to most countries in the world, Brazil’s Gross Domestic Product (GDP) does not present the same pace of growth as that of China or other countries of Latin America, such as, Chile and Argentina. This macro indicator of Brazil’s wealth also does not show a direct and consistent correlation with health indicators and living conditions of the population. According to data from studies conducted on Brazil, this is not a poor country, but an unjust and unequal one. The comparison of per capita income of Brazil against other countries places it among the richest one-third of countries in the world. However, the average percentage of families living in Brazil with up to half the monthly minimum wage (one of the indicators of poverty, i.e., around 75 dollars per capita a month for meeting basic needs), is much higher than in countries with income similar to that of Brazil. The poor population of Brazil represents 30% of the total population; however, in Chile and Argentina, the poor are 10% at most. These data demonstrate that the source of poverty is Brazil is in the poor distribution of existing resources. The average income of the richest 10% in the country is 28 times greater than the average income of the poorest 40%. In the United States, this proportion is five times; in Argentina, 10 times; and in Colombia, 15 times. The distribution of poverty is also unequal among the country’s regions, as is the distribution of families living with up to half the monthly minimum wage, according to data from the national household survey (PNAD) of 2002. In many municipalities of the north region, the percentage of poor children and adolescents exceeds 90%. In the northeast region, especially in the semiarid area, 75% of children and adolescents live in poverty. Meanwhile, in the south region, more specifically in Rio Grande do Sul, there are municipalities with less than 2% of poor children and adolescents. In this context, the distribution is even more unequal regarding poor black children (IBGE, PNAD, 2002). Inequities in Brazil are also revealed by