Abstract
This article describes tendencies in research on social determinants of health (SDH) and health inequities in Brazil (2005-2012) and maps research system structures to analyze capacities for research on health and its social determinants. Brazil has a strong national research system and counts on a wealth of research in the field of SDH drawing on a long tradition of research and political commitment in this area. While innovative strategies seeking to strengthen the links between research, policy and practice have been developed, the impact of SDH research continues to be largely restricted to the academic community with notable but still insufficient repercussions on public policy and the social determinants of health inequities. SDH research in Brazil will therefore need to become even more responsive to social urgencies and better attuned to political processes, enhancing its capacity to influence strategic policy decisions affecting health inequities and mobilize strategic agendas for health equity.
Highlights
Brazil presents both major inequalities in the distribution of wealth as well as considerable levels of poverty, which has shaped health inequalities 1
We found that publications on social determinants of health (SDH) and health inequities are concentrated in two main academic journals whose articles are accepted in English, Spanish and Portuguese and follow the open-access policy: Cadernos de Saúde Pública, published monthly by the National School of Public Health (ENSP/ Fiocruz) and Revista de Saúde Pública, published bimonthly by the Faculty of Public Health of the University of São Paulo (USP) 19
Following Guimarães et al 31, the Brazilian national health research system, continues to face bureaucratic difficulties that hinder the efficient transfer of resources from government level to researchers and research institutes, which may have repercussions on the availability of resources for SDH research
Summary
Brazil presents both major inequalities in the distribution of wealth as well as considerable levels of poverty, which has shaped health inequalities 1. The 2008 report from the Brazilian National Commission on Social Determinants of Health (CNDSS) 1 refers to, amongst other things, the notable social gradient in the use of and access to health services and the socioeconomic, ethnic/racial and regional inequalities in infant mortality, micronutrient deficiency, acute respiratory infections and diarrheas, to name just a few examples Developments such as the democratization process after the military dictatorship from 1964 until the late 1980s, advances in education, and the strong reform movement that led to the inclusion of the right to health in the Brazilian Constitution of 1988 and the creation of the Brazilian Unified National Health System (SUS), have undoubtedly facilitated advances in several areas of public health 1,2. The information presented in this article is based on a mapping exercise, which formed part of the first phase of the European Union funded collaborative action SDH-Net (http://www.sdh-net.eu/) and sought to inform SDH-Net’s phase 2 research capacity building measures and identify entry points for action
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