Brazilian Slum Research Articles

Slums, social disparities and the COVID-19 pandemic: who were the people truly impacted during the pandemic in Brazil?

BackgroundBrazil was heavily impacted by COVID-19 pandemic, which intensified social and health disparities, especially in vulnerable areas such as slums. Therefore, the aim of this study was to investigate which residents of slums in Brazil were most affected by COVID-19 pandemic, with a focus on food insecurity, loss of income, ethnic and racial inequalities, and other social and geographic disparities.MethodsWe conducted a cross-sectional study among the populations of slums in Brazilian capitals and the Federal District by applying a validated instrument. Inferential descriptive statistics were used, with the application of a logistic regression model.ResultsThe study included 1,227 individuals from slums, most of whom were women, black or mixed-race, single, self-employed, and users of the Brazilian public healthcare system. Slum residents in the North region experienced the highest income loss, while those in the South region had the lowest, though the South also had the highest food insecurity. People with incomes below one minimum wage were the most affected by income loss, while those with incomes above three minimum wages were the least affected. White individuals were less impacted by food insecurity. Government aid was associated with families experiencing both income loss and food insecurity.ConclusionThis study highlights the impact of the COVID-19 pandemic among those with lower incomes living in slums, being most of them black or mixed-race women working in informal employment. It also shows that social and structural disparities have been exacerbated by the pandemic, particularly regarding race/ethnicity, income, and geographic region of residence.

The Stigmatisation of Poor Citizens Living in Slums in Brazil: the Rio de Janeiro Scenario as a Study Paradigm

The Stigmatisation of Poor Citizens Living in Slums in Brazil: the Rio de Janeiro Scenario as a Study Paradigm

Prevalence and factors associated with intestinal parasitosis in children from an urban slum in Brazil: a cross-sectional study.

This study aimed to estimate the prevalence and investigate the factors associated with intestinal parasitic diseases in children from an urban slum in Brazil. A cross-sectional study was conducted in children living in SEWA community, an urban slum located in Araguari, Minas Gerais, Brazil. The prevalence of intestinal parasitosis was determined via stool parasitological examination by spontaneous sedimentation. Socioeconomic, demographic, and behavioral data were collected to identify associated factors. The statistical analysis used the Poisson regression model, with robust variance for identification of associations. Fifty-two children were interviewed, 41 of whom underwent parasitological examination. The prevalence of intestinal parasitosis was 43.9% (95% confidence interval - 95%CI 34.6-51.4), and 23% of children presented polyparasitism. Endolimax nana, Entamoeba coli, Giardia lamblia and Strongyloides stercoralis were identified in the stool samples. The adjusted analysis indicated negative associations of parasitosis with annual parasitological examination, possession of private health insurance, a mother who was married or in a stable relationship, and access to water treatment. Positive associations were observed with male sex, habit of playing with dirt, water ingestion from the hose, unemployed parents, low parental education, and the presence of a septic tank at home. The high prevalence of intestinal parasitosis in the SEWA community is a public health problem. The identification of modifiable and preventable factors highlights the need for interventions to improve living conditions not only for children but also for the entire community.

Perception of the food environment by Brazilian slum residents: a qualitative study

Food availability in the territory can influence food consumption by the population. However, it is important to understand how people perceive their food environment to see how food availability affects consumption in different contexts. This study aimed to assess the perception of the food environment by Brazilian slum residents in their neighborhoods. This is a qualitative study, with online focus groups guided by a script in order to gather collective discourses about access to food in Brazilian slums. The invitation to participate in this study was made through social media, and community leaders and nongovernmental organizations with actions in slums were contacted using the snowball sampling technique. Grounded theory analysis was applied with the technique of thematic networks. Access to food for slum residents involves lack of resources and essential elements for an adequate and healthy diet, such as lack of information about food, low income, and low availability of stores that sell healthy food at affordable prices. Public programs and policies are required to encourage the expansion of food and nutritional security resources, such as vegetable gardens and markets, to increase the supply and sell healthy food at affordable prices in slums. Actions are also required to address the complexity of obstacles faced by slum residents in the access to healthy foods.

A study on social contact rates relevant for the spread of infectious diseases in a Brazilian slum

Inspired by the POLYMOD study, an epidemiological survey was conducted in June 2021 in one of the most densely populated and socially vulnerable sectors of Belo Horizonte (Brazil). A sample of 1000 individuals allowed us to identify, within a 24-hour period, the rates of social contacts by age groups, the size and frequency of clique in which respondents participated, as well as other associated sociodemographic factors (number of household residents, location of contact, use of public transportation, among others). Data were analyzed in two phases. In the first one, results between two SIR models that simulated an eight-day pandemic process were compared. One included parameters adjusted from observed contact rates, the other operated with parameters adjusted from projected rates for Brazil. In the second phase, by means of a log-lin regression, we modeled the main social determinants of contact rates, using clique density as a proxy variable. The data analysis showed that family size, age, and social circles are the main covariates influencing the formation of cliques. It also demonstrated that compartmentalized epidemiological models, combined with social contact rates, have a better capacity to describe the epidemiological dynamics, providing a better basis for mitigation and control measures for diseases that cause acute respiratory syndromes.

Carriage prevalence, serotype distribution, antimicrobial resistance, pspA typing and pilus islets of Streptococcus pneumoniae isolated from adults living in a Brazilian urban slum.

For Brazilian adults, pneumococcal vaccines have been usually taken only by those who are at higher risk for development of pneumococcal diseases. Since populations from lower socioeconomic status are at high risk of acquiring pneumococcal infections, we investigated the carriage prevalence, colonization risk factors, capsular and surface protein types, and antimicrobial resistance among pneumococcal isolates recovered from adults living in a Brazilian urban slum. Between September-December 2016, we conducted a cross-sectional study among individuals aged≥18years who attended a public primary clinic in Niterói/RJ, Brazil. Pneumococci were isolated by culture on sheep blood agar plates with and without gentamicin. Antimicrobial susceptibility was determined for all isolates. We used PCR to determine capsular types, PspA families (Fam) and pilus islets (PI). Of 385 adults, 32 (8.3%) were pneumococcal carriers. Three carriers had two different pneumococci, totaling 35 isolates. After multivariate analysis, smoking, previous hospitalization, alcohol consumption and co-habitation with children aged<6years increased the odds of pneumococcal carriage, but antibiotic use in the previous 2weeks was found to be a protective factor. Fourteen different serogroups/serotypes were detected and the prevalent ones were 9N/L, 10A, 15B/C and 35F/47F (n=3; 8.6% each). Non-typeable (NT) isolates made up 31.4%. All isolates were susceptible to chloramphenicol, levofloxacin and vancomycin. We found eight (22.9%) penicillin non-susceptible pneumococci (PNSP) with minimum inhibitory concentrations (MICs) of 0.38-1.5μg/mL. The two (5.7%) erythromycin-resistant isolates had MIC>256μg/mL, cMLSB phenotype and the erm(B) gene. Twelve (34.3%) and 17 (48.6%) isolates had PspA Fam1 and Fam2, respectively. Three (8.6%) isolates had genes for pilitwo PI-1 and one PI-2. We detected a low frequency of pneumococcal carriage among the adult population, but a high diversity of serotypes. Frequencies of PNSP and NT isolates resistant to antimicrobial agents are concerning.

Structural factors associated with SARS-CoV-2 infection risk in an urban slum setting in Salvador, Brazil: A cross-sectional survey.

BackgroundThe structural environment of urban slums, including physical, demographic, and socioeconomic attributes, renders inhabitants more vulnerable to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Yet, little is known about the specific determinants that contribute to high transmission within these communities. We therefore aimed to investigate SARS-CoV-2 seroprevalence in an urban slum in Brazil.Methods and findingsWe performed a cross-sectional serosurvey of an established cohort of 2,041 urban slum residents from the city of Salvador, Brazil between November 2020 and February 2021, following the first Coronavirus Disease 2019 (COVID-19) pandemic wave in the country and during the onset of the second wave. The median age in this population was 29 years (interquartile range [IQR] 16 to 44); most participants reported their ethnicity as Black (51.5%) or Brown (41.7%), and 58.5% were female. The median size of participating households was 3 (IQR 2 to 4), with a median daily per capita income of 2.32 (IQR 0.33–5.15) US Dollars.The main outcome measure was presence of IgG against the SARS-CoV-2 spike protein. We implemented multilevel models with random intercepts for each household to estimate seroprevalence and associated risk factors, adjusting for the sensitivity and specificity of the assay, and the age and gender distribution of our study population. We identified high seroprevalence (47.9%, 95% confidence interval [CI] 44.2% to 52.1%), particularly among female residents (50.3% [95% CI 46.3% to 54.8%] versus 44.6% [95% CI 40.1% to 49.4%] among male residents, p < 0.01) and among children (54.4% [95% CI 49.6% to 59.3%] versus 45.4% [95% CI 41.5% to 49.7%] among adults, p < 0.01). Adults residing in households with children were more likely to be seropositive (48.6% [95% CI 44.8% to 52.3%] versus 40.7% [95% CI 37.2% to 44.3%], p < 0.01). Women who were unemployed and living below the poverty threshold (daily per capita household income <$1.25) were more likely to be seropositive compared to men with the same employment and income status (53.9% [95% CI 47.0% to 60.6%] versus 32.9% [95% CI 23.2% to 44.3%], p < 0.01). Participation in the study was voluntary, which may limit the generalizability of our findings.ConclusionsPrior to the peak of the second wave of the COVID-19 pandemic, cumulative incidence as assessed by serology approached 50% in a Brazilian urban slum population. In contrast to observations from industrialized countries, SARS-CoV-2 incidence was highest among children, as well as women living in extreme poverty. These findings emphasize the need for targeted interventions that provide safe environments for children and mitigate the structural risks posed by crowding and poverty for the most vulnerable residents of urban slum communities.

Inequalities in the prevalence of cardiovascular disease risk factors in Brazilian slum populations: A cross-sectional study.

Social and environmental risk factors in informal settlements and slums may contribute to increased risk of cardiovascular disease (CVD). This study assesses the socioeconomic inequalities in CVD risk factors in Brazil comparing slum and non-slum populations. Responses from 94,114 individuals from the 2019 Brazilian National Health Survey were analysed. The United Nations Human Settlements Programme definition of a slum was used to identify slum inhabitants. Six behavioural risk factors, four metabolic risk factors and doctor-diagnosed CVD were analysed using Poisson regression models adjusting for socioeconomic characteristics. Compared to urban non-slum inhabitants, slum inhabitants were more likely to: have low (less than five days per week) consumption of fruits (APR: 1.04, 95%CI 1.01-1.07) or vegetables (APR: 1.08, 95%CI 1.05-1.12); drink four or more alcoholic drinks per day (APR: 1.05, 95%CI 1.03-1.06); and be physically active less than 150 minutes per week (APR: 1.03, 95%CI 1.01-1.04). There were no differences in the likelihoods of doctor-diagnosed metabolic risk factors or CVD between the two groups in adjusted models. There was a higher likelihood of behavioural and metabolic risk factors among those with lower education, with lower incomes, and the non-White population. Brazilians living in slums are at higher risk of behavioural risk factors for CVD, suggesting local environments might impact access to and uptake of healthy behaviours.

How Social Engagement Against Covid-19 in a Brazilian Slum Helped Mitigate Rising Statistics

How Social Engagement Against Covid-19 in a Brazilian Slum Helped Mitigate Rising Statistics

Water for Domestic Animal Drinking Based on the Categorization of Species in an Urban Brazilian Slum

Every animal needs safe water for drinking. The quality of this water is essential for welfare. This study discusses on the quality of water furnished to about 50 domestic animals based on the categorization of species practiced by residents at São Rafael slum, located in the city of João Pessoa, Brazil. The drinking water comes from three sources: municipal supply system, bottled mineral water and directly from the Jaguaribe River. The water perceived as safest was the same as offered to pets. Domestic animal water samples were tested and rated as not recommended in more than 65% of the samples. The density of thermotolerant coliforms ranged between 0 and 11,000 cells/100 mL. One third of the samples considered unsuitable for animal watering were also outside the recommended pH. In addition, a differential behavior was observed in the choice of water source according to the caretaker's perception of safety. Dogs and cats, considered family members, received the same water as consumed by the family. Even these, 38.5% of the samples, were rated as not recommended and represented a risk to the health of all those who consumed it. As well, a need for good practices of hygiene in water management and cleaning of water dishes, tanks and troughs was seen.

Effect of Sewerage on the Contamination of Soil with Pathogenic Leptospira in Urban Slums.

Leptospirosis is an environmentally transmitted zoonotic disease caused by pathogenic Leptospira spp. that affects poor communities worldwide. In urban slums, leptospirosis is associated with deficient sanitary infrastructure. Yet, the role of sewerage in the reduction of the environmental contamination with pathogenic Leptospira has not been explored. Here, we conducted a survey of the pathogen in soils surrounding open and closed sewer sections in six urban slums in Brazil. We found that soils surrounding conventionally closed sewers (governmental interventions) were 3 times less likely to contain pathogenic Leptospira (inverse OR 3.44, 95% CI = 1.66-8.33; p < 0.001) and contained a 6 times lower load of the pathogen (0.82 log10 units difference, p < 0.01) when compared to their open counterparts. However, no differences were observed in community-closed sewers (poor-quality closings performed by the slum dwellers). Human fecal markers (BacHum) were positively associated with pathogenic Leptospira even in closed sewers, and rat presence was not predictive of the presence of the pathogen in soils, suggesting that site-specific rodent control may not be sufficient to reduce the environmental contamination with Leptospira. Overall, our results indicate that sewerage expansion to urban slums may help reduce the environmental contamination with the pathogen and therefore reduce the risk of human leptospirosis.

Slumming on Social Media? E-Mediated Tourist Gaze and Social Representations of Indian, South African, and Brazilian Slum Tourism Destinations

Slum tourism is a hotly debated genre of travel. While it may foster intercultural encounters with marginalised “others”, it is also accused of reinforcing stereotypes and exploitation. Both aspects are amplified by the communication through social media of the slum tourism experience, that contribute to challenge or confirm stigmatizing representations of slums and their inhabitants. Based on the theoretical constructs of the tourist gaze and of social representations, this article addresses this particular type of digital contact. A lexicometric approach was used to analyse an extensive corpus of reviews on TripAdvisor (N = 8126). The findings not only confirm common themes already identified by the literature: the eye-opening component of touring poverty and the gatekeeping function of guides; but also show the emergence of context-dependent specificities, such as a hedonistic feature in the Cape Town region; or the integration of favelas within the representations of the city of Rio de Janeiro. Furthermore, the results show the tension between the “othering” and the “sameing” mechanisms, making this tourism practice a space in which shallow and deep tourist gazes interact and co-exist, and are crucially mediated by the gatekeeper of the tours: the guide.

FANTASTIC AND COSMIC HORROR IN “HORROR NO MORRO”, BY FELIPE TEODORO

Neste artigo, pretendemos analisar o conto “Horror no morro” (Toda noite é um abismo, 2019), do brasileiro Felipe Teodoro a partir de teorias do fantástico, principalmente as elaboradas por David Roas e Filipi Furtado. Pretendemos, também, identificar a presença do efeito estético do horror cósmico na obra e suas significações em meio ao fantástico do texto. O conto, situado em uma favela brasileira, apresenta durante sua trama diferentes formas de horror para uma criança que é o protagonista da história, desenvolvendo possibilidades para que tanto o real quanto o sobrenatural sejam a origem das experiências negativas vividas pelo garoto. Buscamos, portanto, analisar essas diferentes possibilidades dentro do texto a partir das teorias acima mencionadas.

Genetic Evidence for a Potential Environmental Pathway to Spillover Infection of Rat-Borne Leptospirosis.

In this study, we genotyped samples from environmental reservoirs (surface water and soil), colonized rat specimens, and cases of human severe leptospirosis from an endemic urban slum in Brazil, to determine the molecular epidemiology of pathogenic Leptospira and identify pathways of leptospirosis infection. We identified a well-established population of Leptospira interrogans serovar Copenhageni common to human leptospirosis cases, and animal and environmental reservoirs. This finding provides genetic evidence for a potential environmental spillover pathway for rat-borne leptospirosis through the environment in this urban community and highlights the importance of environmental and social interventions to reduce spillover infections.

Developmental outcomes in children exposed to Zika virus in utero from a Brazilian urban slum cohort study.

BackgroundThe prevalence of developmental alterations associated with in-utero Zika virus (ZIKV) exposure in children is not well understood. Furthermore, estimation of the Population Attributable Fraction (PAF) of developmental alterations attributed to ZIKV has not been performed due to lack of population-based cohorts with data on symptomatic and asymptomatic ZIKV exposures and an appropriate control group. The aim of this study was to characterize neurodevelopmental outcomes of children at 11 to 32 months of age with intrauterine ZIKV exposure and estimate the PAF of alterations secondary to ZIKV exposure.Methodology/Principal findingsWe performed a cohort of biannual community-based prospective serosurveys in a slum community in Salvador, Brazil. We recruited women participating in our cohort, with a documented pregnancy from January 2015 to December 2016 and children born to those mothers. Children were classified as ZIKV exposed in utero (born from women with ZIKV seroconversion during pregnancy) or unexposed (born from women without ZIKV seroconversion or that seroconverted before/after pregnancy) by using an IgG monoclonal antibody blockade-of-binding (BoB). We interviewed mothers and performed anthropometric, audiometric, ophthalmological, neurologic, and neurodevelopmental evaluations of their children at 11 to 32 months of age. Among the 655 women participating in the cohort, 66 (10%) were pregnant during the study period. 46 (70%) of them completed follow-up, of whom ZIKV seroconversion occurred before, during, and after pregnancy in 25 (54%), 13 (28%), and 1 (2%), respectively. The rest of women, 7 (21.2%), did not present ZIKV seroconversion. At 11 to 32 months of life, the 13 ZIKV-exposed children had increased risk of mild cognitive delay (RR 5.1; 95%CI 1.1–24.4) compared with the 33 children unexposed, with a PAF of 53.5%. Exposed children also had increased risk of altered auditory behavior (RR 6.0; 95%CI 1.3–26.9), with a PAF of 59.5%.ConclusionsA significant proportion of children exposed in utero to ZIKV developed mild cognitive delay and auditory behavioral abnormalities even in the absence of gross birth defects such as microcephaly and other neurodevelopmental domains. Furthermore, our findings suggest that over half of these abnormalities could be attributed to intrauterine ZIKV exposure.

Community health workers' attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities.

Community Health Workers (CHW) are a category of social workers described in many countries' health systems as responsible for engaging people in their residences and communities, and other non-clinical spaces to enable access to health services, especially in low-income areas. These professionals have been exposed to numerous new risks during the COVID-19 pandemic. This study describes how the COVID-19 pandemic is perceived by CHWs who work in poor communities or slums in Brazil. We conducted an online survey with a random sample of 775 CHWs operating in 368 municipalities of the 26 Brazilian states. At a confidence level of 95%, results of the survey were subject to a maximum sampling error of 4%. Our data indicate that the negationist agenda increases the challenges to the performance of CHWs within low-income communities, preventing the consensus on the necessity of social distancing, business closures and other measures to face the COVID-19 pandemic. The pandemic imposes unexpected challenges on the usual modes of interaction of public health officers with poor communities. This study provides evidence that these challenges have been ignored or minimized in Brazilian policy prescriptions for primary care in the face of the COVID-19 pandemic.

Inequalities in the prevalence of major depressive disorder in Brazilian slum populations: a cross-sectional analysis.

The mental health of slum residents is under-researched globally, and depression is a significant source of worldwide morbidity. Brazil's large slum-dwelling population is often considered part of a general urban-poor demographic. This study aims to identify the prevalence and distribution of depression in Brazil and compare mental health inequalities between slum and non-slum populations. Data were obtained from Brazil's 2019 National Health Survey. Slum residence was defined based on the UN-Habitat definition for slums and estimated from survey responses. Doctor-diagnosed depression, Patient Health Questionnaire (PHQ-9)-screened depression and presence of undiagnosed depression (PHQ-9-screened depression in the absence of a doctor's diagnosis) were analysed as primary outcomes, alongside depressive symptom severity as a secondary outcome. Prevalence estimates for all outcomes were calculated. Multivariable logistic regression models were used to investigate the association of socioeconomic characteristics, including slum residence, with primary outcomes. Depressive symptom severity was analysed using generalised ordinal logistic regression. Nationally, the prevalence of doctor diagnosed, PHQ-9 screened and undiagnosed depression were 9.9% (95% confidence interval (CI): 9.5-10.3), 10.8% (95% CI: 10.4-11.2) and 6.9% (95% CI: 6.6-7.2), respectively. Slum residents exhibited lower levels of doctor-diagnosed depression than non-slum urban residents (8.6%; 95% CI: 7.9-9.3 v. 10.7%; 95% CI: 10.2-11.2), while reporting similar levels of PHQ-9-screened depression (11.3%; 95% CI: 10.4-12.1 v. 11.3%; 95% CI: 10.8-11.8). In adjusted regression models, slum residence was associated with a lower likelihood of doctor diagnosed (adjusted odds ratio (adjusted OR): 0.87; 95% CI: 0.77-0.97) and PHQ-9-screened depression (adjusted OR: 0.87; 95% CI: 0.78-0.97). Slum residents showed a greater likelihood of reporting less severe depressive symptoms. There were significant ethnic/racial disparities in the likelihood of reporting doctor-diagnosed depression. Black individuals were less likely to report doctor-diagnosed depression (adjusted OR: 0.66; 95% CI: 0.57-0.75) than white individuals. A similar pattern was observed in Mixed Black (adjusted OR: 0.72; 95% CI: 0.66-0.79) and other (adjusted OR: 0.63; 95% CI: 0.45-0.88) ethnic/racial groups. Slum residents self-reporting a diagnosis of one or more chronic non-communicable diseases had greater odds of exhibiting all three primary depression outcomes. Substantial inequalities characterise the distribution of depression in Brazil including in slum settings. People living in slums may have lower diagnosed rates of depression than non-slum urban residents. Understanding the mechanisms behind the discrepancy in depression diagnosis between slum and non-slum populations is important to inform health policy in Brazil, including in addressing potential gaps in access to mental healthcare.

Demographic drivers of Norway rat populations from urban slums in Brazil

The Norway rat is a globally distributed pest, known for its resilience to eradication and control programs. Efficient population control, especially in urban settings, is dependent on knowledge of rat demography and population ecology. We analyzed the relationship between four demographic outcomes, estimated by live-trapping data, and fine-scale environmental features measured at the capture site. Wounds, a proxy for agonistic interactions, were associated with mature individuals. Areas with environmental features favorable to rats, such as open sewers and unpaved earth, were associated with more mature individuals with a better body condition index. The control measures (environmental stressors) are likely to be disrupting the social structure of rat colonies, increasing the frequency and distribution of agonistic interactions, which were common in both sexes and maturity states. The relationship between the favorable environmental conditions and the demographic markers analyzed indicate possible targets for infestation control through environmental manipulation, and could be incorporated into current pest management programs to achieve long-term success. Our study indicate that urban interventions focused on removal of potential resources for rats could be potential long-term solutions by reducing the carrying capacity of the environment.

Drinking water quality in Brazilian urban slums

The study analyzed the quality of drinking water used in Brazilian urban slum residences according to the standards established in Brazilian regulations. Bacteriological (n=231) and physicochemical parameters (n=134) were analyzed, as the Standard Methods for the Examination of Water and Wastewater establishes. The results revealed that contaminants in the water consumed, for the most part, exceed the limits of drinking water quality standards, putting the population's health at risk and reinforcing the urgency of the need for public policies.

Appearances can be Deceptive: Political Polarization, Agrarian Policy, and Coalitional Presidentialism in Brazil

What can we infer about the effect of polarized politics on the Brazilian policy‐making process? We attempt to answer this question by analyzing the country's political landscape and focusing on one specific policy issue concerning agrarian policies, an area that is exposed to much ideological conflict for both the left and right wing. We show how the mechanism has worked in this case to mitigate the polarization effects. Two political groups monopolized national elections over the past two decades sharing very different positions concerning ideological preferences. In this article, we recognize polarization between the two leading parties, but argue that the Brazilian political system features the dynamics of coalitional presidentialism that mitigates party preferences. We analyze funding data for small farmers and rural settlements for the period 1995‐2016, arriving at the conclusion that the agrarian policy of the competing parties resembled one another, despite political polarization.Related ArticlesOndetti, Gabriel. 2008. “Up and Down with the Agrarian Question: Issue Attention and Land Reform in Contemporary Brazil.” Politics &amp; Policy 36 (4): 510‐541. https://doi.org/10.1111/j.1747-1346.2008.00120.xSegatto, Catarina Ianni, and Daniel Béland. 2018. “The Limits of Partisanship: Federalism, the Role of Bureaucrats, and the Path to Universal Health Care Coverage in Brazil.”Politics &amp; Policy 46 (3): 416‐441. https://doi.org/10.1111/polp.12252Wolff, Michael Jerome. 2019. “Sharing Authority: The Politics and Practice of Community Policing in the Brazilian Slum.” Politics &amp; Policy 47 (4): 748‐774. https://doi.org/10.1111/polp.12322