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巴西的健康状况和卫生政策创新:前进的道路。

Health conditions and health-policy innovations in Brazil: the way forward.

机构信息

Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Brazil.

出版信息

Lancet. 2011 Jun 11;377(9782):2042-53. doi: 10.1016/S0140-6736(11)60055-X. Epub 2011 May 9.

Abstract

Brazil is a large complex country that is undergoing rapid economic, social, and environmental change. In this Series of six articles, we have reported important improvements in health status and life expectancy, which can be ascribed largely to progress in social determinants of health and to implementation of a comprehensive national health system with strong social participation. Many challenges remain, however. Socioeconomic and regional disparities are still unacceptably large, reflecting the fact that much progress is still needed to improve basic living conditions for a large proportion of the population. New health problems arise as a result of urbanisation and social and environmental change, and some old health issues remain unabated. Administration of a complex, decentralised public-health system, in which a large share of services is contracted out to the private sector, together with many private insurance providers, inevitably causes conflict and contradiction. The challenge is ultimately political, and we conclude with a call for action that requires continuous engagement by Brazilian society as a whole in securing the right to health for all Brazilian people.

摘要

巴西是一个庞大而复杂的国家,正在经历快速的经济、社会和环境变化。在本系列六篇文章中,我们报道了健康状况和预期寿命的重要改善,这主要归因于社会决定因素方面的进展,以及实施了具有强大社会参与的综合性国家卫生系统。然而,仍有许多挑战。社会经济和地区差异仍然大得令人无法接受,这反映出仍有大量工作需要做,以改善大部分人口的基本生活条件。城市化和社会及环境变化带来了新的健康问题,一些旧的健康问题仍未得到遏制。复杂的、权力下放的公共卫生系统的管理,其中很大一部分服务外包给私营部门和众多私人保险提供者,不可避免地会引起冲突和矛盾。这一挑战最终是政治性的,我们的结论是呼吁采取行动,这需要整个巴西社会不断参与,以确保全体巴西人民的健康权。

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