Programa de Pós-Graduação em Saúde Coletiva, Universidade Estadual do Ceará, Fortaleza, CE, Brazil,
Cien Saude Colet. 2020 May;25(5):1699-1708. doi: 10.1590/1413-81232020255.33972019. Epub 2020 May 8.
The relationship between poverty and healthcare is evident in Brazilian society, constituting one of the faces of the inequalities resulting from a perverse social context. Focusing specifically on primary healthcare, this review of the literature on health policy highlights the tensions between the social question, social rights, and current austerity policies, and the latter's effects on healthcare for the poorest segments of the population. The 1988 Constitution represents a social pact that goes against the principles of austerity policies imposed by neoliberalism. With the deepening financial crisis and approval of Constitutional Amendment 95/2016, social protection policies such as those underpinning Brazil's national health system ("Sistema Único de Saúde") find themselves under threat, with direct consequences for the country's population. Despite the country's achievements in improving access to healthcare for the poorest, austerity measures are likely to strengthen barriers, seriously threatening the progress made in operationalizing the right to health. Therefore, considering that primary healthcare is a differentiated care model, this study reiterates the relationship between primary care and the social dimension, given that the impacts of the dismantling of social policies on population health are already being felt.
巴西社会中,贫困与医疗保健之间存在着明显的关系,这是由扭曲的社会背景所导致的不平等现象之一。本研究特别关注初级卫生保健,对卫生政策文献进行综述,强调社会问题、社会权利与当前紧缩政策之间的紧张关系,以及后者对最贫困人群的医疗保健的影响。1988 年宪法代表了一种与新自由主义所强加的紧缩政策原则背道而驰的社会契约。随着金融危机的加深和宪法修正案 95/2016 的通过,社会保护政策(如巴西国家卫生系统(“Sistema Único de Saúde”)所依据的政策)受到威胁,这对该国人民产生了直接影响。尽管巴西在改善最贫困人群的医疗保健方面取得了成就,但紧缩措施可能会加强障碍,严重威胁到实施健康权方面取得的进展。因此,考虑到初级卫生保健是一种差异化的护理模式,本研究重申初级保健与社会维度之间的关系,因为社会政策解体对人口健康的影响已经开始显现。