Opinion – Esper Kallás: How far does government messages reach

Several factors can interfere with the decisions we make for our health.

There is a perception that is individual and another that can be shared by direct contacts—family, friends, and co-workers. Still, with greater reach, we have the perception influenced by public health policies and propagated, often, by personalities or people with great media and multiplier power. This also includes the authorities that present decisions on public health policies.

The Covid-19 pandemic, for example, sparked intense debates about the best treatment for the disease and adherence to vaccination programs. Both issues were tainted by great political interference.

It was not just a Brazilian phenomenon. Detected in different countries, these interferences reflected the political circumstances of each region.

But to what extent can a speech or a position raise doubts to the point of interfering with the impact of a disease or with the adherence to vaccines at the national level?

Data obtained in the USA demonstrated this reach. Not only did they capture higher mortality in places where Republican Party voters were predominant, but they also saw lower adherence to Covid-19 vaccines in places where then-President Donald Trump voters predominated.

In Brazil it was no different. Led by Diego Xavier, a work carried out by researchers from Fiocruz, UnB and UFRJ showed that mortality from Covid-19, especially in the second wave in 2021, was higher in cities with higher votes for President Bolsonaro, even after taking into account inequalities. structural. The work, published in The Lancet Regional Health – Americas, highlights the evidence of the factors that influenced the distribution of mortality in the country.

A new study, carried out by researchers from USP and Hospital Albert Einstein, led by Professor Vivian Avelino-Silva, was published today and assesses the impact on vaccine acceptance. Regions with the highest percentage of votes for President Bolsonaro had lower vaccination coverage, even after adjustments for sociodemographic variables. The work, published on medRxiv, shows that the relationship is present considering both the 2018 election and the 2022 first round.

Another interesting finding is that this relationship becomes more intense the lower the human development index (HDI) of the municipality. It is quite evident the responsibility that the attitudes of managers have in the population’s adherence to preventive measures, especially among the most disadvantaged.

They are not subjective impressions. The message coming from the government has a direct impact on people’s health.

The higher mortality of Covid-19 and the lower vaccination rate could be minimized if the central government had taken a stance that advocated effective treatments and promoted more emphasis on adherence to vaccines against the disease.

As with the choices made by the technical staff for so many other strategic areas of public administration, so should the choices for health management.

It seems quite logical that health policy should not be delegated to people who are not experts on the subject.

The complexity of the problems is enormous, as well as the implementation of collective measures of solutions. It is not up to those who are not technically prepared to make or interfere in decisions that have a profound impact on many generations of an entire country.