The Covid-19 pandemic has exposed and deepened serious health inequalities that need to be faced by President-elect Luiz Inácio Lula da Silva (PT), and the new state governments that take office on January 1.
The lethality of the disease in poorer municipalities was 30% higher compared to richer cities. Lack of access to quality health services and a higher burden of chronic diseases in vulnerable populations are among the causes.
A survey by Ieps (Institute of Studies for Health Policies), published in the medical journal The Lancet, in 2021, summarized this impact: the biggest comorbidities of Covid were not the age structure of the population nor the prevalence of risk factors. It was, yes, the social inequalities.
Many of the disparities in health also intersect with other inequalities, such as racial and those related to precarious housing, informal working conditions and the educational deficit.
In 2018, another study also in the Lancet used robust scientific evidence to nail: poverty and social inequality seriously harm health and reduce life expectancy even more than other known risk factors.
The authors crossed data from more than 1.7 million adults between 40 and 85 years old and concluded that low socioeconomic status shortens life as much as sedentary lifestyle (2 years on average) and more than obesity, alcohol consumption and hypertension (7 months, 6 months and 1 year and six months, respectively). It is second only to diabetes (3 years and 9 months) and smoking (4 years and 8 months).
They question the fact that health authorities, more specifically the WHO (World Health Organization), do not give social issues the same relevance that they give to other modifiable risk factors. And they argue that, in the same way that smoking cessation can be promoted, the socioeconomic factor can also be modified, with interventions such as promoting early childhood development, poverty reduction policies and improving access to education.
The study gathered data from European countries, the United States and Australia. Brazil, one of the most unequal countries in the world, was left out, but it has a perfect example of disparities in its richest city.
In São Paulo, there is a difference of 21 years in the average age at death between Jardim Paulista (80 years old) and Iguatemi (59 years old), one of the worst HDIs in the capital.
Inequalities kill, and they need to be faced with long-term structuring policies that go far beyond Bolsa Família. Diagnoses and proposals abound.
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