Opinion – Saúde em Público: Occupy the 13th of May, to abolish racial inequalities in health

It is necessary to take a critical look at May 13, considered the Day for the Abolition of Slavery. It is necessary to occupy this symbolic date not only to reflect on which practices we need to abolish today, but also to seek to recognize that the “unfinished abolition” brings perverse and harmful consequences to the black population today.

As highlighted earlier in this blog [1] [2], the Abolition of Slavery took place in an unfinished way – not from a legal point of view, but from a historical-procedural perspective, when taking into account the construction of an unfinished citizenship. The abolitionist laws of the late 19th century, while being important for the process of consolidating abolition, proved to be insufficient and palliative. The absence of effective policies for the integration of the enslaved into society and the maintenance of a logic of racial discrimination, present in social and economic relations throughout the 20th century, represent unfavorable contemporary conditions for the black population.

What is true for the most diverse spheres of social life is especially important for the health of this population segment, which suffers from the worst indices of the social determinants of the health-disease process and, therefore, the most unfavorable outcomes when racial approaches are adopted. . Promoting racial equality is not just the responsibility of the black movement or the Brazilian state, but of everyone. The responsibility is collective, everyone must feel motivated to carry out actions, no matter how small, in favor of the country we want, without poverty and discrimination, as highlighted by the former minister of the Secretariat for Policies for the Promotion of Racial Equality (SEPIR) , Luiza Bairros.

The right to health, in addition to being a constitutional foundation, is a substantive condition for everyone for the full exercise of citizenship. According to the World Health Organization (WHO), health should be understood as “a state of complete physical, mental and social well-being” and not only as the absence of diseases, illnesses and aggravating factors. In other words, more than access to medical care services, it is necessary to face the determinants of health in all their amplitude and with the relevant sociodemographic specificities.

Therefore, it is essential to defend and strengthen the Unified Health System (SUS) as a way of ensuring that health is a right exercised without prejudice of origin, class, race, color, sex, age or any other forms of discrimination, without limiting the debate exclusively about budgetary resources or medical assistance, but treating it as a political, human rights, dignity and social justice issue.

Nevertheless, as highlighted by physician and activist Jurema Werneck, the health of the black population is a conceptual field historically constructed by black and black social movements, collectives and activists, especially women working in the health area. Due to the absence of programs orienting the health system towards the health care of the black population, these groups, for decades, have pressured the Brazilian government to create a policy that contributes to reducing inequities in health conditions and illness in women. black population.

With a lot of struggle, they were able to build the National Policy for the Comprehensive Health of the Black Population (PNSIPN), published by ordinance 992, of May 13, 2009. This policy aims to combat ethnic-racial discrimination in the services offered by SUS and its management, as well as promoting racial equity in health. Among its main guidelines are care, attention, health promotion and disease prevention actions. It proposes participatory management and social control, considering that the development of actions takes place in states and municipalities, which are also responsible for this process.

Since its implementation, the PNSIPN remains without major advances. After 13 years of its officialization, little has been effectively implemented for the policy to work as planned. It is known that, despite being the majority, the black population is excluded from the spaces of power and the construction of public policies. Hence the importance of bringing this topic to the debate, especially on this symbolic date, to draw the attention of society and authorities to this very important topic.

In this sense, researchers, social movements, health professionals and other actors who work in defense of the SUS, with special attention to the health of the black population, have taken initiatives in order to influence the debate on the aforementioned theme. This articulation, involving political actors throughout the national territory, generated the Manifesto in Attention to the Health of the Black Population in Brazil, written by several hands and which today already has adhesions throughout the national territory. It is intended that this will reach the candidates so that the proposals of the document are incorporated into their government programs – as racism remains absent from the political debate in an election year.

It is about once again leading the State to take a position on the racism attributed to the Brazilian black population, and its relationship with health and its indicators, to inform us every day who the SUS users are and their real needs – in addition to the insufficiency of actions to react to such challenges. In the activists’ opinion, “they don’t do it because they don’t want to” – and this constitutes a form of racism. As the main instrument for disseminating this initiative, the “Occupation of the 13th of May” is proposed, with the objective of mobilizing society in the face of the need for concrete actions, programs and policies. Therefore, social movements, networks, forum, collectives, terreiros and intellectuals organized a series of activities that will be carried out throughout the day, in different states – conversation circles, webinars, panels, lectures, debates, cultural live and sessions of videos on issues related to combating social inequalities and structural racism.

Thus, the networks involved in the “Occupation” and the Çare-IEPS Chair – an initiative of the Çare Institute and the Institute of Studies for Health Policy (IEPS) – urge society to react to the absence of health promotion and disease prevention actions. , the devaluation of the National Health Policy for the Black Population and the production of technology and knowledge, through debates with different sectors of society, with a view to guaranteeing the full right to health for the entire population.

It is necessary to Occupy the 13th of May, a date that is remembered for the inequalities and violence of the remnants of the slavery period to which the black population was subjected. Our Occupation must build paths to equity, opportunity, and equality in health, to effectively abolish structural racism in society.