Primary healthcare expansion and mortality in Brazil's urban poor: A cohort analysis of 1.2 million adults
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View abstract on PubMed
Summary
This summary is machine-generated.The Family Health Strategy (FHS) in Brazil significantly reduced mortality among urban poor populations, especially for disadvantaged groups. This highlights the importance of primary healthcare investment for global health equity.
Area Of Science
- Public Health
- Health Services Research
- Epidemiology
Background
- Expanding primary healthcare access for urban poor is crucial in low- and middle-income countries.
- Brazil's Family Health Strategy (FHS) aims to address this, but challenges remain.
- This study assesses the impact of rapid FHS expansion in Rio de Janeiro since 2008.
Purpose Of The Study
- To evaluate the effect of the Family Health Strategy (FHS) on mortality rates in a large urban poor population in Brazil.
- To identify differential impacts of FHS on various socioeconomic and racial/ethnic groups.
Main Methods
- Analysis of a cohort of over 1.2 million low-income adults in Rio de Janeiro (2010-2016).
- Utilized flexible parametric survival models with inverse probability treatment weighting and regression adjustment (IPTW-RA).
- Linked FHS utilization and mortality records to estimate all-cause and cause-specific mortality hazards.
Main Results
- FHS users experienced a 44% lower hazard of all-cause mortality compared to non-users (HR: 0.56).
- Greater mortality risk reductions were observed for FHS users who were black, had no formal education, or received conditional cash transfers.
- Specific reductions were noted for cardiovascular, neoplastic, external, respiratory, and infectious/parasitic disease mortality.
Conclusions
- FHS utilization is strongly associated with reduced mortality risk in Brazil's urban poor.
- The program demonstrated greater benefits for more deprived racial/ethnic and socioeconomic groups, reducing health inequalities.
- Increased investment in primary healthcare is recommended to improve health outcomes and equity globally.
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