Regional health inequalities: changes observed in Brazil from 2000-2016/Desigualdades regionais na saude: mudancas observadas no Brasil de 2000 a 2016

• Published in: Ciência & saude coletiva 2017-04, Vol.22 (4), p.1055
• Main Authors: de Albuquerque, Mariana Vercesi, Viana, Ana Luiza d'Avila, de Lima, Luciana Dias, Ferreira, Maria Paula, Fusaro, Edgard Rodrigues, Iozzi, Fabiola Lana
• Format: Article
• Language: Spanish
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232017224.26862016

Advances in reducing poverty and inequalities in the 2000s had a paradoxical effect in Brazil. This article examines how socioeconomic transformations, and the complexity of health services, are expressed in the regions established for planning purposes and the inter-governmental management of the Brazilian Unified Health System. An effort was made to identify and explain differences in the compositions of the 438 existing health regions and their spatial distribution by comparing situations observed in 2016 with those in 2000. Factor analysis and grouping techniques were used to construct a typology in the two years of the series, which was based on a diverse set of secondary data sources. It was found that there was an evolution in terms of income levels and service provision within the health regions, with a significant improvement in the socioeconomic conditions of the population. These results suggest that there was a positive impact from the combination of strategies related to social, economic and regional policies for the promotion of development, which generated more widespread well-being within the affected areas. However, limitations remain regarding the policies implemented for the universalization of the health system. Key words Health inequalities, Regional health planning, Unified Health System, Health regions Avancos na reducao da pobreza e das desigualdades nos anos 2000 tiveram efeito paradoxal sobre o territorio brasileiro. O artigo tem como objetivo analisar como transformacoes socioeconomicas, de oferta e complexidade de servicos de saude se expressam nas regioes constituidas para fins de planejamento e gestao intergovernamental do Sistema Unico de Saude. Para isso, procurou-se identificar e explicar diferenciacoes nas composicoes das 438 regioes de saude existentes e sua distribuicao espacial, comparando-se situacoes observadas em 2016 com aquelas encontradas em 2000. Tecnicas de analise fatorial e de agrupamentos foram utilizadas para a construcao de uma tipologia nos dois anos da serie, com base em um conjunto diversificado de fontes de dados secundarios. Verificou-se evolucao dos niveis de renda e oferta de servicos entre as regioes de saude, com expressiva melhora nas condicoes socioeconomicas da populacao. Os resultados sugerem impactos positivos da combinacao de estrategias relacionadas a politica social, economica e regional para a promocao do desenvolvimento com geracao de bem-estar de forma mais disseminada no territorio. Ent