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date: 07 December 2023

Health of Indigenous Peoples in Brazil: Inequities and the Uneven Trajectory of Public Policieslocked

Health of Indigenous Peoples in Brazil: Inequities and the Uneven Trajectory of Public Policieslocked

  • Ricardo Ventura Santos, Ricardo Ventura SantosEscola Nacional de Saúde Pública, Fundação Oswaldo Cruz
  • James R. Welch, James R. WelchEscola Nacional de Saúde Pública, Fundação Oswaldo Cruz
  • Ana Lucia Pontes, Ana Lucia PontesEscola Nacional de Saúde Pública, Oswaldo Cruz Foundation
  • Luiza Garnelo, Luiza GarneloInstituto Leônidas e Maria Deane, Fundação Oswaldo Cruz
  • Andrey Moreira CardosoAndrey Moreira CardosoEscola Nacional de Saúde Pública, Fundação Oswaldo Cruz
  •  and Carlos E. A Coimbra Jr.Carlos E. A Coimbra Jr.Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz


Victims of epidemics, slavery, genocide, and countless other episodes of violence during the colonial enterprise in Brazil, which continues decades into the 21st century in some regions, Indigenous peoples face health inequities resulting from a five-century history of social marginalization and vulnerability. Since the late 1990s, the health and well-being of Indigenous peoples in the country have benefited from progressive legislation that values sociocultural diversity within a public primary healthcare subsystem attending to Indigenous peoples living in federal Indigenous lands. However, these transcultural ideals remain elusive in practice. The Indigenous Healthcare Subsystem continues to suffer from numerous systemic problems, including low quality of local services, lack of health professional training for work in intercultural contexts, and unpreparedness for attending to health emergencies involving Indigenous peoples living in voluntary isolation. Being Indigenous in Brazil in the 2020s implies greater chances of higher infant mortality, lower life expectancy, suffering from undernutrition and anemia during childhood, living with a high burden of infectious and parasitic diseases, being exposed to a swift process of nutritional transition, and experiencing a surge in chronic violence. Community case studies have shown the importance of close patient follow-up over long periods of time, the heavy burden of disease due to nutrition transition since the mid-1980s, the relevance of international reference curves for evaluating Indigenous child undernutrition, and failures of primary healthcare provided to Indigenous populations. Improvements in national health information systems in Brazil beginning in the early 2000s have shown external causes, perinatal diseases, infectious and parasitic diseases, and respiratory diseases to be the leading causes of death among the country’s Indigenous population.


  • Global Health
  • Public Health Policy and Governance
  • Special Populations

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