GEO Brasil - UNEP

Regarding the historical perspective,
the current health situation consists
of three main areas conditioned to
socio-environmental factors to a
greater or lesser extent The first is
made up of cardiovascular and
neoplastic diseases (the first and third
causes of death, respectively) This
situation has demonstrated a
tendency for growth over the last ten
years that follows the ageing of the
population (Brazilian Institute of
Geography and Statistics/Instituto
Brasileiro de Geografia e Estatística –
IBGE, 2001 and Interagency Network
of Health Information/Rede
Interagencial de Informações para a
Saúde- RIPSA, 2000) This scenario is
made possible since occurrences of
disease and sickness are considered
the result of genetic, living and work
conditions experienced by population
groups, specially those exposed to
certain chemical pollutants Moreover,
this concept is reinforced by the
increase in health care, the access to
new technologies and health
provisions, even if not available for the
entire population
The second scenario is made up of
infectious parasitical diseases, clearly
determined by socio-environmental
conditions The decreasing fatality rate
for this group (the sixth cause of death)
mainly reflects the use of technical
intervention (massive vaccination
programs) and therapeutic measures
(provision of effective medicine by the
sanitation programs), without
mentioning the improvement of certain
basic needs such as food and nutrition
These factors have affected different
regions and specific social groups in
an uneven fashion It is important to
point out that the above-mentioned
factors do not guarantee the decrease
of all IPD occurrence indicators such
as dengue, malaria and hepatitis, but
favour others, measles and poliomyelitis, for instance Furthermore, as a result
of new socio-environmental situations/conditions, old diseases reappear and
new ones are produced This occurs in different geographical areas with illnesses
and diseases that tend to spread over the territory and increase in occurrence
This tendency originates in peculiar endemic-epidemic forms (AIDS, dengue
and malaria, by way of illustration)
Table 1 - Number and percentage of Brazilian urban and rural population, per region.
Urban
Rural
N. of inhabitants % n. of inhabitants %
North
9014365 69.9 3886339 30.1
Northeast
32975425 69.1 14766286 30.9
Southeast
65549194 90.5 6863217 9.5
South
20321999 80.9 4785617 19.1
Central West
10092976 86.7 1543752 13.3
Source: IBGE - 2001, Demographic census of year 2000
The third scenario is characterised by external factors that include accidents and
violence These are both considered socio-environmental events that cause
trauma, injuries and illnesses Fatality and morbidity tendencies are growing (the
second cause of death) and require preventive therapeutic and control measures
quite different from those traditionally used towards other health problems The
planning and implementation of such measures are still incipient
As a matter of fact, the growing importance of damage and illnesses associated
with these scenarios is directly related to the increase in social inequalities and
the environmental impact produced by developmental policies Bad income
distribution and a high percentage of poor people and regional inequalities
represent factors that together constitute the main driving forces which may
result in the development of favourable conditions to environmental
contamination and in the raise in the demand for environmental health services
(General Co-ordination of Environmental Surveillance/Coordenação Geral de
Vigilância Ambiental, CGVAM- 2001) The development indicators such as the
Human Development Index - HDI mentioned in the United Nations Report and
the United Nations Development Program (UNDP) and Panamerican Health
Organisation-PHO reveal the inequalities observed in different geopolitical
regions of the country, which directly affect the sanitation inequality scenario
According to UN data (CGVAM, 2002a), nearly half of the world population
currently lives in cities and the urban population is growing two and a half times
more than the rural one In Brazil, the 2000 demographic census (IBGE, 2001)
demonstrates a large concentration of people in the urban areas of all regions, as
shown in Table 1
the state of the environment in Brazil
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