SOCIAL DETERMINANTS OF HEALTH AND THEIR IMPLICATIONS FOR CARE IN PRIMARY HEALTH CARE IN THE SUS

Abstract

Social determinants of health represent a set of economic, social, cultural, and environmental factors that directly influence the population’s living conditions, illness processes, and access to health services. In the context of the Brazilian Unified Health System (SUS), understanding these determinants is essential for strengthening Primary Health Care (PHC), considered the preferred gateway to the health system and responsible for promoting equity in care. This article aimed to analyze how social determinants of health influence care in Primary Health Care within the SUS context. This is an integrative literature review with a qualitative approach, conducted between February and April 2026, based on searches in national and international databases and official documents. A total of 17 scientific articles and 7 normative documents were included, totaling 24 analyzed sources. The results show that social determinants of health, such as income, education, housing conditions, and territorial vulnerability, strongly influence access, continuity, and quality of care in Primary Health Care. These factors were directly associated with health inequities, reflecting historical structural inequalities. Despite the normative advances of SUS and the potential of Primary Health Care to promote equity, weaknesses still persist in its operationalization, especially regarding the practical incorporation of social determinants into the healthcare work process. It is concluded that addressing inequities requires strengthening intersectoral policies, professional qualification, and a more integrated organization of Primary Health Care.