SOCIAL DETERMINANTS AND THE BURDEN OF NON-COMMUNICABLE DISEASES (NCDS) IN BRAZIL: IMPLICATIONS FOR PUBLIC HEALTH

Abstract

Noncommunicable diseases (NCDs) are the leading cause of illness and death in Brazil and account for a substantial share of premature mortality, being unequally distributed across different social strata. This study aimed to analyze how social determinants influence the occurrence, distribution, and burden of NCDs in Brazil, discussing their implications for the planning, management, and strengthening of public health policies. This is an integrative literature review conducted in the PubMed/MEDLINE, SciELO, LILACS, and Virtual Health Library (VHL) databases, using descriptors related to social determinants of health, noncommunicable diseases, health inequities, public health, and Brazil, combined through Boolean operators and covering publications from the last five years. After the selection process, twelve studies with diverse designs composed the final sample. The findings showed that educational attainment, income, race/skin color, gender, territory, and working conditions act as structuring axes of the NCD burden, producing consistent social gradients in the prevalence, severity, and mortality of these diseases. More vulnerable populations were found to concentrate higher morbidity and mortality and to face additional barriers to accessing services, while NCDs impose growing costs on the Unified Health System. It is concluded that addressing the NCD burden requires intersectoral, inequity-sensitive policies capable of articulating health promotion, the strengthening of primary health care, and action on the social causes of illness.