Brazil - Health Status and Health Care

As usual, national averages mask wide regional and socioeconomic variations. As in previous decades, infant mortality levels in 1995 were lowest in the South, at 21.1, and highest in the Northeast, where they reached 70.2, more than three times higher. In recent decades, infant mortality generally has been higher in rural areas, except for the poorest urban strata, whose mortality has been higher. State infant mortality rates fluctuate from year to year, depending on economic and public health conditions.

The sharp drop in infant mortality in recent decades did not necessarily reflect a commensurate general improvement in living conditions. To a large extent, the drop was the result of both the decline in fertility, which decreases the risk of infant deaths for biological and socioeconomic reasons, and specific health and sanitation interventions, primarily use of oral rehydration and extension of piped water.

Health status and health care

In 1996 the United Nations Development Programme (UNDP), which worked together with the Applied Economic Research Institute (Instituto de Pesquisa Econ�mica Aplicada--IPEA), released its Human Development Report 1995 for Brazil. Using an index based on income, education, infant mortality, and other socioeconomic indicators, the report showed that Brazil was in a medium human development position as compared with other countries. It suggested that the national territory could be divided into three parts, with standards of living similar to those found in Belgium (the South and Southeast), Bulgaria (Center-West and North), and India (Northeast).

As in the Human Development Report 1995 , infant mortality rates (deaths of children less than one year of age per 1,000 live births) often are used as indicators of living conditions. Since the denominator is births, they are not affected by the population's age structure. Because of underreporting of vital statistics, they must be estimated from census data. The overall average infant mortality rate for Brazil declined from 117 per 1,000 live births to eighty-eight, according to the 1960 and 1980 censuses, respectively. The 1991 census showed that the rate dropped to 49.7 in 1991. In 1995 the estimated rate was 44.4 per 1,000 live births.

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