The high level of violence in Guarulhos is an outcome of the extreme social inequity. © Edson Queiroz, January 2006

How would you characterize the region where you work in socio-economic terms?

Eneida:

In Guarulhos, as in other Brazilian cities (both large and small), there are pronounced social inequities. Approximately 11% of the population lives in favelas (urban slums lacking infrastructure and services), and 3% of all households have precarious access to the sanitation system.

Guarulhos is the second largest city in the province of Sao Paulo. It has 1,251,178 inhabitants, in a metropolitan area with a population of 16 million people (Source: IBGE, 2005). The annual growth rate is of 2.84% (Source: SEADE, 2005). Guarulhos is very near to the city of Sao Paulo, the capital of the province. Guarulhos underwent a rapid urban development process, and public services (including health services) could not keep up with the growth.

There are high rates of unemployment in Guarulhos. The people who are employed predominantly work as manual labourers or in the service industry. Many of the people who live in Guarulhos have to commute to work in San Paulo, as there are not enough job opportunities in the immediate area.

The main health-related social problems in Guarulhos are violence (including homicide), drug trafficking and addiction, alcohol abuse, air pollution and inadequate sanitation.

In Guarulhos, 11% of the population lives in favelas and 3% of all households have precarious access to the sanitation system. © Edson Queiroz, January 2006

The high level of violence is an outcome of extreme social inequity. People are faced with unemployment and lack of educational opportunities. They feel that they do not have the resources necessary to support their families. They feel that there is no way for them to have a better life. The result is desperation, and people feel that they must do something – anything – to ‘get out’.

There are new policies aiming to reduce social inequities in Guarulhos. This is strongly backed by the Mayor, Mr Elói Pietá, who is pushing for intersectoral action in this area. The Office of the Mayor is working to formalize and activate a sustainable process for engaging multi-sector action on social problems, including the socioeconomic determinants of health. It will comprise an intersectoral working group, with representatives from sectors including transportation, education, sport, environment, public safety, industry, and health. Together, representatives will look at the community’s main social problems and see how joint solutions can be found.

The Health for the Family Programme will contribute to this effort, as it aims to reduce health inequalities by creating the conditions for good health, and improving access to health services in the favelas and other socioeconomically deprived areas.

What are some of the prevalent health problems in Guarulhos?

Eneida:

The principle health problems in Guarulhos are cardiovascular and circulatory diseases, violence-related morbidity and mortality, acute respiratory infections, and accidents and injuries (mostly traffic-related).