Abstract
According to the Brazilian Constitution each and every Brazilian has the right to free healthcare. Approximately 40% of the population have taken out a private or company funded health care program. Brazil is the world’s largest producer of alcohol derived from sugar cane and the burning of the sugar cane leaves produces a large amount of fine and ultrafine particles what increases the relative risk of hospital admissions by children increases 3.5-fold due to respiratory diseases.
Chronic obstructive pulmonary disease (COPD) ranks as the sixth greatest cause of death in Brazil, with a prevalence of 15.8% according to the fixed-ratio FEV1/FVC = 0.70 (PLATINO Study).
The occurrence of wheezing in 13-14-year old children over the last 12 months was 20%, while asthma diagnosed by a doctor was at around 10% (ISAAC Study). Mortality from asthma has decreased from 2.2/100 000 in 1980 to 1.37 in 1996, with currently 2500 deaths/year.
Smoking is decreasing in Brazil; 32.6% of the adult population were smokers in 1989 while in 2002, a randomized survey carried out in over 107 Brazilian cities with a population of 200 thousand or over showed that the smoking population over 35 years of age had decreased to 24% (17% of overall population). Approximately one-third of the Brazilian population has been infected by the tuberculosis bacillus and estimates agree that there are 116 000 new cases per year but that only 90 000 are reported. Furthermore Brazil is ranked 14th in the world in the number of tuberculosis cases and the 22nd in incidence. A Family Health Program was created in 1994 and in 2005 there were 24 600 Family Health Teams functioning in Brazil, covering a total of 4986 cities, corresponding to approximately 45% of the 180 million Brazilian population. In 2005 the total number of health community agents reached 208 000 and the investment in the Health Family Program was US$ 1.4 billion.