The main objective of the “Platform for studies and ongoing evaluations of the social determinants and effects of the Bolsa Família Program and other Social Protection Programs on health – Cohort of 100 million Brazilians” is to create a new and innovative cohort that makes possible the study of determinants social and the effects of social policies and programs on the different aspects of health in Brazilian society. To achieve this goal, it links information from social programs and other databases of health information systems, such as mortality, birth, communicable and non-communicable infectious diseases, among other outcomes.
The projects linked to this cohort process, analyze and interpret rigorously the information obtained from large electronic databases, generating new knowledge useful in decision-making processes in the field of social policies – especially those focused on poverty reduction and social inequalities in Brazil.
The following research projects are related to this platform:
1. Social and health inequalities in the Brazilian population
It involves the domains of knowledge on health inequalities in Brazil. It emphasizes economic, social, political and cultural mediations and the relations between institutions, public policies and the participation of society in the perspective of citizenship.
2. Social Determination and Impact of Public Policies on Maternal and Child Health
The aim of this project is to conduct studies that produce consistent and specific evidence to guide social interventions in addition to biomedical interventions to promote healthy birth, health, and child development. The proposal assumes that certain combinations of interventions are most effective in promoting healthy birth, growth and development.
To do so, the studies evaluate the impact of social interventions and social determinants on health (intrauterine death, prematurity, low birth weight, infant and child mortality, and physical growth) in preconception, conception at birth and from birth to two years of age, and may eventually extend into late childhood, adolescence and adulthood. In addition, they explore these results nationally and by subgroups (eg, mother’s schooling) and intervention period (eg preconception, early and late pregnancy). It also evaluates the effects of the Bolsa Família Program on prenatal care indicators (number of prenatal consultations, number of women without prenatal consultations, number of lectures and health education workshops for pregnant women).
3. Social Determination and Impact of Public Policies on the Occurrence of Infectious Diseases
The complexity of the determinants of poverty-related diseases has led to a growing international consensus on the need for intersectoral interventions that more broadly address the health problems of the population, especially those in poverty. Among the possible interventions on the social determinants of health is the policy performance on the material and psychosocial conditions in which people live and work, seeking to ensure better access to clean water, sewage, adequate housing, healthy and nutritious food, environments health services, quality education, etc. The relationship between distributive social policies and their impact on poverty-related infectious diseases worldwide has the potential to provide arguments for the implementation of social interventions – in addition to and in synergy with biomedical interventions – to promote control of related diseases with poverty.
4. Social Determination and Impact of Public Policy on Dating and Mortality Due to Violence
Violence is the third leading cause of death and one of the leading causes of hospital admissions in Brazil. The determinants of interpersonal and self-inflicted violence include economic and gender inequalities, alcohol availability, trafficking in illegal drugs, access to lethal means, low schooling and unemployment. The objective of this research line is to evaluate potential associations among social determinants, such as education, race, employment situation, income, family composition, as well as the impact of the Bolsa Família Program on reducing violence deaths in the country, homicide and suicide.
5. Methodological approaches in the evaluation of the impact of public policies
The objective of this study is to compare and develop statistical methodologies that consistently estimate the causal effect of intervention studies, also assessing bias control due to the confounding present in non-experimental studies, since sophisticated methodologies of statistical analysis have been made available with increasing speed to respond to research questions that can not be answered through other methods of analysis.