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The Brazilian Family Health Strategy and adult health: Evidence from individual and local data for metropolitan areas

Natalia N. Ferreira-Batista, Fernando Antonio Slaibe Postali, Maria Dolores Montoya Diaz, Adriano Dutra Teixeira and Rodrigo Moreno-Serra ()

Economics & Human Biology, 2022, vol. 46, issue C

Abstract: Previous studies have found that the expansion of primary health care in Brazil following the country-wide family health strategy (ESF), one of the largest primary care programs in the world, has improved health outcomes. However, these studies have relied either on aggregate data or on limited individual data, with no fine-grained information available concerning household participation in the ESF or local supply of ESF services, which represent crucial aspects for analytical and policy purposes. This study analyzes the relationship between the ESF and health outcomes for the adult population in metropolitan areas in Brazil. We investigate this relationship through two linked dimensions of the ESF: the program’s local supply of health teams and ESF household registration. In contrast with previous studies focusing on comparisons between certain definitions of "treated" versus "nontreated" populations, our results indicate that the local density of health teams is important to the observed effects of the ESF on adult health. We also find evidence consistent with the presence of positive primary health care spillovers to people not registered with the ESF. However, current ESF coverage levels in metropolitan areas have limited ability to address prevailing health inequalities. Our analysis suggests that the local intensity of ESF coverage should be a key consideration for evaluations and policy efforts related to future ESF expansion.

Keywords: Family health strategy; Self-assessed health; Fixed effects; Pooled cross-section; Health surveys (search for similar items in EconPapers)
JEL-codes: C23 I15 I18 (search for similar items in EconPapers)
Date: 2022
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Persistent link: https://EconPapers.repec.org/RePEc:eee:ehbiol:v:46:y:2022:i:c:s1570677x22000399

DOI: 10.1016/j.ehb.2022.101143

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