Ministry of Health of Brazil Secretariat of Health Surveillance ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Dr. Guilherme Franco Netto Director of Surveillance Department in Environmental and Occupational Health

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Determinants of Health Social Environme ntal Economic

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Brazilian Gini Index Decade 1960 = 0.5 (median) Brazilian Gini Index Decade 1970/80 = was in the group of countries with greater inequalities in the world Brazilian Gini Index Decade 1990/2000 = back to the level of the 1960s

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Inequalities inside of the country / Death rate per 100 thousand inhabitants: Southeast Region year 1999: 2.24 Northeast Region year 1999: 8.81

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Rio 92 (UN) Agenda 21 Set of actions on Environmental issues, Economic and Social affairs, including Health. Rio + 20

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Methodology Selection of municipalities with highest and lowest Human Development Index (HDI) in Relation of the Brazilian states HDI and corresponding them with the HDI of the countries. It was used the five municipalities with lower HDIs between 2000 and 2010.

EstadoIDH-Estado, 2000IDH-Pais 2000 Brasil0.766Brasil Distrito Federal0.844Argentina Santa Catarina0.822Costa Rica São Paulo0.82Costa Rica Rio Grande do Sul0.814St Kits & Nevis Rio de Janeiro0.807Lituania Paraná0.787Panama Mato Grosso do Sul0.778República Dominicana Goiás0.776Romênia Mato Grosso0.773Líbia Minas Gerais0.773Líbia Espírito Santo0.765Tailândia Amapá0.753Filipinas Roraima0.746Peru Rondônia0.735Albania Pará0.723Tunisia Amazonas0.713 Quirguizistão Tocantins0.71Guyana Pernambuco0.705El Salvador Rio Grande do Norte0.705El Salvador Ceará0.7Moldova Acre0.697Algeria Bahia0.688Vietnam Sergipe0.682Guine Equatorial Paraíba0.661Takijistan Piauí0.656Mongolia Alagoas0.649Bolivia Maranhão0.636Gabão Fonte: PNUD, 2000 TABLE 1 - Human Development Index of Brazilian states compared to the countries, 2000

IDHMunicípioPaís 0,919São Caetano do Sul, SPIrlanda 0,908Águas de São Pedro, SPItália 0,886Niterói, RJGrécia 0,875Florianópolis, SCMalta 0,871Santos, SPBarbados 0,486Centro do Guilherme, MALaos 0,479Guaribas, PIIêmen 0,479Iraipú, ALIêmen 0,475Jordão, ACHaiti 0,467Manari, PEMadagascar Fonte: PNUD, 2000 Table 2 - Brazilian municipalities with extreme rates of HDI and relevant countries, 2000

Figure 1 - Evolution of social, economic and environmental indicators of municipalities with the lowest HDI in Brazil, from 2000 to 2010

Figure 2 - Evolution of social, economic, environmental and health indicators in Brazil, from 2000 to 2010

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Conclusions 1) Improving the social inclusion process. 2) Limited growth of environmental indicator, related to the difficulty in understanding sanitation as a right. 3) Need for intensification of public policies integrated with the three pillars of sustainability.

ENVIRONMENTAL HEALTH AND INEQUALITIES: BUILDING INDICATORS FOR SUSTAINABLE DEVELOPMENT Authors Guilherme Franco Netto (DSAST/SVS) Carlos Corvalam (OPAS) Fernando Carneiro (UNB) Carlos Machado (Fiocruz) Luiz Belino Ferreira Sales (DSAST/SVS)