In Brazil, there exists a pronounced socioeconomic disparity, with a small, affluent upper echelon contrasting sharply against a vast majority positioned at the lower end of the income spectrum. Occupying the intermediate socioeconomic space is a considerable and heterogeneous middle class. The metric for salary measurement in Brazil is typically indexed to the official minimum wage due to the persistent issue of inflation. It is noteworthy that approximately two-thirds of the employed populace receive compensation equivalent to or less than twice the minimum wage. A stark regional discrepancy is evident, with nearly 50% of the labor force in the Northeast earning below the minimum wage, whereas in the Southern and Southeastern regions, close to 80% of workers have incomes surpassing five times the minimum wage threshold.

The nation’s healthcare challenges are further compounded by extensive malnutrition and the prevalence of endemic illnesses, including malaria, yellow fever, dengue fever, amoebic dysentery, tuberculosis, schistosomiasis, and the feared Chagas disease, which is transmitted through the bite of an insect commonly found in the wattle-and-daub construction of rural dwellings. These health conditions predominantly affect lowland regions and are less common at higher altitudes and within subtropical climates. The Oswaldo Cruz Foundation, situated in Rio de Janeiro, stands as the preeminent Brazilian institution for research on tropical diseases, playing a pivotal role in addressing these public health concerns.

In the context of Brazil’s major urban centers, significant strides have been made in the eradication of endemic tropical diseases. However, the influx of migrants from regions where such diseases persist has led to a resurgence of certain illnesses, with cases reported as far south as São Paulo. The health risks are further compounded by substandard sanitation and housing conditions, particularly affecting the numerous inhabitants of shantytowns, known locally as “favelados”, who reside predominantly in the vicinities of São Paulo, Rio de Janeiro, and other metropolitan areas. Enhancements in the infrastructure for clean drinking water and sewage systems have been instrumental in curtailing the propagation of diseases in these localities. Both government initiatives and private sector-supported clinics have made significant contributions to the enhancement of health conditions, with a special emphasis on prenatal and infant care services.

The social security framework in Brazil encompasses a comprehensive array of worker benefits, including health and unemployment insurance, retirement funds, severance compensation, mandatory savings schemes, and vacation remuneration. These benefits are financed by employers who make contributions to the National Social Security Institute on behalf of their employees. Notably, Brazil allocates a more substantial portion of its gross domestic product to social services than to its military expenditure. Despite these investments, the public health system has been subject to criticism regarding the administration, scope, and quality of the benefits provided. This prompted a structural reform of the health system in the 1990s, following the exposure of corruption involving several officials.

The healthcare landscape in Brazil features a predominance of public hospitals, accounting for approximately 80% of all hospitals. There is a notable disparity in the doctor-to-population ratio across the country, with the lowest figures in the North and Northeast regions, and progressively higher ratios in the South, Central-West, and the highest in the Southeast. The concentration of medical professionals and hospital facilities is markedly higher in urban areas. The quality and timeliness of healthcare services vary considerably, with public hospitals—serving primarily the economically disadvantaged—facing criticism for slow emergency responses and delayed treatment provision. A myriad of state and federal agencies administer healthcare services, although their programs are often constrained in scope.