Visualizing Brazil’s score on health and equity goals

A girl holds a sign that says “Fifa go Home” during a protest against the money spent on the FIFA 2014 World Cup in Paulista Avenue in São Paulo Brazil, on June 23, 2014. --AP

While soccer fans globally have been following the excitement of the World Cup matches in Brazil, riots in the country have thrust its poverty and inequality into the international spotlight. While Brazil has made progress in reducing poverty and improving health, much work remains to improve well-being in the country.

Last month, Brazilian officials announced that their country’s economy grew just 0.2% in the first quarter of 2014, which is a stark contrast to the prosperity it experienced during much of the last decade. A recent Wall Street Journal article reports that slower economic growth and rising inflation sparked protests over the last year.

The government’s spending of $11.63 billion on the World Cup—the most expensive in history–was equivalent to approximately 61% of the national education budget in Brazil and further catalyzed public discontent. In the weeks leading up to the World Cup, strikes among transit workers, police officers, and other public employees have caused substantial delays in cities such as São Paulo and Rio de Janeiro. Also, violent protests erupted in São Paulo on the opening day of the World Cup.

So just how much progress has Brazil made in improving the health of its people?

The screen grab below, taken from one of the Institute for Health Metrics and Evaluation’s Global Burden of Disease data visualization tools, shows that early death from lower respiratory infections, preterm birth complications, and diarrhea decreased by 57%, 60%, and 90%, respectively, between 1990 and 2010.

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As shown below, the red shading indicates communicable, maternal, nutritional, and newborn diseases, which tend to decline as a country becomes more developed, poverty decreases, and access to education, health care, clean water, and improved sanitation increases. At the same time, early death from diseases associated with rising levels of development – non-communicable diseases (shown in blue) and road injuries – increased. And, perhaps most notable, interpersonal violence has moved up in the ranking.

Leading causes of premature death in Brazil and percent change, 1990 and 2010

Brazil 1

Brazil Key

Despite the progress in reducing communicable, maternal, nutritional, and newborn diseases, Brazil’s health indicators lag behind developed countries and its wealthier Latin American neighbors Uruguay, Argentina, and Chile.

The screen grab below shows that early death from communicable, maternal, nutritional, and newborn diseases (the first seven diseases from the bottom) in Brazil far exceed levels in Australia and high-income countries in Europe and North America, as well as in Uruguay, Argentina, and Chile. The disease and injury patterns in the screen grab have been adjusted for differences in population size and ages across countries. Compared to the other countries shown in the figure, early deaths occurring in newborns (“neonatal disorders”) were especially large in Brazil.

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Rates of premature death by cause in Brazil compared to wealthier countries, 2010

Brazil causes death disability
IHME

 Note: Rates are adjusted for differences in population size and ages across countries

The graph below, provided by the World Bank, shows the percentage of the population living on less than $2 per day in Brazil dropped between 2004 and 2009. The following map from the World Bank shows the percentage of the population living in poverty in Brazil is comparable to Latin American countries such as Ecuador, Peru, and Paraguay but exceeds levels in Mexico, Venezuela, Uruguay, Chile, and Argentina.

Brazil: Poverty headcount ratio at $2 a day (PPP) (% of population)

World Bank Brazil poverty
World Bank

Global poverty headcount ratio at $2 a day (% of population)

(Go to World Bank data website for interactive map of ‘Purchasing Power Parity.” Below is just a screen grab)

Brazil WB purchasing parity map
World Bank

Despite the progress in improving health and cutting poverty, these data highlight the magnitude of the gaps between Brazil and higher-performing countries. As substantial numbers of Brazilians continue to live lives riddled with poverty and preventable diseases, it’s hard not to think about how the $11.63 billion budget of the World Cup could have been spent differently.

Katie Leach-Kemon, a weekly contributor of global health visual information posts for Humanosphere, is a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

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About Author

Katie Leach-Kemon

Katherine (Katie) Leach-Kemon is a policy translation specialist at the Institute for Health Metrics and Evaluation (IHME). Katie specializes in two of IHME's research areas, the Global Burden of Disease and health financing. Katie has helped produce IHME's Financing Global Health report since it was first published in 2009. She received an MPH from the University of Washington and served as a Peace Corps volunteer in Niger. Her work has been published in The Lancet, Health Affairs, and the Journal of the American Medical Association. You can follow her on Twitter @kleachkemon.