Government, Social Services
INPS, urban workers, maternity rights, sickness benefit, Chagas
The Brazilian government first established a social security provision in 1911. During the 1930s dictator Getulio Vargas implemented a welfare system that was advanced for its time, providing workers with minimum wages, unemployment insurance, and retirement benefits. During the 1960s a range of benefits covering medical assistance, sickness benefit, workmen’s compensation, and pensions were brought together under the National Institute for Social Provision (INPS), which was financed by contributions from workers and employers. In 1988 the framers of the new constitution sought to provide equality of access to welfare, health care, and social assistance. They extended equal benefits for pensions and maternity rights to rural and urban workers.
Financial constraints have led to a decline in the quality of the public health service, and many of the more affluent people belong to private health programs. The federal government finances about 70 percent of the public health services, the balance coming from the states and municipalities. Considerable inequity also exists in access to medical services, favoring cities and the more populated Southeast. One-third of all hospitals are in the Southeast, and there are more than twice as many people per doctor in the impoverished Northeast state of Piaui as there are in Sao Paulo.
Despite these difficulties, life expectancy at birth rose from 57 years in 1960 to an average of 64 years—59 years for men and 67.9 years for women—in 2002. The infant mortality rate fell from 95 deaths per 1,000 live births in 1970 to 36 deaths per 1,000 live births in 2002. As a reflection of increasing prosperity, the principal causes of death match those found in developed countries. However, parasitic diseases, gastric ailments, and malnutrition are still threats to the impoverished and the young. Tropical diseases, which are endemic to some areas, include malaria, yellow fever, Chagas’ disease, hookworm, and schistosomiasis.
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