Dados vol. 23 n. 2 Rio de Janeiro 1980

Estado e Saúde Pública no Brasil (1889-1930)

Santos, Luiz A. de Castro


This article studies the formative years of the public health movement in Brazil in a comparative-historical analysis of the states of São Paulo and Bahia and the city of Rio de Janeiro. The historiography of public health in Brazil during the First Republic indicates that there was a strong imbalance in the allocation of health services at the regional level. In fact, public health campaigns were practically limited to the state of São Paulo and to Rio de Janeiro, in spite of the critical sanitary conditions of Northeastern states like Bahia. A puzzle of difficult solution is that the city of Salvador represented - until the beginning of the 20th century - one of the best centers of medical education and research in Brazil, after the city of Rio de Janeiro. The theoretical position adopted here indicates that the factors which explain the unequal distribution of health resources and programs in Brazil are to be found at the power structure level (both national and regional). One hypothesis, which we call structural, suggests that it was in the interest of the coffee oligarchies to protect the health of arriving immigrants; a second hypothesis, of a historic-cultural nature, looks at an ideology with access to the center of power: Positivism, widely disseminated among the military and intellectuals in the South, contributed to the emergence of sanitary campaigns in Rio de Janeiro and in São Paulo.

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Estado e Saúde Pública no Brasil (1889-1930)