Racial equity and tobacco control in health planning instruments within the brazilian unified health system
1
National Cancer Institute, Rio de Janeiro/Rio de Janeiro, Brazil
2
Oswaldo Cruz Foundation – Amazonas, Manaus/Amazonas, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A3613
ABSTRACT
INTRODUCTION:
In brazil, black and quilombola populations are disproportionately affected by social determinants of health that reinforce structural inequalities and shape patterns of disease and health-related behaviors, including tobacco use, which remains more prevalent among black populations. Within the brazilian unified health system -SUS, health planning instruments play a central role in guiding policies and actions aimed at reducing health inequities. In a global context marked by persistent social injustices and widening health inequities, integrating racial equity into health planning is essential to advancing inclusive and sustainable health systems. This study aimed to analyze how racial equity and tobacco control are articulated in health plans developed under the SUS.
METHODS:
A qualitative documentary analysis was conducted of 178 health planning instruments developed within the SUS, , referred to as health plans, including 52 state health plans, two plans from the federal district, 52 municipal health plans from state capitals, and 72 municipal health plans from municipalities with a high concentration of quilombola populations. plans covering the periods 2020–2023 and 2024–2027 (states and federal district) and 2018–2021 and 2022–2025 (capitals and selected municipalities) were analyzed. The analysis focused on the presence, depth, and integration of racial equity and tobacco control within situational analyses, objectives, and proposed strategies.
RESULTS:
The analysis revealed a low level of institutionalization of ethnic-racial issues across the health plans. Tobacco use was predominantly addressed in a fragmented manner, being framed mainly as a risk factor for chronic noncommunicable diseases and not recognized as a disease in its own right, with limited consideration of racial inequities or the specific vulnerabilities and social contexts of black and quilombola populations.
CONCLUSIONS:
Health planning instruments within the Brazilian Unified Health System insufficiently integrate racial equity into tobacco control strategies, limiting their capacity to address structural health inequalities.
In brazil, black and quilombola populations are disproportionately affected by social determinants of health that reinforce structural inequalities and shape patterns of disease and health-related behaviors, including tobacco use, which remains more prevalent among black populations. Within the brazilian unified health system -SUS, health planning instruments play a central role in guiding policies and actions aimed at reducing health inequities. In a global context marked by persistent social injustices and widening health inequities, integrating racial equity into health planning is essential to advancing inclusive and sustainable health systems. This study aimed to analyze how racial equity and tobacco control are articulated in health plans developed under the SUS.
METHODS:
A qualitative documentary analysis was conducted of 178 health planning instruments developed within the SUS, , referred to as health plans, including 52 state health plans, two plans from the federal district, 52 municipal health plans from state capitals, and 72 municipal health plans from municipalities with a high concentration of quilombola populations. plans covering the periods 2020–2023 and 2024–2027 (states and federal district) and 2018–2021 and 2022–2025 (capitals and selected municipalities) were analyzed. The analysis focused on the presence, depth, and integration of racial equity and tobacco control within situational analyses, objectives, and proposed strategies.
RESULTS:
The analysis revealed a low level of institutionalization of ethnic-racial issues across the health plans. Tobacco use was predominantly addressed in a fragmented manner, being framed mainly as a risk factor for chronic noncommunicable diseases and not recognized as a disease in its own right, with limited consideration of racial inequities or the specific vulnerabilities and social contexts of black and quilombola populations.
CONCLUSIONS:
Health planning instruments within the Brazilian Unified Health System insufficiently integrate racial equity into tobacco control strategies, limiting their capacity to address structural health inequalities.
| eISSN: | 2654-1459 |
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