BACKGROUND:
Primary Health Care (PHC) is internationally recognized as the cornerstone of universal health systems, playing a central role in promoting equity and care coordination. However, even in urban contexts with high human development, significant disparities persist in the experience of care, influenced by social determinants and the territorial organization of health services.

METHODS:
This study aimed to analyze inequalities in the experience of care in PHC, considering health indicators, access, problem-solving capacity, and users’ perceptions across different urban territories in the municipality of Vitória, Espírito Santo, Southeastern Brazil. This cross-sectional study was conducted in Vitória, a municipality characterized by a high Human Development Index and a territorialized PHC network. A total of 641 adult users (≥18 years) linked to eight health units were interviewed. Sociodemographic profile, health indicators, access to services, and perceived problem-solving capacity were assessed using structured questionnaires. Data were analyzed using IBM SPSS software, version 31.

RESULTS:
The sample was predominantly female (68%) and low-income, with 42.6% earning up to two minimum wages. A marked gradient of territorial inequality was observed. More socially vulnerable regions showed higher prevalences of physical inactivity (58.1%) and obesity (35.8%). Statistically significant differences were found in perceived problem-solving capacity (p=0.000). Areas with higher educational levels and access to private health insurance reported problem-solving capacity above 67%, whereas more vulnerable territories presented the lowest levels (40.3%) and lower overall satisfaction. Community Health Workers were highly valued across all strata, emerging as key actors in trust-building and access facilitation.

CONCLUSIONS:
It is concluded that the experience of care in PHC is strongly shaped by social determinants. Even in municipalities with high human development, strengthening universal health systems requires equity-oriented territorial strategies, asymmetric investments, and the recognition of community-based work in the organization and daily management of PHC.