Challenges in ensuring access to health care for vulnerable populationsThe Unified Health System (SUS), despite its achievements and limitations, remains the main instrument for realizing the universal right to health in Brazil. However, social determinants of health pose additional challenges that demand innovative, evidence-based, ethical, and democratically grounded responses. The studies presented in this thematic issue were developed in this spirit, engaging directly with everyday practices of care, management, education, and research.
The health of vulnerable population groups in Brazil is a complex, multidimensional issue involving social, economic, racial, territorial, gender, and access inequalities. These populations face greater risks of illness, reduced access to prevention and treatment, and longstanding marginalization. Thus, the SUS is continuously challenged to ensure universal, equitable, and high-quality care for these groups while confronting both acute and chronic crises with resilience1-3.
The articles selected address diverse topics, from condom use among the elderly and its socioeconomic correlates to legislative initiatives on the therapeutic use of Cannabis sativa, traditional community practices in Family Health Strategy territories, barriers to participation in public physical activity programs, perceptions of discrimination in health services, and experiences of violence and racism. The issue concludes with an article assessing the resilience of the SUS - its capacity to respond to acute crises such as pandemics and disasters, as well as chronic challenges like underfunding, workforce shortages, and ineffective information systems that disproportionately affect the population as a whole, though especially vulnerable population groups4.
Together, these articles reveal not only the persistence of barriers faced by excluded groups but also illuminate experiences, strategies, and potential pathways to address them. Ensuring the right to health - particularly for populations marked by social invisibility, historical discrimination, and multiple forms of violence - requires sustained efforts to recognize differences and to formulate public policies grounded in equity.
References
- 1 Jatobá A, Castro-Nunes P, Carvalho PVR. On the epistemology of resilience in public health: a novel perspective in a changing world. Front Health Serv 2025; 4:1453006.
- 2 Jatobá A. Resilience in public health: What is and what should never be. Health Policy Technol 2025; 14(1):100974.
- 3 Castro-Nunes P, Palmieri P, Simões PP, Carvalho PVR, Jatobá A. Leveraging machine learning on the role of hospitalizations in the dynamics of dengue spread in Brazil: an ecological study of health systems resilience. Lancet Reg Health Am 2025; 44:101042.
- 4 Jatobá A, Carvalho PVR. The resilience of the Brazilian Unified Health System is not (only) in responding to disasters. Rev Saude Publica 2024; 58:22.
