Analysis of the Comprehensive Health Policy for the Black Population and its Impact on Care

Abstract

We aimed to analyze policy documents that emphasize the health of the Black population, seeking to understand the influences that influenced the development of the PNSIPN (National Health Plan for the Prevention of Black People) and the impacts of racism on health. This documentary research is anchored in the concepts of Stephen Ball (1994), based on these ideals in health policies conducted by Rezende and Baptista (2015), and the concepts of Structural Racism by Silvio Almeida (2019) and Institutional Racism in Health proposed by Jurema Werneck (2016) and Kabenguele Munanga (1999). As a result, the development of policies aimed at the Black population was analyzed in two phases: the process of formulating the policy text and the process of (non-)implementation, with its advances and setbacks. Structural and institutional racism has had a profound impact on health policies for the Black population, resulting in many negative repercussions on health services. These negative influences are evident in several aspects, including limited access to health care, disparities in health outcomes, differential and biased treatment, and a lack of representation and inclusion in health institutions. We conclude that the use of the policy cycle demonstrated the path taken by the policy text, from its inclusion on the political agenda to the inclusion of the race/color issue in health information systems. However, it is necessary to reinforce the incompleteness of the cycle when we cover the policy implementation stage in Brazilian states, raising awareness among professionals and health training schools, and the importance of expanding civil society participation in decision-making spaces and in the PNSIPN monitoring and evaluation indicators. It is worth emphasizing that recognizing the existence of the myth of racial democracy, with the false idea of a state of equality among subjects, is an important path toward building affirmative action and eliminating anti-racist health practices. Furthermore, strategies for deconstructing institutional racism aim to promote health equity in the SUS.