CHALLENGES FACED BY PUBLIC HEALTH

Abstract

Public health, as a fundamental social right, demands state action to ensure universal, comprehensive, and equitable access to services. However, it faces structural, organizational, and financial challenges that compromise the effectiveness of public policies. The complexity of the systems, coupled with demographic transitions and social determinants, amplifies inequalities and puts pressure on healthcare capacity. Underfunding, fragmentation of services, and precarious working conditions reduce the quality and continuity of care. In this context, it becomes essential to strengthen integrated, sustainable, and evidence-based policies, guaranteeing greater equity, efficiency, and stability to public health systems for the entire contemporary Brazilian population. This study critically analyzes the challenges of public health, evaluates its impacts on healthcare, and examines strategies adopted to address contemporary structural, organizational, and institutional problems. The text addresses the fundamentals of public health, its historical evolution, its consolidation in Brazil with the SUS (Unified Health System), and highlights social determinants as structural factors that produce inequalities and influence processes of collective illness. This is a literature review study, with a qualitative approach, descriptive and analytical character, based on scientific principles, aiming to critically analyze recent publications on the contemporary challenges of public health. The analysis addresses the main structural challenges of public health, their impacts on care such as fragmentation and inequities, and the institutional strategies for addressing them, including integrated management, participatory governance, and professional qualification. It concludes that the structural challenges of public health involve social inequalities, weaknesses in management, financing, and human resources, requiring equity, intersectoral integration, and sustainable institutional strengthening.