FROM VULNERABILITY TO PLANNING: HOW PRIMARY HEALTH CARE CAN TURN INEQUALITIES INTO CARE PRIORITIES

Abstract

This chapter discusses how information on social vulnerability can be converted into planning decisions in Primary Health Care. It is a narrative literature review with a theoretical and applied approach, based on Brazilian studies on the Family Health Strategy, the Mais Médicos Program, PMAQ-AB, the School Health Program, oral health, disability, and inequalities in access. The aim is to demonstrate that recognizing Social Determinants of Health is insufficient if income, race/skin color, education, rurality, disability, and territorial conditions do not modify the distribution of resources, professionals, targets, and care strategies. Evidence shows that redistributive policies expanded coverage in less advantaged areas, reduced inequalities in physician distribution, and narrowed performance gaps between teams. However, gradients in access related to income, race/skin color, gender, and disability persist. The chapter proposes a planning logic in which territorialization, vulnerability stratification, active outreach, differentiated financing, and disaggregated monitoring guide local decisions. Equity becomes a management practice when inequalities cease to be merely described and begin to define concrete priorities for resource allocation and follow-up.