The Importance of Primary Care in Reducing Health Inequalities: A Focus on Public Health
Authors: Araújo Warlen Miller Rocha , Moreira Sarah Goes Barreto da Silva , Da Silva Luana Pinheiro , Fossa Ângela Márcia , Brito Darciel Lucas , Dos Santos Juliane Macedo , Barbosa João Victor Manarelli , Da Silva Maria Fernanda Bandeira , Gurgel Hortência Ferreira , João Belmiro do Nascimento 
Published: January 2024

Objective: This article aims to revisit and consolidate the available scientific evidence on the impact of Primary Care on reducing health inequalities. Through a critical and comprehensive analysis, the goal is to highlight effective interventions, identify gaps in current research, and provide tangible recommendations for public policies that promote a more equitable approach in delivering health services. Thus, it seeks to contribute to the ongoing dialogue on how Primary Care can serve as a vital instrument in building healthier and fairer societies.

Theoretical Framework: The theory of social determinants of health, developed by Dahlgren and Whitehead, emphasizes the direct influence of social, economic, and environmental factors on population health. Primary Health Care (PHC), by addressing not only medical conditions but also social determinants, emerges as a vital instrument in reducing health inequalities. The 1978 Alma-Ata Declaration defined Primary Care as an essential component of health systems. The theory underscores the importance of accessible health services, community participation, and a comprehensive approach to health needs.

Method: This study adopts an exploratory and analytical approach, aiming to comprehensively investigate the relationship between Primary Health Care (PHC) and the reduction of health inequalities. A retrospective design was adopted to analyze existing data and evidence, providing a holistic view over time. A systematic literature review was conducted to identify relevant studies published up to the cut-off date of this work. Electronic databases such as PubMed, Scopus, and Web of Science were consulted using specific keywords related to PHC, health inequalities, and pertinent theories.

Results and Conclusion: Case studies conducted in different geographical contexts revealed nuances in the implementation of PHC and its effects on reducing health inequalities. Communities adopting a patient-centered approach and actively involving the community demonstrated substantial improvements in health indicators, corroborating applied theories. The analysis of local and national health policies highlighted the importance of a favorable regulatory environment to strengthen Primary Care. Regions implementing policies prioritizing equitable access to primary care showed more positive results in reducing health inequalities.

Implications of the Research: The results of this research provide important insights for the formulation of public health policies. Findings underscore the importance of prioritizing and strengthening Primary Health Care as a fundamental strategy in reducing health inequalities. Health policies should be directed towards supporting the implementation and expansion of PHC, considering the theories and practices indicated in the research.

Originality/Value: The research integrates a variety of relevant theories, from social theories to patient-centered care models. This holistic approach provides a more comprehensive understanding of the intersection between Primary Health Care and health inequalities.