Bolsa Família is the Brazilian government’s main direct cash transfer program for low-income families. It provides monthly financial assistance to combat hunger, promote food security, and support the integration of health, education, and social assistance policies.

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One of the pieces of evidence considered most robust by the researchers relates to maternal and child health. Among women who received the benefit, the risk of death from causes related to pregnancy and childbirth was up to 31 percent lower than among those who did not receive the benefit.

According to the researchers, this outcome is linked, among other factors, to greater access to prenatal care and health services promoted by the program’s conditionalities.

The effects are also evident early in life. In a study analyzing more than 4 million births, women who received the benefit during pregnancy were less likely to give birth to low-birth-weight infants. The impact was even more pronounced among black and indigenous mothers.

Other studies found a reduction in the incidence of preterm births and a 16 percent decline in mortality among children under five in families benefiting from the program.

Diseases

The body of studies also revealed significant impacts on diseases associated with poverty. In the case of tuberculosis, for example, Bolsa Família beneficiaries had a 41 percent lower incidence of the disease and a 31 percent lower risk of death after diagnosis. Among indigenous people, the reduction in mortality was even more pronounced.

Similar results were observed for HIV/AIDS. A study tracking more than 22 million Brazilians found lower disease incidence, lower mortality, and better health indicators among Bolsa Família beneficiaries in the poorest segments of the population.

The researchers also identified a reduction in the incidence of leprosy in municipalities with high transmission rates, as well as higher treatment adherence and cure rates among beneficiaries.

Mental health

One of the studies found that the suicide rate was 56 percent lower among Bolsa Família beneficiaries. Other analyses showed reductions in hospitalizations for psychiatric disorders and for problems related to alcohol and other drug use, especially in municipalities with higher poverty rates.

For epidemiologist Mauricio Barreto of Fiocruz Bahia, the findings help explain how economic and social factors directly influence health outcomes.

“Countless health problems are shaped by social and economic factors, especially poverty and inequality. Reducing poverty and encouraging the use of health, education, and social assistance services must be part of efforts to improve the health of the Brazilian population,” said Barreto.

Research

The results were presented this week during a webinar that brought together Brazilian and international scientists. The event focused on the main findings of the so-called Platform for Continuous Studies and Evaluations of the Social Determinants and Health Effects of the Bolsa Família Program and Other Social Protection Programs - Cohort of 100 Million Brazilians.

The studies used data from the Brazilian government’s Single Registry for Social Programs (CadÚnico), cross-referenced with information on births, hospitalizations, disease notifications, and deaths. Using this dataset, the researchers sought to measure the effects of cash transfers on the health of the country’s most vulnerable populations.

According to Mauricio Barreto, the findings reinforce the view that combating poverty is also a strategy for promoting health.

“The existence of Brazil’s public healthcare system, the SUS, is fundamental to protecting and meeting the needs of the population. But when it operates in conjunction with a robust social protection program such as Bolsa Família, it becomes possible to reduce the effects of the main social determinants that negatively affect health,” Barreto stated during the meeting.

The researchers highlight that the studies were conducted using evaluation methodologies considered innovative for public policy, allowing comparisons between population groups with similar characteristics and estimates of the program’s effects over time.

The evidence produced by CIDACS over the past decade reinforces, according to the authors, the importance of integrating social protection policies with the health system.

For the first time, Brazil has entered the category of countries with “very high” human development. In 2024, the country reached 0.805 on the municipal human development index (MHDI), compared to 0.744 in 2012. The scale ranges from 0 to 1, with an indicator above 0.800 considered very high.

The information comes from the United Nations Development Programme (UNDP) Brazil, which released a survey on Tuesday (May 26).

The index assesses parameters related to health and longevity, education, and income generation, broken down by race (black and white) and gender (women and men). The report covers the 13-year period from 2012 to 2024.

When the United Nations program began calculating this index 30 years ago, Brazil was a country with a low MHDI, that is, below 0.555.

Education

The factor that most contributed to the increase in the MHDI during this period was education – which rose from 0.679 in 2012 to 0.798 in 2024.

Betina Barbosa, coordinator of the Human Development Unit at UNDP Brazil, highlighted the Bolsa Família program, the federal government’s cash transfer program.

“It is the Bolsa Família program that removes a huge number of children from the workforce and provides them with the means and the obligation to attend school. So, here I see the direct effect of a Brazilian public policy,” she said.

Barbosa noted that the program, created in 2003, began to show results about ten years later, precisely when the first group of beneficiaries completed a satisfactory period of schooling.

Black Families

The improvement in education indicators during this period, Barbosa went on to note, is most significant among lower-income families, which are predominantly black families.

“This is where the black population begins to show better indicators and improved educational performance. Here, the policy takes a group that was previously excluded and brings it into the debate about human development. This has been happening in an upward trend since 2016,” she remarked.

She emphasized that there is no alternative for improving Brazil’s development without including the black population in the public policy agenda. The same applies to women. “These are two serious obstacles for Brazil – racial inequality and gender inequality.”

Health care and income

Barbosa explained that, among the sub-indices, public health care policy is the one that yields the most positive results for the country, having already achieved a “very high development” score in 2012 (0.829), due to the consolidation of Brazil’s public health care system, the SUS. Still, it is the one showing the slowest growth – it reached 0.860 in 2024.

The income parameter is growing at a slow pace, from 0.732 in 2012 to 0.760 in 2024, but is now at the high development level.

COVID-19

According to the UNDP, Brazil faced a systemic crisis due to the Covid-19 pandemic from 2020 to 2022. In 2021, its MHDI stood at 0.757. Barbosa notes that the most concerning aspect was Brazil’s denial that this collapse would have negative effects on development.

“This denial and the lack of swift action to create public policies that combat systemic crises are serious,” she explained. “In terms of life expectancy, we have not yet recovered from the blow of COVID-19,” she added.

In this regard, child mortality is the indicator of greatest concern to the UNDP and is linked to public policies that require a rapid response. “There was not a sufficiently rapid response in the country regarding the impacts of COVID-19.”

The results of the survey were based on data from the Continuous National Household Sample Survey, conducted by Brazil’s statistics bureau IBGE, in partnership with the technical team and researchers from the João Pinheiro Foundation.