James Macinko Reports on a Health Reform Innovation in Brazil

James Macinko’s research on an innovative health reform initiative undertaken in Brazil is featured in Battling Chronic Disease Worldwide, a special issue of HealthAffairs.

Macinko, an associate professor of public health and health policy, and his colleagues examined the Family Health Program, an initiative aimed to strengthen the Brazilian national health system. Brazil’s family health program uses a medical team — a doctor, nurse, medical assistant, and up to six community health workers — to provide primary care, make home visits, and educate communities in an effort to help improve the health of the100 million people they serve. Macinko’s study found that from 1999 to 2007, hospitalizations in Brazil for ambulatory care–sensitive chronic diseases, including cardiovascular disease, stroke, and asthma, fell at almost twice the rate of hospitalizations for all other causes.

“These results suggest that investment in primary care through the rapid expansion of the Family Health Program was responsible for some of the decline in hospitalization and helped improve the health system performance in Brazil,” Macinko said.

James Macinko is a faculty member in Steinhardt’s Department of Nutrition, Food Studies, and Public Health.