Resumo O racismo institucional impera nos serviços de saúde no Brasil, fundados em relações concretas de poder que subjugam, dominam e excluem negros/as do adequado acesso aos serviços e instituições de saúde. Este ensaio crítico analisa a importância da ampliação do debate e da produção do conhecimento sobre a saúde da população negra (SPN), focando dois pontos: o papel da Política Nacional de Saúde Integral da População Negra (PNSIPN) e a importância da inserção do quesito cor nos sistemas de informação em saúde; e a necessidade de um processo de formação permanente dos/as profissionais, inserindo conteúdos relacionados à compreensão do racismo como um dos elementos de determinação social de saúde/doença e seus efeitos. Para demonstrar como o racismo estrutural e institucional tem afetado a população negra, trazemos também exemplos das populações quilombolas no contexto da pandemia de COVID-19 no país a partir de 2020. Conclui-se que a promoção do cuidado, a redução das iniquidades e a qualidade da atenção à saúde precisam passar por mudanças em várias dimensões, como o fortalecimento do SUS e o combate cotidiano ao racismo estrutural e institucional.

There is a consensus that modern humans arrived in the Americas 15,000–20,000 y ago during the Late Pleistocene, most probably from northeast Asia through Beringia. However, there is still debate about the time of entry and number of migratory waves, including apparent inconsistencies between genetic and morphological data on Paleoamericans. Here we report the identification of mitochondrial sequences belonging to haplogroups characteristic of Polynesians in DNA extracted from ancient skulls of the now extinct Botocudo Indians from Brazil. The identification of these two Polynesian haplogroups was confirmed in independent replications in Brazil and Denmark, ensuring reliability of the data. Parallel analysis of 12 other Botocudo individuals yielded only the well-known Amerindian mtDNA haplogroup C1. Potential scenarios to try to help understand these results are presented and discussed. The findings of this study may be relevant for the understanding of the pre-Columbian and/or post-Columbian peopling of the Americas.

Background: The health and nutritional situation of adults from three rural vulnerable Amazonian populations are investigated in relation to the Social Determinants of Health (SDH) and the epidemiologic transition. Aim: To investigate the role of the environment and the SDH on the occurrence of chronic-degenerative diseases in these groups. Subjects and methods: Anthropometric, blood pressure and demographic data were collected in adults from the RDS Mamirauá, AM (n = 149), Flona Caxiuanã, PA (n = 148) and quilombolas, PA (n = 351), populations living in a variety of socio-ecological environments in the Brazilian Amazon. Results: Adjusting for the effect of age, quilombola men are taller (F = 9.85; p < 0.001) and quilombola women present with higher adiposity (F = 20.43; p < 0.001) and are more overweight/obese. Men from Mamirauá present higher adiposity (F = 9.58; p < 0.001). Mamirauá women are taller (F = 5.55; p < 0.01) and have higher values of waist circumference and subscapular/triceps index. Quilombolas present higher prevalence of hypertension in both sexes and there are significant differences in rates of hypertension among the women (χ² = 17.45; p < 0.01). The quilombolas are more dependent on government programmes, people from Mamirauá have more economic resources and the group from Caxiunã have the lowest SES. Conclusion: In these populations, the SDH play a key role in the ontogeny of diseases and the ‘diseases of modernity’ occur simultaneously with the always present infectoparasitic pathologies, substantially increasing social vulnerability.

Institutional racism is prevalent in the health services in Brazil and is based on concrete power relations that subjugate, dominate and exclude blacks from having adequate access to health care and health institutions. This critical essay analyzes the importance of expanding the debate, and the production of knowledge about the health of the black population (HBP), focusing on two points: the role of the National Policy for the Integral Health of the Black Population (PNSIPN) and the importance of including the skin color item in the health information systems; and the need for a process of permanent training of professionals, including contents related to the understanding of racism as an element of the social determination of health/disease and heir effects. To demonstrate how structural and institutional racism have affected the black population, we bring also examples of the quilombola populations in the context of the Covid-19 pandemic in the country since 2020. It is concluded that the promotion of care, the reduction of inequities and the quality of health care need to undergo changes in several dimensions, such as the strengthening of the SUS, the daily fight against structural and institutional racism, among others.