This article summarizes the evaluation of three public health programs in relation to their efficacy and impact on social inequalities in health. These programs involved the fluoridation of the public water supply in the Brazilian context, the provision of antiretroviral therapeutics to Aids patients, and the distribution of flu vaccinations to elderly people in São Paulo. These three interventions were judged to be effective insofar as they led to a reduction in disease among the population. However, they achieved conflicting results in terms of their impact on inequalities in health. The article concludes that public health programs need to be implemented with an immediately and effectively universal reach, channelling additional resources to those groups with greater health needs. This strategy would simultaneously reduce the overall level of illness in the population and of inequalities in how diseases are experienced among different social strata.
Evaluation in health; Inequalities in health; Social class