Brazil – Health Issues

What are the most common health issues and diseases in Brazil?

Brazil contends with what health authorities describe as a “triple burden of disease” — a simultaneous struggle against chronic non-communicable conditions, communicable illnesses, and harm caused by accidents and violence. All three represent substantial pressures on the healthcare system and on the broader health of the population, making Brazil’s disease profile considerably more complex than that of many comparable economies.

Figures from 2019 show that non-communicable diseases (NCDs) accounted for 76% of all deaths in Brazil, with 66.1% of those deaths occurring prematurely — that is, among people between 30 and 69 years of age. Heart disease, stroke, diabetes, and cancer represent the dominant causes of mortality, mirroring patterns found in many middle- and higher-income nations, though Brazil’s rates of premature death from these conditions continue to exceed the regional average.

Looking at the specific toll of cardiovascular and malignant disease: circulatory and heart conditions are responsible for 65.7 deaths per 100,000 inhabitants, while cancer accounts for 26.7 deaths per 100,000. These statistics position cardiovascular illness as the single greatest threat to life in the country — a pattern familiar across Europe and North America, but made more acute in Brazil by persistent inequalities in access to preventive and primary care.

Lifestyle-driven conditions including hypertension, type 2 diabetes, and heart disease are rising steadily, and Brazil already carries one of the heaviest NCD burdens of any country in the world. At the same time, diseases largely eradicated in wealthier nations remain a significant public health issue here: leprosy still affects around 24,000 Brazilians each year, and tuberculosis strikes close to 80,000 people annually — claiming roughly 14 lives every single day. These illnesses disproportionately affect poorer communities and those in more remote regions.

Health outcomes in Brazil are not distributed evenly. Broadly speaking, the wealthier southern and southeastern states benefit from better infrastructure and outcomes, while the northeast and the Amazon basin carry a heavier burden of infectious disease, malnutrition, and inadequate healthcare access. Geography and income remain powerful determinants of health across the country.

Is Brazil considered a healthy country? How do health outcomes compare internationally?

Brazil’s population reached an average life expectancy of 76.6 years in 2024, up by 2.5 months compared to 2023. This represents meaningful progress over the long run — in 1940, life expectancy stood at just 59.5 years — and reflects sustained improvements in vaccination coverage, maternal health services, and poverty alleviation. That said, Brazil still falls short of the averages recorded in most high-income countries across Europe and East Asia.

Breaking this down by sex, male life expectancy rose from 73.1 to 73.3 years during the period under review, while female life expectancy edged upward from 79.7 to 79.9 years. To put Brazil’s figures in global context: Monaco leads the world at 86.5 years, followed by San Marino (85.8), Hong Kong (85.6), Japan (84.9), and South Korea (84.4) — figures that indicate how much ground Brazil still has to cover.

Within the broader Americas region, Brazil’s life expectancy of 76 years in 2024 sits below the regional average, though it is 6.4 years higher than the 2000 figure of 69.6 years. Genuine improvement has occurred, but avoidable premature deaths remain a persistent challenge. In 2019, Brazil recorded an adjusted rate of 249 potentially preventable premature deaths per 100,000 population — a decline of 29.2% compared to 2000, yet still 9.8% above the average for the Americas as a whole.

Looking ahead, IBGE projects continued gains: life expectancy is forecast to reach 77.8 years by 2030, 79.7 years by 2040, and 81.3 years by 2050, suggesting sustained confidence in the trajectory of healthcare and living standards. Expats seeking current figures should consult the WHO Brazil country profile and IBGE, both of which are regularly updated.

The COVID-19 pandemic inflicted a severe setback: life expectancy in Brazil dropped to 72.8 years in 2021, exposing deep vulnerabilities in the health system’s capacity to manage large-scale crises. Recovery has been evident from 2022 onwards, and by 2024 progress appears to be back on track. Nevertheless, health inequality across regions and income groups persists as a structural challenge that cannot be resolved through recovery statistics alone.

What infectious diseases or environmental health risks should expats be aware of in Brazil?

Mosquito-borne illnesses — including dengue fever, Zika, chikungunya, malaria, and yellow fever — are endemic across the Amazon basin, and anyone travelling to or settling in Brazil is strongly encouraged to complete all recommended vaccinations and to practise consistent mosquito avoidance measures. For expats arriving from countries where such diseases are essentially absent, the temptation to underestimate these risks is real — but they represent a genuine and ongoing danger throughout much of Brazil.

The scale of Brazil’s dengue problem was sharply illustrated in 2024, when a major epidemic saw more than 6 million people infected and over 4,000 deaths recorded by June of that year alone. Dengue is present in every Brazilian state. Crucially, unlike malaria — which is largely confined to the Amazon — dengue, Zika, and chikungunya are transmitted by the Aedes aegypti mosquito, which thrives in urban environments including major cities such as São Paulo and Rio de Janeiro.

While Brazil does not require arriving travellers to show proof of yellow fever vaccination, both the CDC and WHO recommend the vaccine for all travellers nine months of age and older who are visiting areas where transmission risk exists. The importance of this advice was underscored by outbreaks of sylvatic yellow fever during 2016–2017, which spread to southeastern coastal areas including Rio de Janeiro and São Paulo — regions historically considered low-risk. A number of unvaccinated travellers fell seriously ill and some died, prompting the WHO and CDC to update their coverage recommendations for Brazil in 2017.

Neglected tropical diseases — among them Chagas disease, leishmaniasis, lymphatic filariasis, and trachoma — continue to affect significant numbers of people in Brazil, primarily those living in poverty. Expats based in urban settings face a lower risk, but those working or spending time in rural areas or jungle environments should seek specific medical advice and take appropriate precautions.

Travellers’ diarrhoea is the most frequently reported travel-related illness, and the risk is elevated for those who eat raw produce, consume unpasteurised dairy products, or purchase food from street stalls. Expats newly arrived in Brazil are advised to pay close attention to food and water hygiene in their first weeks while their digestive systems adjust to an unfamiliar microbial environment.

Brazil is home to a variety of endemic fungi — including Paracoccidioides, which is concentrated in the south and southeast — and inhaling soil-borne spores can lead to serious respiratory illness. Urban air quality is also a concern: outdoor pollution significantly increases the risk of respiratory, cardiovascular, and dermatological diseases as well as certain cancers. Data from 2010 to 2012 showed that four of Brazil’s five most populous cities with available measurements exceeded the WHO annual mean guideline for fine particulate matter (PM2.5).

Before relocating, expats are strongly advised to consult their home country’s official travel health authority — such as the UK’s NHS Travel Health, the US CDC Travel Health, or an equivalent national body — as well as Brazil’s Ministry of Health (Ministério da Saúde), for up-to-date vaccination guidance and disease alerts.

Is smoking common in Brazil, and what are the laws around it?

Approximately 9.3% of Brazilian adults smoked as of 2023, and PAHO data from the same year puts tobacco use among people aged 15 and older at 11.7%. While these figures are far from negligible, they represent a dramatic improvement on rates recorded in previous decades, when smoking was far more embedded in everyday life. Brazil has earned widespread international recognition as a trailblazer in tobacco control policy.

The legal framework underpinning Brazil’s approach to smoking was overhauled in 2011 with the passage of Law 12.546, which banned tobacco use in all enclosed collective and public spaces — covering restaurants, bars, workplaces, airports, and public transport. At the time of its introduction, this legislation placed Brazil among the most progressive countries globally on tobacco restriction, comparable to the strictest bans seen across Scandinavia or in countries such as Ireland and New Zealand. No-smoking signage is clearly displayed in applicable venues, and enforcement is generally effective in urban areas.

Smoking is recognised as a key risk factor for all four of the largest non-communicable disease categories — cancer, cardiovascular disease, respiratory illness, and diabetes — and individuals living with mental health conditions are almost twice as likely to smoke compared to the general population. On the question of vaping and e-cigarettes, Brazil has taken a particularly uncompromising stance: as of 2024, ANVISA (Brazil’s National Health Surveillance Agency) maintains a ban on the sale, importation, and advertising of electronic cigarettes — one of the strictest such positions in the world. Despite this prohibition, use of vapes is observable, particularly among younger city-dwellers.

Expats arriving from countries with robust indoor smoking bans will find Brazil’s rules broadly familiar and consistently enforced in cities. Outdoor smoking remains visible in some public spaces, though social attitudes have shifted considerably, with smoking now widely viewed in a negative light.

Is obesity or poor diet a significant health concern in Brazil?

Data from Brazil’s Ministry of Health surveillance programme (VIGITEL) reveals a 96% increase in adult obesity over just 15 years — climbing from 11.8% in 2006 to 22.4% in 2021. This sharp upward trajectory reflects global patterns but stands out for the speed at which it has occurred, driven by rapid urbanisation, shifting diets, and increasingly sedentary lifestyles. PAHO figures for 2022 indicate that the combined prevalence of overweight and obesity among Brazilians aged 15 and older had reached 63.0%.

The causes are well understood: urbanisation has altered daily activity levels, and traditionally healthier eating habits have given way to heavier consumption of ultra-processed products. Brazil’s culinary heritage — centred on rice, beans, fresh vegetables, grilled meats, and tropical fruits — offered a nutritionally balanced foundation, but the widespread availability and low cost of industrially processed foods has fundamentally reshaped what people eat, particularly in cities. The COVID-19 pandemic added further fuel to this trend, with evidence showing that ultra-processed food consumption increased among Brazilian adults during the health crisis.

Regional variation is significant: obesity prevalence among capital cities ranged from 11% to 17%, with the highest concentrations recorded in the south. While excess weight and diet-related illness dominate the picture in wealthier regions, undernourishment and food insecurity remain real concerns in parts of the northeast and among lower-income populations elsewhere.

In 2019, 47% of Brazilians reported insufficient levels of physical activity — a risk factor that cuts across socioeconomic lines. Government public health campaigns have sought to encourage healthier behaviours, but structural barriers including food poverty and the aggressive marketing of ultra-processed goods make progress difficult. NCDs linked to inadequate nutrition now account for 71% of all deaths in Brazil — a figure that underlines just how central this issue is to the country’s overall health burden.

What are the mental health attitudes and services like in Brazil?

The 2023 “Global Health Service Monitor” survey by Ipsos found that 52% of Brazilians identified mental health as the country’s most pressing wellbeing issue. A separate survey conducted in August 2024 produced a similar finding, with approximately 54% of respondents naming mental health as the leading healthcare concern in Brazil. Public awareness of this issue is not only high — it is accelerating.

The COVID-19 pandemic worsened an already challenging situation. The 2024 Global Mind Project — drawing on responses from more than 420,000 participants across 70 countries — ranked post-pandemic Brazil among the worst performers globally for mental health. Current estimates suggest that more than 18 million Brazilians are living with conditions such as anxiety or depression.

Despite heightened public awareness, stigma continues to obstruct access to care in many parts of the country. In urban, educated, and younger communities, conversations about mental health have become noticeably more normalised. In rural areas and more traditional settings, however, seeking psychological support can still be met with social disapproval — a pattern that parallels challenges found across much of Latin America, Southern Europe, and parts of Asia.

Within the public system, mental health services are delivered primarily through the Centros de Atenção Psicossocial (CAPS — Psychosocial Care Centres) under the SUS framework, offering community-based support. Yet a 2023 PAHO report found that 80% of people diagnosed with anxiety and depression across the Americas lack access to treatment — a sobering figure that speaks to the gap between need and provision. Waiting times within the public system can be substantial.

Private mental health provision is more readily accessible, with a growing community of psychologists and psychiatrists practising in major cities including São Paulo, Rio de Janeiro, Curitiba, and Belo Horizonte. The expansion of teletherapy platforms has extended access to Portuguese-language psychological support across much of the country. Expats who require therapy in languages other than Portuguese will need to search for private practitioners, who are most likely to be found in the larger metropolitan centres.

Are there any health risks specific to expats living in Brazil?

Expats moving to Brazil encounter several health challenges unlikely to have featured in their daily lives back home. Chief among these are infectious disease risks — above all mosquito-borne illnesses — that demand ongoing attention rather than being resolved through a single pre-departure vaccination. Practical measures such as applying insect repellent, wearing protective clothing in higher-risk environments, and ensuring that accommodation is fitted with effective mosquito screens all form part of sensible daily precautions.

Climate adaptation is another common early challenge. Brazil’s tropical and subtropical conditions — especially along the coast and throughout the Amazon — can cause heat exhaustion, dehydration, and skin problems in those unaccustomed to sustained heat and high humidity. Expats arriving from cooler climates should allow themselves adequate time to acclimatise, maintain good hydration, and take UV protection seriously. Solar radiation is intense across much of Brazil throughout the year, and national skin cancer rates are rising.

Lengthy waits for consultations, diagnostic tests, and procedures represent one of the most frequently cited frustrations with Brazil’s public system, and can affect even patients requiring urgent or ongoing care. This is why most expats — and particularly those managing pre-existing health conditions — choose to take out private health insurance, which opens access to Brazil’s extensive and generally high-quality private hospital and clinic network. Coverage can be arranged before departure or upon establishing residency, and several international providers offer plans specifically designed for expatriates.

Adjustment to food and water is also relevant, especially during the first weeks in the country. While tap water in major cities such as São Paulo and Rio de Janeiro is treated and formally meets safety standards, a large proportion of residents — locals and expats alike — prefer filtered or bottled alternatives. Street food is an integral part of Brazilian culture and is generally considered safe in busy, well-established locations, but foodborne illness is a realistic risk during the early settling-in period.

Brazil recorded 41 new tuberculosis cases per 100,000 population in 2022 — a considerably higher rate than most high-income countries. Expats who will be working in healthcare, community-facing roles, or densely populated informal neighbourhoods should discuss TB screening and preventive options with a doctor before or shortly after arrival. Registering with a local physician — through either the SUS or a private provider — is strongly recommended as an early priority after relocating.

Where can expats find reliable health information and services in Brazil?

The main official point of reference for health information in Brazil is the Ministério da Saúde (Ministry of Health), which provides up-to-date guidance on vaccination schedules, disease outbreaks, and public health programmes. ANVISA (Agência Nacional de Vigilância Sanitária), Brazil’s national health surveillance body, oversees the regulation of medicines, medical devices, and food safety standards.

The Pan American Health Organization (PAHO) Brazil office publishes internationally comparable health statistics and in-depth reports, making it a valuable resource for expats wanting to contextualise Brazil’s health situation within the wider region. The WHO Brazil country profile is equally useful for reviewing health indicators and disease-specific data across time.

In legal terms, all residents of Brazil — including expats holding valid residency status — are entitled to access the SUS. In practice, service quality varies enormously between regions and municipalities, and the Portuguese-language environment can present a significant navigational barrier for those without sufficient fluency. Expats in large cities will generally find that the private healthcare sector — particularly in São Paulo and Rio de Janeiro — operates to a high international standard.

The Federal Council of Medicine estimates a ratio of one doctor per 470 people in Brazil, although this figure conceals a deeply uneven distribution between the public and private sectors and between urban and rural areas. Expats living in large metropolitan areas will have far greater access to specialist care than those based in remote or rural settings.

It is also worth checking your home country’s travel health and foreign affairs websites both before departure and on an ongoing basis once you are living in Brazil. These sites provide not only pre-travel vaccination advice but also timely alerts about outbreaks and evolving health risks. Guidelines and recommendations can change quickly, and official sources should always take precedence over general reference material such as this article.

Frequently Asked Questions About Health Issues in Brazil

Do I need vaccinations before moving to Brazil?

Yes. A number of vaccinations are recommended before moving to Brazil. These include yellow fever — especially important if you plan to spend time in or near the Amazon or in other areas carrying transmission risk — as well as hepatitis A and B, typhoid, and standard routine immunisations. The yellow fever vaccine is recommended by both the CDC and WHO for most parts of Brazil. Always verify current requirements with your home country’s travel health authority and Brazil’s Ministry of Health before departure, as recommendations can be revised.

Is the tap water safe to drink in Brazil?

Tap water is treated and officially compliant with safety standards in most major Brazilian cities, though quality and consistency can vary between neighbourhoods and regions. A large proportion of residents — both local and foreign — opt for filtered or bottled water, particularly when first arriving while the body is still adjusting to a new environment. In rural areas, water safety is less assured, and additional precautions are advisable.

Can expats use Brazil’s public health system (SUS)?

The SUS provides universal healthcare coverage to all residents of Brazil. In principle, expats who hold legal residency status can use the SUS without charge. In practice, services are often under strain, waiting times can be long, and navigating a system that operates entirely in Portuguese presents a real challenge for those without adequate language skills. Most expats who are financially able to do so also take out private health insurance, which grants access to Brazil’s broader private hospital and clinic network and typically comes with shorter waiting periods and greater language flexibility.

How serious is dengue fever for expats living in Brazil?

Dengue remains a major and recurring threat in Brazil. In 2024, an epidemic infected more than 6 million people and caused over 4,000 deaths by June of that year alone. The disease is present in every Brazilian state, and symptoms include high fever, intense headache, pain in the joints and muscles, and a characteristic rash. No specific antiviral treatment exists; management relies on supportive care. Prevention through mosquito control — repellents, window screens, and eliminating standing water — remains the most effective defence. A dengue vaccine is available and worth discussing with a healthcare provider.

What are the biggest lifestyle health risks in Brazil?

Hypertension, type 2 diabetes, and cardiovascular disease are all on the rise, and Brazil bears one of the heaviest non-communicable disease burdens globally. For expats specifically, the combination of dietary changes during relocation, reduced physical activity while settling in, significant sun exposure, and the effects of sustained heat and humidity can all take a toll. Keeping up regular physical activity, maintaining a balanced diet, attending health check-ups, and ensuring that any existing medical treatment continues without interruption are all practical priorities.

Is mental health support available in English or other languages in Brazil?

Public mental health services under the SUS are delivered in Portuguese. In the private sector, especially in larger cities such as São Paulo, Rio de Janeiro, and Curitiba, it is increasingly feasible to find psychologists and therapists who practise in English, Spanish, French, and other languages. The growth of teletherapy platforms has also broadened access to support delivered remotely. Expats who need therapy in a language other than Portuguese are most likely to find suitable practitioners by searching within the private sector in major urban areas.

Is air quality a health concern in Brazil?

Yes, particularly for urban residents. Outdoor air pollution raises the risk of respiratory, cardiovascular, and dermatological conditions, and data from 2010 to 2012 showed that four of Brazil’s five most populated cities with available measurements exceeded the WHO annual mean guideline for fine particulate matter (PM2.5). Air quality in São Paulo can deteriorate notably during peak traffic periods, and the increasingly severe wildfires that burn across the Amazon and central-west regions during the dry season produce significant smoke and associated health risks over large areas of the country. Those with existing respiratory conditions are advised to track air quality indices and act accordingly.

Where should I go if I have a medical emergency in Brazil?

For any medical emergency, dial SAMU (Serviço de Atendimento Móvel de Urgência) on 192 — Brazil’s national ambulance and mobile emergency response service. The fire brigade, reachable on 193, also provides emergency medical assistance. Public emergency departments (UPAs — Unidades de Pronto Atendimento) are open to all, though waiting times can be considerable. Expats with private insurance should keep their insurer’s emergency helpline number readily accessible, as private hospitals can often provide faster access to specialist care. Ensure that copies of your prescription medications, medical history, and key health records are always within easy reach.