Social determinants of self perceived health among quilombola communities in the lower amazon and implications for equity in health care

This study analyzed the association between self-perceived health and social determinants among residents of quilombola communities in the Lower Amazon region, located in the municipality of Santarém, Pará State, Brazil. A cross-sectional, analytical, and quantitative study was conducted with 500 participants living in quilombola communities officially recognized by the Federation of Quilombola Organizations of Santarém. Data were collected using a structured and validated instrument addressing sociodemographic, behavioral, and cultural variables. Self-perceived health was assessed using a Likert-type scale and dichotomized into positive (very good/good) and negative (regular/poor/very poor). Pearson’s Chi-square and Spearman’s correlation tests were applied, adopting a significance level of p < 0.05. A predominance of positive self-perceived health (74.2%) was observed, significantly associated with age group ( p = 0.003), physical activity ( p = 0.003), use of traditional care practices ( p < 0.001), and presence of self-reported comorbidities ( p = 0.004). The negative correlation between the Expanded Risk Factor Index and self-perceived health (ρ = −0.220; p < 0.001) indicated that the accumulation of vulnerability factors decreases the likelihood of positive health perception. The findings demonstrate that self-perceived health reflects the social and cultural inequities shaping daily life in quilombola communities, being influenced by living conditions, territorial belonging, and traditional care practices These findings highlight the potential relevance of ancestral knowledge and equity-oriented, culturally sensitive care; further longitudinal and mixed-methods studies are needed to clarify pathways and causal mechanisms.