Health and environment in São Paulo, Brazil: methods of data linkage and questions of policy

This article addresses the development of data linkage methods for the analysis of urban environmental health problems and the development of appropriate policies and discusses, based on existing experience of data linkage in São Paulo (Brazil), the potential for routine environmental health monitoring and management in a major developing country industrial centre. The article looks briefly at two major environmental health problems in São Paulo: first, air pollution which has potential impacts on health of the whole population; and second, environmental differentials in conditions between groups within cities, which have substantial health effects on the economically deprived. The article argues that the health impact of environmental differentials in São Paulo is large, but unmonitored as a serious environmental health threat. In contrast, air pollution is monitored routinely, although its health effects are relatively small at present. The paper concludes with a discussion of policy implications of environmental health monitoring--which potentially require a substantial shift in attitudes of the urban wealthy.