Abstract
The right to health represents one of the main social achievements consolidated by the Brazilian Federal Constitution of 1988, which recognized health as a right of all and a duty of the State and established the foundations for a public system based on universality, comprehensiveness, and equity. However, the existence of normative guarantees does not eliminate the profound economic, social, territorial, and institutional inequalities that affect health conditions and actual possibilities of access to services. This article aims to analyze the challenges to implementing the right to health in the context of Brazilian social inequalities, considering social determinants of health, regional differences in the distribution of resources and professionals, barriers faced by vulnerable populations, public financing, and the need for intersectoral policies. This is a narrative literature review with a qualitative and descriptive-analytical approach, based on scientific studies, Brazilian legislation, and institutional documents related to the Unified Health System and health equity policies. The analysis indicates that formal universality does not necessarily mean substantive equality of access. Income, education, housing conditions, work, sanitation, transportation, race/skin color, gender, and territory influence both exposure to health risks and the ability to access health services in a timely manner. In this context, implementation of the constitutional right depends on strengthening the Unified Health System, Primary Health Care, sustainable financing, regionalization, reduction of access barriers, and coordination among social policies. It is concluded that reducing health inequities requires understanding health as a fundamental right inseparable from actual living conditions and recognizing equity as an essential element for transforming legal equality into social justice.