Social Determination of Zoonotic Diseases in Brazil, 2007-2023: A One Health Analysis

Zoonotic diseases represent a persistent public health challenge worldwide, particularly in lowand middle-income countries marked by social and environmental inequalities. In Brazil, despite a consolidated national surveillance system and recent institutional advances in the One Health agenda, zoonoses remain endemic and unevenly distributed. This study aimed to analyze the national patterns of zoonotic disease morbidity and mortality from 2007 to 2023, interpreting these outcomes through the lens of social determination of health within a One Health framework. We conducted a nationwide ecological and analytical study using secondary data from official surveillance systems, integrating temporal trend analyses (Joinpoint regression), spatial analyses (Moran’s I and Local Indicators of Spatial Association), and social and territorial indicators, including municipal deprivation levels, territorial typologies, and race/ethnicity. The results revealed marked spatial clustering of high incidence and mortality in socially deprived, rural, and remote municipalities, particularly in the North and Northeast regions. While mortality rates declined over time, incidence remained persistent or increased in several regions, indicating ongoing transmission despite improvements in clinical management. Indigenous, Black, and mixed-race populations experienced a disproportionate burden of zoonotic diseases, highlighting intersecting social and territorial vulnerabilities. These findings demonstrate that zoonoses in Brazil are not randomly distributed biological events but socially determined outcomes shaped by structural inequalities and environmental contexts. Adopting a One Health perspective grounded in social determination underscores the need for integrated and equity-oriented strategies that address the root causes of zoonotic transmission, moving beyond sectoral and biomedical approaches toward transformative public health action.