**Acknowledgements**

The environment plays a fundamental role associated with health conditions, as environmental factors can cause ecological imbalance and, consequently, the proliferation of pests, which can be vectors of diseases [34]. Wooden houses are characteristic in the Amazon and are mostly built on stilts to avoid river flooding, for being economically viable, and to provide some thermal comfort to residents in local climatic conditions. Based on data collected, the epidemiological profiles of the region and the municipality are marked by overlapping of diseases resulting from local living conditions and low access to prevention and control mea-

Institutions such as the World Health Organization (WHO) and the Pan American Health Organization (PAHO) [36, 37], ministries and health departments are responsible for planning, monitoring, inspecting, and promoting actions to promote health in the world. In the last five decades, several important global events have been held in relation to global public

Intersectoral dialog has become increasingly necessary between institutions and countries. Advances in technology and science allow a better analysis and understanding of environmental interventions in order to mitigate damages caused to exposed populations. Globalization causes strong impact on economic, social, political and cultural areas, and, at the same time, on spatial organization that reflects on health conditions. The scales of the impact caused by globalization are differentiated around the world and very particular in realities like the

Ponta de Pedras is one of the largest açaí producers in Brazil, but the fruit trade has brought only few benefits to the population, particularly to small and medium producers and traders of the fruit, even with the overall projection of açaí consumption. This study, although lacking comparative temporal data, points to the direction that the global açaí market might have interfered in the health conditions of the residents. Both perception of inhabitants and some available official data point that noncommunicable chronic diseases are becoming more important health issues among the residents. On the other hand, infectious diseases and high infant mortality persist, very much related to the poor sanitary infrastructure and public ser-

In spite of efforts of the federal government in providing electricity, public internet access, and minimum allowance for underprivileged population, local governments find it difficult to implement health policies and sanitation systems, and to receive and use resources for a number of reasons of administrative, technological, educational nature, and distance from regional centers that make important decisions. Thus, although some economic resources and consumer goods are more accessible to a portion of the population, most of the residents

Deficiencies in the form of poverty exist at all territorial scales—regional, national, and global—and increasingly affect remote municipalities, such as Ponta de Pedras, and directly influence health, a scenario that is commonly seen in many other Brazilian municipalities.

remain vulnerable to social and environmental health determinants.

sures, in addition to poor health services.

municipality of Ponta de Pedras.

vices, low educational level, and poverty.

policies, especially those that reinforce health promotion.

**5. Final remarks**

24 Current Issues in Global Health

The authors are thankful to São Paulo Research Foundation (FAPESP), Brazilian National Council for Scientific and Technological Development (CNPq), and Coordination for the Improvement of Higher Education Personnel (CAPES) for the financial support to this research, as well as to the University of São Paulo, Department of Environmental Health and University of Vale do Paraiba (UNIVAP), Laboratory for Studies of Cities, São José dos Campos, SP, Brazil.
