**2. Aging and Quilombola communities in Brazil**

*Quality of Life - Biopsychosocial Perspectives*

of life [2].

framework [3].

nomically vulnerable [4].

communities [6].

The Brazilian black population's historical trajectory shows that these individuals have been seeking better living and health conditions through social struggles, which allowed them to achieve some social rights: the universal right to health and social participation. However, in order to address social inequalities, it is necessary to reduce the level of poverty, as well as to enable a more equitable distribution of goods and services that allow achieving the well-being and quality

On February 7, 2007, the *Política Nacional de Desenvolvimento Sustentável dos Povos e Comunidades Tradicionais* was instituted, by Decree No. 6040. According to it, these people and communities are understood as culturally differentiated groups that recognize themselves as such, which have characteristic forms of social grouping, and that, through traditionally generated knowledge and practices, use territories and natural resources as a condition for reproducing their cultural

Quilombola communities are examples of social groups that constitute traditional communities [4]. These represent approximately 5 million Brazilians. Due to their historical characteristics of fighting racial discrimination and specific conditions of poverty and inequality, they live in relative geographic isolation and have little access to governmental public policies, factors that make them more socioeco-

According to the Brazilian legislation (Decree No. 4887, November 20, 2003), Quilombola communities are groups according to criteria of self-attribution, which have a historical trajectory, with a presumption of black ancestry related to the resistance to the historical oppression suffered. They are socially more vulnerable and have a predominantly rural geographical position [5]. The Palmares Cultural Foundation has been responsible for the recognition and certification of

According to Law 7668, from Brazilian Government, the Palmares Cultural Foundation was created on August 22, 1988, linked to the Ministry of Culture in order to promote the preservation of cultural, social, and economic values arising

There are almost 2 million people living in about 2997 Quilombola communities that are certified by the Palmares Foundation. Officially recognized Quilombola communities are found across all regions of Brazil. Their geographical distribution is related to the racial formation process and settlement policy implemented during the period of Portuguese colonization (from the discovery of the country in 1500 to independence in 1822) and the imperial governments (from independence in 1822 to the abolition of slavery in 1888 and subsequent emergence of the Republic in 1889). The majority of Quilombola communities are concentrated in the country*'*s Northeast Region (63%) [8]. So, the distribution of these communities among the regions of Brazil reflects the structure of occupation and territorial exploitation made by the Portuguese crown during the colonization process. The great flow of enslaved black labor was concentrated in the Northeast Region of the

In the northeast of Brazil, there are 2061 Quilombos Remnant Communities (CRQ ) certified by the Palmares Foundation (until May 2019) distributed among the federative units of this region: Bahia, 801 (38.8%) CRQs; Maranhão, 787 (38.2%) CRQs; Pernambuco, 161 (7.8%) CRQs; Piauí, 87 (4.2%) CRQs; Alagoas, 69 (3.3%); Ceará, 50 (2.4%) CRQs; Paraíba, 41 (1.9%) CRQs; Sergipe, 36 (1.7%)

The *Baixada Maranhense* region has historically been home to a large number of Quilombola communities since the second half of the nineteenth century and

from the black influence in the formation of Brazilian society [7].

CRQs; and Rio Grande do Norte, 29 (1.4%) CRQs [9].

**220**

country.

Population aging is a global phenomenon and is strongly linked to socioeconomic and health status, lifestyle, and social and health behaviors. In Brazil, several population surveys with the elderly have shown that there are important inequalities in this group in their quality of life and health, being inequalities in the living conditions and health status of older persons particularly more pronounced among vulnerable groups living in remote area, such as older persons living in Quilombola communities [8].

In Brazil, initiatives related to the well-being of the elderly population are still scarce. Although the concept of quality of life has an extensive field of variability between population groups, the promotion of good physical, mental, and emotional health should always be encouraged, as it is known that with advancing age, health problems in overall tend to increase [8, 11].

The aging of the Brazilian population, characterized by the increase of the average age of the individuals, is evidenced (comparing the data from the censuses of the year 2000 and the year 2010) by the decrease of the population growth (in the urban and rural areas) and by the increase of the proportion of people aged 60 and older. Maranhão showed the largest reduction in population growth in urban areas when comparing the two periods: in the 2000 census, the growth rate was 6.1% and in the 2010 census, 2.1%, which corresponds to a decrease of 67.5% [12, 13].

Regarding the increase in the proportion of the population over 60, comparing the census data from 2000 to 2010, there was an increase of 41.6%. Also, when comparing the data from these same periods, there was an increase of 30.6% in the individuals who declared themselves white, 57% for those who declared themselves as part of the black population, 124.6% for yellow population, 60.8% for brown-skinned population, and 6.8% for those classified as indigenous [12–14].

Over the years, Quilombola communities face obstacles and struggles for ethniccultural and historical recognition. Among the problems faced are racial prejudice, territorial losses to irregular occupations, insufficient family income, extreme poverty, and ineffective health services [1].

The literature on the quality of life and living conditions of the Quilombola population in the country is scarce, and the existing data are mostly directed to those located mainly in Bahia, whose results show that this population group lives in a vulnerable situation and has less access to goods and services [15].

The interest in this research is due to the identification of the reality faced and the sociodemographic and epidemiological problems in the studied communities and how it can possibly contribute to the planning and development of policies and actions that take into account the social, political, and environmental context of these communities.

This research is perceived as fundamental because it allows the population and the public power to develop strategies that effectively meet the many needs of the Quilombos Remnant Communities recognized by the Palmares Foundation and located in the municipality of Bequimão.

As it is a historically abated population and for generations it has suffered the absence of social investments to improve their living and health conditions, it is expected that the results of this study point to the health reality of the Quilombola elderly and that this is marked by a set of vulnerabilities and socioeconomic needs.

Thus, this study aims to describe the socioeconomic, sanitary, and demographic characteristics of living conditions of the elderly in Quilombola communities in a city of Baixada Maranhense region.
