The present study introduces reflections on the Social Determinants of Health and their impacts on the treatment of children from the riverside of Marajó hospitalized at the Santa Casa de Misericórdia do Pará Foundation. This research, approved by the Ethics Committee/Plataforma Brasil, under opinion 5,381,235, is of a exploratory type, in which we carried out bibliographical, documental and field research. Based on this study and on what is recommended by federal law 8.080/90 and by the National Policy for Integral Attention to Children’s Health - PNAISC, we observe that it is not exactly the existence of social determinants that hinders the access to health services for these children, but the failure to understand and include them, when thinking about and implementing differentiated public policies, that could embrace the specificities present in the Marajó region.