Quality of basic health care and social vulnerability: a spatial analysis

Souza, Katyucia Oliveira Crispim de; Fracolli, Lislaine Aparecida; Ribeiro, Caíque Jordan Nunes; Menezes, Andreia Freire de; Silva, Glebson Moura; Santos, Allan Dantas dos

doi:10.1590/1980-220x-reeusp-2020-0407

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“…Considering this, we analyze high-risk areas of diarrhea- and gastroenteritis-related deaths, and their correlation with SDH in the state of Alagoas, between 2000 and 2019, using space–time risk modeling. This approach allows for monitoring the impact of diarrheal diseases in space and time [ 14 , 15 , 16 , 17 ]. As a result, this could significantly contribute to health systems in planning disease control strategies, and reduce the mortality rate from diarrhea and gastroenteritis, mainly among children.…”

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confidence: 99%

Space–Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study

et al. 2022

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Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.

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