COVID-19's intra-urban inequalities and social vulnerability in a medium-sized city

Abstract

Background: Social conditions are related to the impact of epidemics on human populations. This study aimed to investigate the spatial distribution of cases, hospitalizations, and deaths from COVID-19 and its association with social vulnerability. Methods: An ecological study was conducted in 81 urban regions (UR) of Juiz de Fora from March to November 2020. Exposure was measured using the Health Vulnerability Index (HVI), a synthetic indicator that combines socioeconomic and environmental variables from the Demographic Census 2010. Regression models were estimated for counting data with overdispersion (negative binomial generalized linear model) using Bayesian methods, with observed frequencies as the outcome, expected frequencies as the offset variable, and HVI as the explanatory variable. Unstructured random-effects (to capture the effect of unmeasured factors) and spatially structured effects (to capture the spatial correlation between observations) were included in the models. The models were estimated for the entire period and quarter. Results: There were 30,071 suspected cases, 8,063 confirmed cases, 1,186 hospitalizations, and 376 COVID-19 deaths. In the second quarter of the epidemic, compared to the low vulnerability URs, the high vulnerability URs had a lower risk of confirmed cases (RR=0.61; CI95% 0.49-0.76) and a higher risk of hospitalizations (RR=1.65; CI95% 1.23-2.22) and deaths (RR=1.73; CI95% 1.08-2.75). Conclusions: The lower risk of confirmed cases in the most vulnerable UR probably reflected lower access to confirmatory tests, while the higher risk of hospitalizations and deaths must have been related to the greater severity of the epidemic in the city’s poorest regions.

Influence of socioeconomic factors on COVID-19 mortality in children: a scoping review

“…Figura 3 -Descrição dos artigos, segundo autor, ano, local, tipo de estudo, amostra e principais resultados. São Carlos, SP, Brasil, 2023 Dos 15 estudos analisados, no que se refere às desvantagens socioeconômicas, três evidenciaram que as relações sociais e econômicas afetaram a incidência e mortalidade de crianças pelo vírus (7,13,21) , oito demonstraram vulnerabilidade social com destaque para baixa renda e pobreza (7,(11)(12)(13)(20)(21)(22)24) , seis salientaram os fatores étnicos/raciais (15)(16)(17)(18)(19)(20) , e três, as desigualdades econômicas (7,(20)(21) , que exerceram influência na mortalidade. Além disso, também indicaram variáveis relacionadas ao tamanho da família e moradia lotada (24) , família monoparental (21) , país de origem e problemas graves de moradia (21) , condições sanitárias (11) e geográficas (20) , e regiões geopoliticamente desfavorecidas (15,23) .…”

The impact of urban spatial environment on COVID-19: a case study in Beijing

“…The key to understanding spatial justice is recognizing that the unequal distribution of spatial resources and services within cities can lead to inequality among social groups. In this case, low-end and mid-end may face a higher risk of epidemic outbreaks because they may not have access to the favorable internal environmental conditions found in high-end ( 63 , 64 ). Research has shown that the age of community construction can affect the degree of spatial openness, with older communities being much more exposed than newly built ones.…”