Human development, social vulnerability and COVID-19 in Brazil: a study of the social determinants of health

Abstract

Background: Coronavirus disease 2019 (COVID-19) was confirmed in Brazil in February 2020. Since then, the disease has spread throughout the country, reaching the poorest areas. This study analyzes the relationship between COVID-19 and the population's living conditions. We aimed to identify social determinants related to the incidence, mortality, and case fatality rate of COVID-19 in Brazil, in 2020. Methods: This is an ecological study evaluating the relationship between COVID-19 incidence, mortality, and case fatality rates and 49 social indicators of human development and social vulnerability. For the analysis, bivariate spatial correlation and multivariate and spatial regression models (spatial lag model and spatial error models) were used, considering a 95% confidence interval and a significance level of 5%. Results: A total of 44.8% of municipalities registered confirmed cases of COVID-19 and 14.7% had deaths. We observed that 56.2% of municipalities with confirmed cases had very low human development (COVID-19 incidence rate: 59.00/100 000; mortality rate: 36.75/1 000 000), and 52.8% had very high vulnerability (COVID-19 incidence rate: 41.68/100 000; mortality rate: 27.46/1 000 000). The regression model showed 17 indicators associated with transmission of COVID-19 in Brazil. Conclusions: Although COVID-19 first arrived in the most developed and least vulnerable municipalities in Brazil, it has already reached locations that are farther from large urban centers, whose populations are exposed to a context of intense social vulnerability. Based on these findings, it is necessary to adopt measures that take local social aspects into account in order to contain the pandemic.

Airports, highways and COVID-19: An analysis of spatial dynamics in Brazil

“…Besides the aspects related to the state's highways and airways, it is pertinent to highlight the importance of other factors that when present in the territories favor spatial dispersion, among which are the population's living conditions and the social dynamics in different countries and regions ( de Souza et al, 2020b ; Biggs et al, 2020 ; Bambra et al, 2020 ; Hawkins, 2020 ). In Brazil, about 59% in the variation in the incidence of COVID-19 is attributed to social inequalities of income, population density, and higher lethality ( Figueiredo et al, 2020 ).…”

“…13, 2020 ; de Souza et al, 2020a ). Initially, the disease reached the large urban centers of the country and from these, it started a process of interiorization, reaching the poorest municipalities of Brazil ( de Souza et al, 2020b ), where the limited healthcare network soon collapsed 6 ( Rache, Rocha, Nunes, Spinola, Malik, Massuda ). This process of interiorization of the disease becomes even more worrying in a country of continental dimensions, where intense socio-spatial inequality is observed ( Campello et al, 2018 ).…”

Effect of Socioeconomic Status on Risk of Developing COVID-19: a Community-based Case-control Study

“…[2] Studies regarding the relationship between Socioeconomic Status (SES) and occurrence of COVID-19 disease are usually ecological studies and have limitations due to ecological fallacy. [3][4][5] On the other hand, most individual-level studies are hospital-based and more focused on ethnic and racial disparities than SES. [6][7][8] Socioeconomic factors are considered major determinants in life expectancy, well-being, and health.…”

Development and implementation of a potential coronavirus disease 2019 (COVID-19) vaccine: A systematic review and meta-analysis of vaccine clinical trials

“…As of December 27, 2020, this virus had infected more than 79.2 million people and resulted in over 1.7 million fatalities across the globe [3]. The deaths toll resulted from the novel coronavirus infection affected most developed and developing countries worldwide, but it has severely impacted on developing countries, such as Brazil, where vulnerable people are more likely to be associated with coronavirus-related mortality [4]. Therefore, there is an urgent need to prevent COVID-19 infection with the implementation of a safe and effective vaccination program as well as the development of potential therapeutic interventions for treatment.…”