Proximity matrix indicates heterogeneity in the ability to face child malnutrition and pandemics in Brazil: An ecological study

Abstract

BackgroundAmong the social inequalities that continue to still surpasses the basic rights of several citizens, political and environmental organizations decisively “drag” the “ghost” of hunger between different countries of the world, including Brazil. The COVID-19 pandemic has increased the difficulties encountered in fighting poverty, which has led Brazil to a worrying situation regarding its fragility in the fight against new pandemics.ObjectivesThe present study aims to estimate, compare, and report the prevalence of mortality due to child malnutrition among the macro-regions of Brazil and verify possible associations with the outcome of death by COVID-19. This would identify the most fragile macro-regions in the country with the greatest need for care and investments.MethodsThe prevalence of mortality was determined using data from the federal government database (DataSus). Child malnutrition was evaluated for the period from 1996 to 2017 and COVID-19 was evaluated from February to December 2020. The (dis)similarity between deaths from malnutrition and COVID-19 was evaluated by proximity matrix.ResultsThe North and Northeast regions have above average number of deaths than expected for Brazil (p < 0.05). A prospective analysis reveals that the distribution of the North and Northeast macro-regions exceeds the upper limit of the CI in Brazil for up to the year 2024 (p < 0.05). The proximity matrix demonstrated the close relationship between deaths from COVID-19 and malnutrition for the Northern region followed by the Northeast region.ConclusionsThere are discrepancies in frequencies between macro-regions. Prospective data indicate serious problems for the North and Northeast regions for the coming years. Therefore, strategies to contain the outcome of health hazards must be intensified in the macro-regions North and Northeast of the country.

Geographic heterogeneity of the epidemiological impact of the COVID-19 pandemic in Italy using a socioeconomic proxy-based classification of the national territory

“…Nevertheless, studies on geographic differences in the epidemiological impact of the pandemic have been mainly conducted in the United States, especially, and some developing countries (19,20,(25)(26)(27)(28)(29), despite the topic being extremely relevant to public health decision-making worldwide, including Italy (30). In Italy, the National Strategy of "Inner Areas" (SNAI) recently created a new classification of municipalities, with six categories on the basis of the distance to the nearest metropolitan area: metropolitan (municipal or intermunicipal), peri-urban, intermediate, peripheral, ultra-peripheral.…”