Why Does COVID-19 Affect Some Cities More than Others?: Evidence from the First Year of the Pandemic in Brazil

Abstract

This paper investigates what explains the variation in impacts of COVID-19 across Brazilian cities. I assemble data from over 2,500 cities on COVID-19 cases and deaths, population mobility, and local policy responses. I study how these outcomes correlate with pre-pandemic local characteristics, drawing comparisons with existing US estimates when possible. As in the United States, the connections between city characteristics and outcomes in Brazil can evolve over time, with some early correlations fading as the pandemic entered a second wave. Population density is associated with greater local impact of the disease in both countries. However, in contrast to the United States, the pandemic in Brazil took a greater toll in cities with higher income levels consistent with the fact that higher incomes correlate with greater mobility in Brazil. Socioeconomic vulnerabilities, such as the presence of slums and high residential crowding, correlate with higher death rates per capita. Cities with such vulnerabilities in Brazil suffered higher COVID-19 death rates despite their residents' greater propensity to stay home. Policy responses do not appear to drive these connections.

Inclusive Cities: Healthy Cities for All

“…These estimates show that, contrary to what has been observed in the United States (Desmet and Wacziarg, 2021), cities with higher average income per capita in Brazil were relatively more affected by COVID-19, in terms of both cases and deaths, after controlling for all other covariates. Chauvin (2021b) shows that higher-income cities also experienced higher mobility, as a smaller share of the population stayed at home for most of this period. In contrast with cities in high-income countries, in Brazilian cities a large part of the population is unable to perform their work from home and lacks the savings to support prolonged periods of economic inactivity.…”

“…Figure 19 shows the cross-city distribution of the number of confirmed cases per 100 thousand people in six countries from the region as of January 2021. Part of this variation reflects differences in testing capabilities, but even after addressing these concerns, it is clear that during the first year of COVID-19, the city you lived in mattered for how exposed you were to the virus (Chauvin, 2021b). For Brazilian cities above the 75th percentile of confirmed cases per capita, the incidence was more than four times the number of confirmed cases of the cities at the bottom 25 percent.…”

“…Note: Authors calculations with data of 3,761 Brazilian cities with population greater or equal to 5,000. Data comes from Chauvin (2021b). Prevalence of diseases per patient is computed using hospitals patients' data from 2019.…”

“…Vertical lines correspond to the 95 percent confidence intervals. The impact of COVID-19 is computed for 3,762 cities using data from Chauvin (2021b). 4.…”

“…4. Chauvin (2021b) shows that the effects of city characteristics on local cases and deaths can fluctuate over time. However, for most variables the direction of the effect is consistent throughout the first year of the pandemic.…”