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Determinants of COVID-19 Mortality and Temporal Trends in the Health Regions of the State of São Paulo, Brazil

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  • Tatiana Pestana Barbosa

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Thais Zamboni Berra

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Antônio Carlos Vieira Ramos

    (Department of Nursing, State University of Minas Gerais, Passos Campus, Passos 37900-106, Brazil)

  • Yan Mathias Alves

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Reginaldo Bazon Vaz Tavares

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Fernando Spanó Junqueira de Paiva

    (Polytechnic School, University of São Paulo, São Paulo 05508-010, Brazil)

  • Jonas Bodini Alonso

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Titilade Kehinde Ayandeyi Teibo

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Juliana Soares Tenório de Araújo

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Ariela Fehr Tártaro

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

  • Ricardo Alexandre Arcêncio

    (Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, Brazil)

Abstract

Background: This study investigated the determinants of COVID-19 mortality and its temporal trends within São Paulo state’s Departamentos Regionais de Saúde (DRS) (health regions) to inform the development of targeted public health interventions. Methods: Utilizing an ecological study design, we analyzed confirmed COVID-19 cases and deaths (February 2020–December 2021) obtained from the COVID Panel, incorporating relevant social and health indicators. The Generalized Additive Model for Location, Scale, and Shape (GAMLSS) was used to identify key determinants, and temporal trends in mortality and vaccination rates were analyzed across each DRS. Results: The average mortality rate was 15.1 deaths per 100,000 inhabitants (median 7.00). Higher chronic disease mortality was associated with an increase in COVID-19 mortality. Moreover, an increase in the percentage of adults led to a decrease in deaths from COVID-19. Conclusions: COVID-19 mortality in São Paulo is shaped by a complex interplay of 12 behavioral, economic, demographic, and environmental factors. Region-specific public health policies should consider these factors, along with geographic, socioeconomic, and budgetary contexts, to effectively address health disparities across the state’s DRS.

Suggested Citation

  • Tatiana Pestana Barbosa & Thais Zamboni Berra & Antônio Carlos Vieira Ramos & Yan Mathias Alves & Reginaldo Bazon Vaz Tavares & Fernando Spanó Junqueira de Paiva & Jonas Bodini Alonso & Titilade Kehin, 2025. "Determinants of COVID-19 Mortality and Temporal Trends in the Health Regions of the State of São Paulo, Brazil," IJERPH, MDPI, vol. 22(5), pages 1-14, May.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:5:p:772-:d:1655064
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    References listed on IDEAS

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