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Were the socio-economic determinants of municipalities relevant to the increment of COVID-19 related deaths in Brazil in 2020?

Author

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  • Julio Castro-Alves
  • Lídia Santos Silva
  • João Paulo Lima
  • Marcelo Ribeiro-Alves

Abstract

Background: The COVID-19 pandemic in Brazil has been showing a pattern of distribution of related deaths associated with individual socioeconomic status (SES). However, little is known about the role of SES in the distribution of the mortality rate in different population, from an ecological perspective. Objective: The objective of this study was to evaluate the role of socioeconomic factors in the distribution of the COVID-19-related mortality rate among Brazilian municipalities in 2020. Methods: We conducted a retrospective, cross-sectional, observational, population-wide, and ecological study, using data of COVID-19-related deaths from the Influenza Epidemiological Surveillance Information System database (SIVEP-Gripe) and SES from the Social Vulnerability Index (SVI), the Human Development Index (HDI), the Geographic Index of the Socioeconomic Context and Social Studies (GeoSES), and 2010 Demographic Census (IBGE/Brazil). We computed crude, age- and sex-standardized, and the latter offset by the time of exposure to the epidemic mortality rates. To determine socioeconomic factors associated with mortality rates we used log-linear models with state codes as a random effect and Haversine variance-covariance matrix. Results: 191,528 deaths were related to COVID-19 and distributed in 4,928 (88.55%) Brazilian municipalities. Whatever the socioeconomic indexes used, the R2 were very small to explain SMRT. Consistent across all socioeconomic indexes used, high-income, more educated, and well infrastructure municipalities generally had higher mortality rates. Conclusion: Excluding the effect of demographic structure and pandemic timing from mortality rates, the contribution of SES to explain differences in COVID-19-related mortality rates among municipalities in Brazil became very low. The impact of SES on COVID-19-related mortality may vary across levels of aggregation. Urban infrastructure, which includes mobility structures, more complex economic activities and connections, may have influenced the average municipal death rate.

Suggested Citation

  • Julio Castro-Alves & Lídia Santos Silva & João Paulo Lima & Marcelo Ribeiro-Alves, 2022. "Were the socio-economic determinants of municipalities relevant to the increment of COVID-19 related deaths in Brazil in 2020?," PLOS ONE, Public Library of Science, vol. 17(4), pages 1-18, April.
    • Handle: RePEc:plo:pone00:0266109
    DOI: 10.1371/journal.pone.0266109
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    References listed on IDEAS

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    1. Clouston, Sean A.P. & Natale, Ginny & Link, Bruce G., 2021. "Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities," Social Science & Medicine, Elsevier, vol. 268(C).
    2. François Roubaud & Mireille Razafindrakoto & João Saboia & Marta Castilho & Valeria Pero, 2020. "Municípios in the time of Covid-19 in Brazil: socioeconomic vulnerabilities, transmission mechanisms and public policies," Working Papers DT/2020/12, DIAL (Développement, Institutions et Mondialisation).
    3. Caitlin S. Brown & Martin Ravallion, 2020. "Inequality and the Coronavirus: Socioeconomic Covariates of Behavioral Responses and Viral Outcomes Across US Counties," NBER Working Papers 27549, National Bureau of Economic Research, Inc.
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