Abstract
To analyze the influence of socioeconomic, demographic, epidemiological factors, and the health system structure in the evolution of the COVID-19 pandemic in Brazil. Ecological study with variables extracted from databases, having the incidence and mortality by COVID-19 until August 23, 2020, in Brazilian states, as response variables. The magnitude of the associations was estimated using Spearman's correlation coefficient and multiple regression analysis. In the Brazilian states, 59.8% of variation in the incidence of COVID-19 was justified by income inequality, significant home densification, and higher mortality. In the case of mortality, those same variables explained 57.9% of the country's variations in federal units. Our results indicate that socioeconomic factors influenced the evolution and impact of COVID-19 in Brazil. Thus, we suggest comprehensive actions to ensure economic conditions and strengthening of health networks for populations with socioeconomic vulnerability.
Highlights
The coronavirus of severe acute respiratory syndrome 2 (SARS-CoV-2) is transmitted mainly through contact with secretions and respiratory system fluids, both through droplets and aerosols and by contact with contaminated surfaces[1]
The positive correlation between the time of the pandemic, the Gross Domestic Product (GDP) per capita, and variables of the system structure, associated with the negative correlation with variables related to inadequate housing conditions and a higher percentage of people without education, suggests that the pandemic started in Federative Units (FU) with better socioeconomic conditions and expanded to more vulnerable areas
These findings are in line with an ecological study conducted in the United States of America (USA) that points out a higher percentage of COVID-19 cases in areas with lower income and higher levels of poverty[23]
Summary
The coronavirus of severe acute respiratory syndrome 2 (SARS-CoV-2) is transmitted mainly through contact with secretions and respiratory system fluids, both through droplets and aerosols and by contact with contaminated surfaces[1]. Despite promising research and advances, there is no vaccine or specific pharmacological treatment available, making individual prevention measures and social distancing essential to avoid increasing the number of cases and deaths[4]. These measures are recommended by the World Health Organization (WHO), and each country use them in varying degrees of intensity, according to its reality[5]. Few studies have evaluated the association of the evolution and impact of the pandemic by COVID-19 with socioeconomic factors[7] These factors may be important in countries like Brazil, characterized by social inequality, where large population contingents live below the poverty line and in housing without basic sanitation[8].
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