Highways and outposts: economic development and health threats in the central Brazilian Amazon region

Abstract

BackgroundEconomic development is often evoked as a driving force that has the capacity to improve the social and health conditions of remote areas. However, development projects produce uneven impacts on local communities, according to their different positions within society. This study examines the spatial distribution of three major health threats in the Brazilian Amazon region that may undergo changes through highway construction. Homicide mortality, AIDS incidence and malaria prevalence rates were calculated for 70 municipalities located within the areas of influence of the Cuiabá-Santarém highway (BR-163), i.e. in the western part of the state of Pará state and the northern part of Mato Grosso.ResultsThe municipalities were characterized using social and economic indicators such as gross domestic product (GDP), urban and indigenous populations, and recent migration. The municipalities' connections to the region's main transportation routes (BR-163 and Trans-Amazonian highways, along with the Amazon and Tapajós rivers) were identified by tagging the municipalities that have boundaries crossing these routes, using GIS overlay operations. Multiple regression was used to identify the major driving forces and constraints relating to the distribution of health threats. The main explanatory variables for higher malaria prevalence were: proximity to the Trans-Amazonian highway, high proportion of indigenous population and low proportion of migrants. High homicide rates were associated with high proportions of migrants, while connection to the Amazon River played a protective role. AIDS incidence was higher in municipalities with recent increases in GDP and high proportions of urban population.ConclusionsHighways induce social and environmental changes and play different roles in spreading and maintaining diseases and health threats. The most remote areas are still protected against violence but are vulnerable to malaria. Rapid economic and demographic growth increases the risk of AIDS transmission and violence. Highways connect secluded localities and may threaten local populations. This region has been undergoing rapid localized development booms, thus creating outposts of rapid and temporary migration, which may introduce health risks to remote areas.

Social geography of AIDS in Brazil: identifying patterns of regional inequalities

“…Highways can lead to different changes in the social environment and play distinct roles in the spread and maintenance of diseases and health threats, such as HIV transmission and violence, since they act as links between isolated locations 27 .…”

Social Vulnerability to Climatic Shocks Is Shaped by Urban Accessibility

“…The social risks posed by building roads in Amazonia are supported by evidence that they become focal points for violent social conflict (Dalakoglou and Harvey 2012), marginalization of vulnerable social groups, and disease outbreaks (Barcellos et al 2010;Ibisch et al 2016). Moreover, road building in Amazonia would be maladaptive because the inevitable deforestation and land use change would contribute to further climate change (Ibisch et al 2016), outweighing the potential benefits to some inhabitants of a given city (Eriksen et al 2011).…”

The AIDS epidemic in the Amazon region: a spatial case-control study in Rondonia, Brazil

“…Municipalities with higher urbanization and population density, accompanied by economic relationships with other regions, tend to attract migratory populations and seasonal workers. 2,9 Regions with greater movement of people, goods, and associated changes in the sociodemographic structure have been shown to have increased infection risk, in Brazil and worldwide. 2,9,17 The disease is associated with a reduced number of doctors (doctors per 1,000 inhabitants) in the fourth period.…”

“…2,9 Regions with greater movement of people, goods, and associated changes in the sociodemographic structure have been shown to have increased infection risk, in Brazil and worldwide. 2,9,17 The disease is associated with a reduced number of doctors (doctors per 1,000 inhabitants) in the fourth period. This indicates the importance of health services and related educational and prevention programs in preventing AIDS.…”

“…However, it attracted migrants searching for work and a better life, eventually leading to growth in a marginalized population concentrated along the region's main highway, allowing for daily interaction with people from various parts of the country. 2 Frontier regions are often areas at high risk of disease and death. This is due to the flow of workers, typically with lower skill and education levels, who comprise a large group of individuals vulnerable to infection via un-safe sex practices and prostitution.…”