Social vulnerability in the pandemic period: correlation between social determinants of health and COVID-19 incidence in Brazilian regions

Abstract

The social determinants of health directly influence in the health-disease process. In the pandemic caused by the novel Coronavirus, denominated Coronavirus Disease 2019 (COVID-19), these factors imply the transmission and worsening of the disease. This work is aimed to correlate the social vulnerability in Brazilian regions with the number of COVID-19 confirmed cases. The analysis was made through a qualitative approach in the search for information made available by public agencies such as the Brazilian Institute of Geography and Statistics (IBGE), State Department of Health, Municipal Department of Health and the literature indexed on the Scientific Electronic Library Online (SciELO) database using the health descriptors: “Social determinants of health”, “Health-disease process”, “Social vulnerability” and “COVID-19”. As results, the discrepancy between regionals incidence and mortality rates suggests a relationship with social inequality and COVID-19 indices in the regions of Brazil. North and Northeast had the worst rates in most of the evaluated parameters. Therefore, the vulnerable population of fundamental resources for dignified survival is more susceptible to aggravations and failures in coping with new infectious diseases.

Water, sanitation and the COVID-19 in the Amazon

“…The most significant portion of the residents (70.2%) have no connection to the sewage collection network, with their excreta drained to septic tanks (42.1%) or, in the worst situation, to ditches, rudimentary pits, water bodies and other forms of drains, as do 28.1% of these residents (IBGE, 2020c). The studies by Gois et al (2020), Rodrigues and Rodrigues (2020) and Tavares and França (2020) corroborate our results. According to Varela et al (2020), despite the greater percentage of the population with access to the general drinking water distribution network, the health risks of those who do not have this service increases, due to the lack of access to sewage collection and treatment services, already that sanitary effluents end up coming into direct or indirect contact with surface or underground waters that are used for supply.…”

“…As of April 22, the North Region emerged as the new and most significant grouping of cases and deaths, corroborating the Amazon region as an important focus for the dissemination of COVID-19. The studies by França (2020), Gois et al (2020), Ribeiro et al (2020) and Rodrigues and Rodrigues (2020) also indicate the high risks of incidence and mortality in the North Region of Brazil.…”

“…It is noteworthy that the lack of basic sanitation in cities and rural regions in the Amazon can increase the circulation of SARS-CoV-2 in the precarious surface and underground water supply systems, establishing the need for continuous monitoring of this pathogen in these environments, in order to predict and minimize future outbreaks of COVID-19. Barrozo et al (2020), França (2020), Gois et al (2020), Ribeiro et al (2020), Rodrigues and Rodrigues (2020) and Tavares and França (2020) were unanimous in concluding about the direct relationship between the greatest socioeconomic and environmental vulnerability in the Brazilian Amazon, especially in the North Region of Brazil, with the highest incidence and mortality from COVID-19 recorded in the respective study periods. Socio-spatial discrepancies within and between regions exacerbate the risks of contagion and death in the current pandemic scenario.…”

Social vulnerability indicators in pandemics focusing on COVID‐19: A systematic literature review

“…Health risk score (Kim & Bostwick, 2020) % Obesity (Cupertino et al, 2020;Karmakar et al, 2021;Snyder & Parks, 2020) % Smoking (Snyder & Parks, 2020) % Hypertension (Boserup et al, 2020;Cupertino et al, 2020;Snyder & Parks, 2020;Surendra, 2020) % Diabetes (Boserup et al, 2020;Calderón-Larrañaga et al, 2020;Cupertino et al, Testing rate (Calderón-Larrañaga et al, 2020;Credit, 2020) Reserved medical stocks (Pyne et al, 2020) regional level secure essential supply chains (Pyne et al, 2020) % Population access to health insurance (Esobi et al, 2021;Snyder & Parks, 2020;Yellow Horse et al, 2021) % Population access to life insurance (Esobi et al, 2021) persons younger than 65 years without health insurance (Karmakar et al, 2021;Yellow Horse et al, 2020) % Children with no access to the health insurance (Adwiluvito & Rakhmawan, 2020) Number of healthcare facilities or hospitals in the area understudy (Adwiluvito & Rakhmawan, 2020;Credit, 2020) % households with electricity, piped water, sufficient water supply and sewage disposal (Biggs et al, 2020;Coelho et al, 2020;Cutter et al, 2003;De Freitas et al, 2020;De Gois et al, 2020;De Souza et al, 2020;Prasad et al, 2020;Yellow Horse et al, 2020) urban households with garbage collection service…”

Analysis of the comprehension of the instrument for measuring social determinants of health

“…In the case of Chile, surveys have been carried out such as the CASEN 2015 and the National Health Survey 2009 (Undersecretariat of Public Health of Chile, 2018), at the level of Portugal the European Deprivation Index under the Townsend theorization (Ribeiro, et al 2017). On the other hand, Brazil carried out the study with data from the demographic census of the Brazilian Institute of Geography and Statistics (IBGE) (Moura de Gois, et al 2020) and Colombia used the ASIS Health Situation Analysis (Ministerio de Salud y Protección Social, 2015).…”