دورية أكاديمية
أعرض في EDS

Higher risk of death from COVID-19 in low-income and non-White populations of São Paulo, Brazil.

التفاصيل البيبلوغرافية
العنوان: Higher risk of death from COVID-19 in low-income and non-White populations of São Paulo, Brazil.
المؤلفون: Li SL; School of Geography and the Environment, University of Oxford, Oxford, UK lisabrinaly@gmail.com rafael.pereira@ipea.gov.br., Pereira RHM; Institute of Applied Economic Research, Brasília, Brazil lisabrinaly@gmail.com rafael.pereira@ipea.gov.br., Prete CA Jr; Department of Electronic Systems Engineering, University of São Paulo, São Paulo, Brazil., Zarebski AE; Department of Zoology, University of Oxford, Oxford, UK., Emanuel L; Institute of Applied Economic Research, Brasília, Brazil., Alves PJH; Institute of Applied Economic Research, Brasília, Brazil., Peixoto PS; Department of Applied Mathematics, Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil., Braga CKV; Institute of Applied Economic Research, Brasília, Brazil., de Souza Santos AA; Oxford School of Global and Area Studies, Latin American Centre, University of Oxford, Oxford, UK., de Souza WM; Department of Zoology, University of Oxford, Oxford, UK.; Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil., Barbosa RJ; Institute of Social and Political Studies (IESP), State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil., Buss LF; Departamento de Molestias Infecciosas e Parasitarias andInstituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Mendrone A; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil., de Almeida-Neto C; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.; Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Ferreira SC; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.; Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco - Immuno - Hematology (LIM-31) HCFMUSP, University of São Paulo Medical School, São Paulo, Brazil., Salles NA; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.; Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco - Immuno - Hematology (LIM-31) HCFMUSP, University of São Paulo Medical School, São Paulo, Brazil., Marcilio I; Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, University of São Paulo, São Paulo, Brazil., Wu CH; Mathematical Sciences, University of Southampton, Southampton, UK., Gouveia N; Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, Brazil., Nascimento VH; Department of Electronic Systems Engineering, University of São Paulo, São Paulo, Brazil., Sabino EC; Departamento de Molestias Infecciosas e Parasitarias andInstituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., Faria NR; Department of Zoology, University of Oxford, Oxford, UK.; Departamento de Molestias Infecciosas e Parasitarias andInstituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.; MRC Centre for Global Infectious Disease Analysis; and the Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, UK., Messina JP; School of Geography and the Environment, University of Oxford, Oxford, UK.; Oxford School of Global and Area Studies, University of Oxford, Oxford, UK.
المصدر: BMJ global health [BMJ Glob Health] 2021 Apr; Vol. 6 (4).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101685275 Publication Model: Print Cited Medium: Print ISSN: 2059-7908 (Print) Linking ISSN: 20597908 NLM ISO Abbreviation: BMJ Glob Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, [2016]-
مواضيع طبية MeSH: Pneumonia, Viral*/epidemiology , Poverty Areas*, COVID-19/*ethnology , COVID-19/*mortality , Ethnicity/*statistics & numerical data , Hospital Mortality/*ethnology , Residence Characteristics/*statistics & numerical data, Adult ; Aged ; Aged, 80 and over ; Brazil/epidemiology ; Cross-Sectional Studies ; Female ; Health Status Disparities ; Humans ; Male ; Middle Aged ; Pandemics ; SARS-CoV-2 ; Seroepidemiologic Studies ; Socioeconomic Factors
مستخلص: Introduction: Little evidence exists on the differential health effects of COVID-19 on disadvantaged population groups. Here we characterise the differential risk of hospitalisation and death in São Paulo state, Brazil, and show how vulnerability to COVID-19 is shaped by socioeconomic inequalities.
Methods: We conducted a cross-sectional study using hospitalised severe acute respiratory infections notified from March to August 2020 in the Sistema de Monitoramento Inteligente de São Paulo database. We examined the risk of hospitalisation and death by race and socioeconomic status using multiple data sets for individual-level and spatiotemporal analyses. We explained these inequalities according to differences in daily mobility from mobile phone data, teleworking behaviour and comorbidities.
Results: Throughout the study period, patients living in the 40% poorest areas were more likely to die when compared with patients living in the 5% wealthiest areas (OR: 1.60, 95% CI 1.48 to 1.74) and were more likely to be hospitalised between April and July 2020 (OR: 1.08, 95% CI 1.04 to 1.12). Black and Pardo individuals were more likely to be hospitalised when compared with White individuals (OR: 1.41, 95% CI 1.37 to 1.46; OR: 1.26, 95% CI 1.23 to 1.28, respectively), and were more likely to die (OR: 1.13, 95% CI 1.07 to 1.19; 1.07, 95% CI 1.04 to 1.10, respectively) between April and July 2020. Once hospitalised, patients treated in public hospitals were more likely to die than patients in private hospitals (OR: 1.40%, 95% CI 1.34% to 1.46%). Black individuals and those with low education attainment were more likely to have one or more comorbidities, respectively (OR: 1.29, 95% CI 1.19 to 1.39; 1.36, 95% CI 1.27 to 1.45).
Conclusions: Low-income and Black and Pardo communities are more likely to die with COVID-19. This is associated with differential access to quality healthcare, ability to self-isolate and the higher prevalence of comorbidities.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust; MC_PC_19012 United Kingdom MRC_ Medical Research Council; MR/R015600/1 United Kingdom MRC_ Medical Research Council; MR/S019510/1 United Kingdom MRC_ Medical Research Council
فهرسة مساهمة: Keywords: cross-sectional survey; epidemiology; geographic information systems; mathematical modelling; public health
تواريخ الأحداث: Date Created: 20210430 Date Completed: 20210507 Latest Revision: 20230829
رمز التحديث: 20230830
مُعرف محوري في PubMed: PMC8094342
DOI: 10.1136/bmjgh-2021-004959
PMID: 33926892
قاعدة البيانات: MEDLINE
الوصف
تدمد:2059-7908
DOI:10.1136/bmjgh-2021-004959