Demenech Lauro Miranda, Dumith Samuel de Carvalho, Vieira Maria Eduarda Centena Duarte, Neiva-Silva Lucas
Centro de Estudos sobre Risco e Saúde, Universidade Federal do Rio Grande - Rio Grande (RS), Brasil.
Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande - Rio Grande (RS), Brasil.
Rev Bras Epidemiol. 2020 Oct 5;23:e200095. doi: 10.1590/1980-549720200095. eCollection 2020.
To assess, through space-time analyses, whether the income inequality of the Federative Units (FUs) in Brazil can be associated with the risk of infection and death by COVID-19.
This was an ecological study, based on secondary data on incidence and mortality rates for COVID-19. Data were analyzed at the state level, having the Gini coefficient as the main independent variable. Records of twelve days were used, spaced one week each, between April 21th and June 7th, 2020. The weekly variation in the rates was calculated through Prais-Winsten regression, aiming at measuring the evolution of the pandemic in each FU. Spearman's correlation test was used to assess correlation between the rates and their weekly evolution and the independent variables. Lastly, a spatial dependence diagnosis was conducted, and a Spatial Regression lag model was used when applicable.
Incidence and mortality rates of COVID-19 increased in all Brazilian FUs, being more pronounced among those with greater economic inequality. Association between Gini coefficient and COVID-19 incidence and mortality rates remained even when demographic and spatial aspects were taken into account.
Income inequality can play an important role in the impact of COVID-19 on the Brazilian territory, through absolute and contextual effects. Structural policies to reduce inequality are essential to face this and future health crises in Brazil.
通过时空分析，评估巴西联邦单位（FU）的收入不平等是否与新冠病毒感染和死亡风险相关。
这是一项基于新冠病毒发病率和死亡率二手数据的生态学研究。数据在州层面进行分析，以基尼系数作为主要自变量。使用了2020年4月21日至6月7日期间每隔一周的12天记录。通过普雷斯-温斯坦回归计算发病率的每周变化，旨在衡量每个联邦单位内疫情的演变。使用斯皮尔曼相关性检验来评估发病率及其每周演变与自变量之间的相关性。最后，进行了空间依赖性诊断，并在适用时使用了空间回归滞后模型。
巴西所有联邦单位的新冠病毒发病率和死亡率均有所上升，在经济不平等程度较高的单位中更为明显。即使考虑到人口和空间因素，基尼系数与新冠病毒发病率和死亡率之间的关联仍然存在。
收入不平等通过绝对效应和背景效应，可能在新冠病毒对巴西的影响中发挥重要作用。减少不平等的结构性政策对于应对巴西当前及未来的健康危机至关重要。
